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In community-dwelling women frailty is associated with imminent risk of osteoporotic fractures

SUMMARY: Frailty reflects an accelerated health decline. Frailty is a consequence of fracture and contributes to fracture. Greater frailty was associated with higher fracture risk. Frail women were at immediate risk (within 24 months) of a hip or major fracture. Fracture prevention could be improved...

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Autores principales: Bartosch, P., Malmgren, L., Kristensson, J., McGuigan, F.E., Akesson, K.E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer London 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8387253/
https://www.ncbi.nlm.nih.gov/pubmed/33661308
http://dx.doi.org/10.1007/s00198-021-05886-7
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author Bartosch, P.
Malmgren, L.
Kristensson, J.
McGuigan, F.E.
Akesson, K.E.
author_facet Bartosch, P.
Malmgren, L.
Kristensson, J.
McGuigan, F.E.
Akesson, K.E.
author_sort Bartosch, P.
collection PubMed
description SUMMARY: Frailty reflects an accelerated health decline. Frailty is a consequence of fracture and contributes to fracture. Greater frailty was associated with higher fracture risk. Frail women were at immediate risk (within 24 months) of a hip or major fracture. Fracture prevention could be improved by considering frailty status. INTRODUCTION: Frailty encompasses the functional decline in multiple systems, particularly the musculoskeletal system. Frailty can be a consequence of and contribute to fracture, leading to a cycle of further fractures and greater frailty. This study investigates this association, specifically time frames for risk, associated fracture types, and how grade of frailty affects risk. METHODS: The study is performed in the OPRA cohort of 1044, 75-year-old women. A frailty index was created at baseline and 5 and 10 years. Women were categorized as frail or nonfrail and in quartiles (Q1 least frail; Q4 most frail). Fracture risk was assessed over short (1 and 2 years) and long terms (5 and 10 years). Fracture risk was defined for any fracture, major osteoporotic fractures (MOFs), and hip and vertebral fracture, using models including bone mineral density (BMD) and death as a competing risk. RESULTS: For women aged 75, frailty was associated with higher risk of fracture within 2 years (Hip SHR(adj.) 3.16 (1.34–7.47)) and MOF (2 years SHR(adj.) 1.88 (1.12–3.16)). The increased risk continued for up to 5 years (Hip SHR(adj.) 2.02 (1.07–3.82)); (MOF SHR(adj.) 1.43 (0.99–2.05)). Grade of frailty was associated with increased 10-year probability of fracture (p = 0.03). Frailty predicted fracture independently of BMD. For women aged 80, frailty was similarly associated with fracture. CONCLUSION: Frail elderly women are at immediate risk of fracture, regardless of bone density and continue to be at risk over subsequent years compared to identically aged nonfrail women. Incorporating regular frailty assessment into fracture management could improve identification of women at high fracture risk. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00198-021-05886-7.
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spelling pubmed-83872532021-09-09 In community-dwelling women frailty is associated with imminent risk of osteoporotic fractures Bartosch, P. Malmgren, L. Kristensson, J. McGuigan, F.E. Akesson, K.E. Osteoporos Int Original Article SUMMARY: Frailty reflects an accelerated health decline. Frailty is a consequence of fracture and contributes to fracture. Greater frailty was associated with higher fracture risk. Frail women were at immediate risk (within 24 months) of a hip or major fracture. Fracture prevention could be improved by considering frailty status. INTRODUCTION: Frailty encompasses the functional decline in multiple systems, particularly the musculoskeletal system. Frailty can be a consequence of and contribute to fracture, leading to a cycle of further fractures and greater frailty. This study investigates this association, specifically time frames for risk, associated fracture types, and how grade of frailty affects risk. METHODS: The study is performed in the OPRA cohort of 1044, 75-year-old women. A frailty index was created at baseline and 5 and 10 years. Women were categorized as frail or nonfrail and in quartiles (Q1 least frail; Q4 most frail). Fracture risk was assessed over short (1 and 2 years) and long terms (5 and 10 years). Fracture risk was defined for any fracture, major osteoporotic fractures (MOFs), and hip and vertebral fracture, using models including bone mineral density (BMD) and death as a competing risk. RESULTS: For women aged 75, frailty was associated with higher risk of fracture within 2 years (Hip SHR(adj.) 3.16 (1.34–7.47)) and MOF (2 years SHR(adj.) 1.88 (1.12–3.16)). The increased risk continued for up to 5 years (Hip SHR(adj.) 2.02 (1.07–3.82)); (MOF SHR(adj.) 1.43 (0.99–2.05)). Grade of frailty was associated with increased 10-year probability of fracture (p = 0.03). Frailty predicted fracture independently of BMD. For women aged 80, frailty was similarly associated with fracture. CONCLUSION: Frail elderly women are at immediate risk of fracture, regardless of bone density and continue to be at risk over subsequent years compared to identically aged nonfrail women. Incorporating regular frailty assessment into fracture management could improve identification of women at high fracture risk. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00198-021-05886-7. Springer London 2021-03-04 2021 /pmc/articles/PMC8387253/ /pubmed/33661308 http://dx.doi.org/10.1007/s00198-021-05886-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Article
Bartosch, P.
Malmgren, L.
Kristensson, J.
McGuigan, F.E.
Akesson, K.E.
In community-dwelling women frailty is associated with imminent risk of osteoporotic fractures
title In community-dwelling women frailty is associated with imminent risk of osteoporotic fractures
title_full In community-dwelling women frailty is associated with imminent risk of osteoporotic fractures
title_fullStr In community-dwelling women frailty is associated with imminent risk of osteoporotic fractures
title_full_unstemmed In community-dwelling women frailty is associated with imminent risk of osteoporotic fractures
title_short In community-dwelling women frailty is associated with imminent risk of osteoporotic fractures
title_sort in community-dwelling women frailty is associated with imminent risk of osteoporotic fractures
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8387253/
https://www.ncbi.nlm.nih.gov/pubmed/33661308
http://dx.doi.org/10.1007/s00198-021-05886-7
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