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Comprehensive geriatric assessment for identifying older people at risk of hip fracture: cross-sectional study with
Raquel Ramírez-Martín1,2, María Victoria Castell Alcalá2,3,4, Teresa Alarcón1,2
1Department of Geriatrics, La Paz University Hospital, Madrid, Spain.
Insights
Older adults with low body mass index (BMI), disability, muscle weakness, and vitamin D deficiency are at higher risk for hip fractures (HF). Identifying these factors via comprehensive geriatric assessment (CGA) aids in implementing preventative strategies.
Area of Science:
- Gerontology
- Orthopedics
- Public Health
Background:
- Hip fracture (HF) is a prevalent and serious fragility fracture, posing a significant challenge to healthcare systems.
- Identifying individuals at high risk for HF is crucial for effective prevention and management.
Purpose of the Study:
- To identify characteristics from comprehensive geriatric assessment (CGA) that predict increased risk of hip fracture in older adults.
Main Methods:
- A comparative study involving 509 hip fracture patients and 1315 community-dwelling older adults without hip fractures.
- Demographic, functional, cognitive, and nutritional data were collected and analyzed using bivariate and logistic regression models.
Main Results:
- Hip fracture patients were older, more frequently female, and exhibited higher rates of disability, cognitive impairment, lower handgrip strength, lower body mass index (BMI), and vitamin D deficiency.
- Key predictors for hip fracture included BMI < 22 kg/m2 (OR=5.11), disability (OR=4.32), muscle weakness (OR=3.01), and vitamin D deficiency (OR=2.13).
Conclusions:
- Easily obtainable CGA factors, including low weight, disability, malnutrition, muscle weakness, and vitamin D deficiency, are strongly associated with fragility hip fractures.
- Early detection of these risk factors in older adults can facilitate the implementation of targeted prevention strategies to reduce hip fracture incidence.
Background:
Hip fracture (HF) is by far the most common serious fragility fracture. Its care is a major challenge to all healthcare systems.
Aim:
To determine whether there are characteristics of older people identified via comprehensive geriatric assessment (CGA) that help identify those with an increased risk of HF.
Methods:
The demographic, functional, cognitive and nutritional data of a cohort of patients admitted for acute HF were compared with those of a population cohort representing community-dwelling older people in the same urban district without HF. Bivariate analysis was performed on the variables in both the complete samples and in a subsample of age and sex paired subjects, followed by logistic regression analysis.
Results:
A total of 509 HF patients and 1315 community-dwelling older people were included. The HF patients were older and more frequently women and had more frequent disability and cognitive impairment, lower handgrip strength, lower body mass index (BMI) and a higher frequency of vitamin D deficiency compared with the community controls (P < 0.001). The variables most strongly associated with the presence of HF in the multivariate analysis, aside from age and female sex, were BMI<22 kg/m2 [odds ratio (OR) = 5.11], disability (OR = 4.32), muscle weakness (OR = 3.01), and vitamin D deficiency (OR = 2.13).
Conclusions:
There are easily obtained CGA determinants that are strongly associated with fragility HF. The detection of low weight, disability, malnutrition, muscle weakness, and vitamin D deficiency can help identify at-risk older people to implement prevention strategies.
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