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Posturale Defizite und Sturzrisiko bei älteren Personen mit Verdacht auf Osteoporose

Postural deficits and risk of falling in elderly persons with incipient osteoporosis

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Zusammenfassung

Hintergrund

Stürze sind eines der Hauptprobleme in der Geriatrie. Bei postmenopausalen Frauen mit Osteoporose sind 80–90% der Schenkelhalsfrakturen sturzbedingt.

Fragestellung

Ziel dieser Untersuchung war die Prüfung eines neuen posturographischen Messsystems (Interaktives Balancesystem, IBS) hinsichtlich seiner Leistungsfähigkeit zur Sturzprädiktion bei Osteoporosepatienten.

Material und Methoden

In die Untersuchung wurden 228 Personen mit Osteoporoseverdacht eingeschlossen. In der Eingangsanalyse wurde neben der Knochenmineralisation die posturale Regulation getestet. In einem Follow-up-Zeitraum von 12 Monaten wurden alle Stürze anhand eines Sturztagebuchs erfasst. Als sturzgefährdet wurde klassifiziert, wer mehr als 2 Stürze/Jahr erlitt.

Ergebnisse

Bei Patienten mit bestätigter Osteoporose (n=139) erwies sich der posturographische Frequenzbereich F2–4 als geeignet zur Prädiktion von Stürzen. Die ROC-Analyse für einen abgeleiteten Sturzindex FIORF2–4 ergab einen AUC-Wert von 0,88.

Schlussfolgerung

Das IBS ist ein leistungsfähiges Assessment zur Prädiktion von Stürzen bei Osteoporosepatienten. Insbesondere den peripher-vestibulären Steuerungsmechanismen scheint eine große Bedeutung für die Sturzgenese zuzukommen.

Abstract

Background

Falls and fall-dependent complications represent major problems in geriatrics. Approximately 80–90% of femoral neck fractures in postmenopausal women are caused by falls.

Study question

The goal of this study was to evaluate a new posturographic measurement system (Interactive Balance System, IBS) regarding its potential to predict falls in osteoporotic patients.

Materials and methods

A total of 228 patients admitted for osteodensitometry because of suspected osteoporosis were included in the study. During the baseline investigation, bone density and postural regulation were measured. Over a follow-up period of 12 months, all falls were recorded in a fall diary. Participants with more than two falls per year were classified as persons at high risk of falling.

Results

In patients with confirmed osteoporosis (n=139), the posturographic frequency range F2–4 was found to be predictive for falls. The ROC analysis of the dependent fall index FIORF2–4 showed an AUC value of 0.88.

Conclusion

IBS is an effective assessment for fall prediction in osteoporosis. Especially peripheral-vestibular regulation mechanisms seem to be of great importance in the evaluated patient group.

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Literatur

  1. Cummings SR, Melton JL (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761–1767

    Article  PubMed  Google Scholar 

  2. Dellinger AM, Boyd R, Haileyesus T (2008) Fall injuries in older adults from an unusual source: entering and exiting a vehicle. J Am Geriatr Soc 56:609–614

    Article  PubMed  Google Scholar 

  3. Fleming J, Matthews FE, Brayne C (2008) Falls in advanced old age: recalled falls and prospective follow-up of over-90-year-olds in the Cambridge City over 75 s cohort study. BMC Geriatrics, Doi:10.1186/1471-2318-8-6

  4. Gandevia SC, Burke D (1992) Does the nervous system depend on kinesthetic information to control natural limb movements? Behav Brain Sci 15:614–632

    Google Scholar 

  5. Ganz DA, Bao Y, Shekelle PG, Rubenstein LZ (2007) Will my patient fall? JAMA 297:77–86

    Article  PubMed  Google Scholar 

  6. Gates S, Fisher JD, Cooke MW et al (2008) Multifactorial assessment and targeted intervention for preventing falls and injuries among older people in community and emergency care settings: systematic review and meta-analysis. BMJ 332:130–133

    Article  Google Scholar 

  7. Gillespie LD, Gillespie WJ, Robertson MC et al (2003) Interventions for preventing falls in elderly people. Cochrane Database Syst Rev 4:CD000340

    PubMed  Google Scholar 

  8. Graafmans WC, Ooms ME, Hofstee HMA et al (1996) Falls in the elderly: a prospective study of risk factors and risk profiles. Am J Epidemiol 142:1129–1136

    Google Scholar 

  9. Guralnik JM, Ferrucci L, Simonsick EM et al (1995) Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 322:556–561

    Article  Google Scholar 

  10. Hauer K, Lamb SE, Jorstad EC et al (2006) Systematic review of definitions and methods of measuring falls in randomised controlled fall prevention trials. Age Ageing 35:5–10

    Article  PubMed  Google Scholar 

  11. Kannus P, Sievanen H, Palvanen M et al (2005) Prevention of falls and consequent injuries in elderly people. Lancet 366:1885–1893

