Importance of bone mineral density and comorbidity index for functionality

Abstract

Background: Assessing elderly ambulatory patients at risk of osteoporotic fractures is crucial for achieving appropriate functioning, including daily activities, rehabilitation, lifestyle improvements, and dietary optimization. Aim: This study focuses on evaluating bone health and comorbidities in patients to predict osteoporotic fracture functionality, using multiple logistic regression and comparing cohorts for optimal operating points. Methods: A retrospective study was conducted at Prince Rashid bin Al-Hasan Military Hospital, Jordan, to examine the correlations and quality of patients' functionality statuses based on Age-adjusted Charlson Co-Morbidity Index (AACCI) and femoral hip bone mineral density (fH_BMD). The study categorized patients into two cohorts, with functional grades ranging from III-IV to I-II. The results were analyzed using statistical tests and confidence intervals. Results: A Multiple Logistic Regression model was developed to simulate the relationship between patients' Age-adjusted Charlson Co-Morbidity Index (AACCI) and femoral hip bone mineral density (fH_BMD) and their functionality statuses. The model was statistically significant, explaining variation in the dependent variable from 30%-40.2% depending on the reference method. It correctly classified 78.2% of cases, with the explained variation ranging from 30%-40.2% depending on the method used. Conclusion: A small, non-sponsored study found an exponential association between patients' femoral bone mineral density and their functionality status, with this correlation shifting to the right when the Age-adjusted Charlson Co-Morbidity Index is ≥4.