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Correlates of bone mineral density in nursing home residents
S Itkin Zimmerman1, W Hawkes, J Chandler
1University of Maryland, School of Medicine, Department of Epidemiology and Preventive Medicine, 660 W. Redwood Street, Suite 200, Baltimore, Maryland, 21201, USA. sizimmer@email.unc.edu
Purpose:
To explore correlates of bone mineral density (BMD) in nursing home residents, examining factors associated with BMD in community cohorts and factors prevalent among nursing home residents.
Methods:
A cross sectional study of 2156 elderly residents from a representative state-wide sample of 47 nursing homes in Maryland. Data consisted of BMD scans of the distal radius and ulna; information on comorbidities, activities, behavior and medications abstracted from medical charts and interviews; and observation of cognitive and neuromuscular performance.
Results:
Forty-two percent of the variance in BMD was explained by age, gender, race and weight. Fracture, use of steroids and seizure medications, and alcohol use were also related to low BMD. Other factors prevalent in nursing home populations, such as cognitive impairment and depressive symptomatology, were not strongly associated with low BMD.
Conclusions:
Despite the diversity of the nursing home population, their older age and greater dependency and comorbidity, the factors most closely related to low BMD in nursing home residents were comparable to those in community-dwellers. Demographic information, along with other clinical factors such as fracture and use of steroid and seizure medications, may aid health care providers in identifying high risk individuals in nursing homes.