    Article  PubMed  Google Scholar 

  12. Kennedy TE, Coppard LC (1987) The prevention of falls in later life. A report of the kellogg international work group on the prevention of falls by the elederly. Dan Med Bull 34 (Suppl 4):1–24

    Google Scholar 

  13. Kohen-Raz R (1991) Application of tetra-ataxiametric posturography in clinical and developmental diagnosis. Percept Mot Skills 73:635–656

    Article  CAS  PubMed  Google Scholar 

  14. Lamb SE, Jorstad-Stein EC, Hauer K, Becker C (2005) Development of a common outcome data set for fall injury prevention trials: the prevention of falls network europe consenus. JAGS 53:1618–1622

    Article  Google Scholar 

  15. Lord SR, Menz HB, Tiedema A (2003) A physiological profile approach to falls risk assessment and prevention. Phys Ther 83:237–252

    PubMed  Google Scholar 

  16. Patel A, Tweed K, Chinappen U (2005) Fall-related risk factors and osteoporosis in older women referred to an open access bone densitometry service. Age Ageing 34:67–71

    Article  PubMed  Google Scholar 

  17. Raîche M, Hébert R, Prince F, Corriveau H (2000) Screening older adults at risk of falling with the Tinetti balance scale. Lancet 356:1001–1002

    Article  PubMed  Google Scholar 

  18. Schwartz AV, Hillier TA, Sellmeyer DE et al (2002) Older women with diabetes have a higher risk of falls. Diabetes care 25:1749–1754

    Article  PubMed  Google Scholar 

  19. Schwartz S, Segal B, Barkana Y et al (2005) The effect of cataract surgery on postural control. Invest Ophthalmol Vis Sci 46:920–924

    Article  PubMed  Google Scholar 

  20. Schwesig R (2006) Das posturale System in der Lebensspanne. Kovac, Hamburg

  21. Schwesig R, Kluttig A, Kriebel K et al (2009) Prospektiver Vergleich von Assessments zur Beurteilung der Sturzgefahr bei Pflegeheimbewohnern. Z Gerontol Geriat (im Druck)

  22. Stevens JA, Olson S (2000) Reducing falls and resulting hip fractures among older women. MMWR Recomm Rep 49:3–12

    CAS  PubMed  Google Scholar 

  23. Stewart A, Calder LD, Torgerson DJ et al (2000) Prevalence of hip fracture risk factors in women aged 70 years and over. QJM 93:677–680

    Article  CAS  PubMed  Google Scholar 

  24. Tinetti ME (1986) Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 43:119–126

    Google Scholar 

  25. Tinetti ME (2003) Preventing falls in elderly persons. N Engl J Med 348:42–49

    Article  PubMed  Google Scholar 

  26. Vasallo M, Poynther L, Sharma JC et al (2008) Fall risk-assessment tools compared with clinical judgement: an evaluation in a rehabilitation ward. Age Ageing 37:277–281

    Article  Google Scholar 

  27. Voermans NC, Snijeder AH, Schoon Y, Bloem BR (2007) Why old people fall (and how to stop them). Pract Neurol 7:158–171

    Article  CAS  PubMed  Google Scholar 

  28. Wagner H, Melhus H, Gedeborg R et al (2009) Simply ask them about their balance – future fracture risk in a nationwide cohort study of twins. Am J Epidemiol 169:143–149

    Article  PubMed  Google Scholar 

  29. Wolfson L, Judge J, Whipple R, King M (1995) Strength is a major factor in balance, gait, and the occurance of falls. J Gerontol 50A:64–67

    Google Scholar 

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Authors and Affiliations

  1. Department Sportwissenschaft, Martin-Luther-Universität Halle-Wittenberg, 06099, Halle / Saale, Deutschland

    R. Schwesig & S. Leuchte

  2. III. Orthopädische Abteilung, Orthopädisches Spital Speising, Wien, Österreich

    S. Becker

  3. Netzwerk Alternsforschung, Heidelberg, Deutschland

    A. Lauenroth

  4. Niedergelassener Arzt für Physikalische Medizin und Rehabilitation, Leipzig, Deutschland

    K. Müller

  5. Zentrum für Innere Medizin, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland

    H.-D. Esperer

  6. Institut für Medizinische Epidemiologie, Biostatistik und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale, Deutschland

    A. Kluttig

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  1. R. Schwesig
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  2. S. Becker
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  3. A. Lauenroth
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  4. K. Müller
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  7. A. Kluttig
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Correspondence to R. Schwesig.

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Schwesig, R., Becker, S., Lauenroth, A. et al. Posturale Defizite und Sturzrisiko bei älteren Personen mit Verdacht auf Osteoporose. Z Gerontol Geriat 43, 158–164 (2010). https://doi.org/10.1007/s00391-009-0065-1

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  • DOI: https://doi.org/10.1007/s00391-009-0065-1

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