Poor nutritional status is associated with a higher risk of falling and fracture in elderly people living at home in France: the Three-City cohort study

Abstract

Summary

Falling and fractures are a public health problem in elderly people. The aim of our study was to investigate whether nutritional status is associated with the risk of falling or fracture in community-dwelling elderly. Poor nutritional status was significantly associated with a higher risk of both falling and fractures.

Introduction

Nutrition could play a role to prevent falls and fractures. The purpose of this study is to investigate whether a poor nutritional status is associated with the risk of falling and of fracture in community dwelling elderly.

Methods

Baseline nutritional status of participants was assessed using the Mini Nutritional Assessment (MNA). After a follow-up of 12 years, 6040 individuals with available data for falls and 6839 for fracture were included. People who presented the outcomes at baseline were excluded. Cox models were used to evaluate the associations between nutritional status and the risks of fall or fracture.

Results

The frequency of poor nutritional status (MNA ≤ 23.5), at baseline, was respectively 12.0 % in the “fall study sample” and 12.8 % in the “fracture study sample.” Incident fall and fracture over 12 years were reported in 55.8 and 18.5 % of the respective samples, respectively. In multivariate models controlled for sociodemographic data and several baseline health indicators, poor nutritional status was significantly associated with a higher risk of falling (hazard ratio (HR) = 1.66, 95 % confidence interval (95 % CI) 1.35–2.04 in men and HR = 1.20, 95 % CI 1.07–1.34 in women) and with a higher risk of fracture (HR = 1.28, 95 % CI 1.09–1.49).

Conclusion

Poor nutritional status was associated with a higher risk of both falling and fractures in French elderly community-dwellers. Early screening and management of the nutritional status may be useful to reduce the frequency of these events in older people.

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Study funding

The Three-City Study is conducted under a partnership agreement between the Institut National de la Santé et de la Recherche Médicale (INSERM), the Victor Segalen–Bordeaux II University, and Sanofi-Aventis. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study. The 3C Study is also supported by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, MGEN, Institut de la Longévité, Conseils Régionaux of Aquitaine and Bourgogne, Fondation de France, and Ministry of Research–INSERM Programme « Cohortes et collections de données biologiques. » This work was supported by the « Fondation Plan Alzheimer » and by grants from the « ANR—Agence Nationale de la Recherche, » The French National Research Agency « Programme National de Recherche en Alimentation et nutrition humaine, » project « COGINUT ANR-06-PNRA-005, » and the « Programme Longévité et vieillissement, » COGICARE 07-LVIE 003 01. The funding organizations played no role in the design and conduct of the study; in the collection, management, analysis, and interpretation of the data; or in preparation, review, or approval of the manuscript.

Conflicts of interest

Marion J Torres was supported by Nutricia France and participated at different meetings with Danone Research. Beatrice Dorigny and Yvette Luiking are employed by Nutricia. Pascale Barberger-Gateau reports grants and non-financial support from Danone Research and Vifor Pharma, personal fees and non-financial support from Nutricia, grants and non-financial support from Groupe Lipides et Nutrition, and non-financial support from ILSI Europe. C. Féart received fees for conferences from Danone Research and Nutricia. L. Letenneur received fees for conferences from Danone Research. Cécilia Samieri and Claudine Berr declare that they have no conflict of interest.

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Torres, M.J., Féart, C., Samieri, C. et al. Poor nutritional status is associated with a higher risk of falling and fracture in elderly people living at home in France: the Three-City cohort study. Osteoporos Int 26, 2157–2164 (2015). https://doi.org/10.1007/s00198-015-3121-2

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Keywords

  • Aged
  • Community-dwellers
  • Epidemiology
  • Fall
  • Fracture
  • Nutritional status