Low Bone Mineral Density and Risk of Fracture in White Female Nursing Home Residents

Chandler, Julie; Zimmerman, Sheryl; Girman, Cynthia J.; Martin, Allison R.; Hawkes, William; Hebel, J. Richard; Sloane, Philip D.; Holder, Lawrence E.; Magaziner, Jay

doi:10.1001/jama.284.8.972

Cited by 155 publications

(117 citation statements)

References 33 publications

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“…Older studies reported the highest risk ratios in the youngest senior age strata [15,25]. For the LTC cohort, our incidence rates were similar to [15,27,28] or lower than [29,30] other published studies on institutionalized populations, particularly Chandler et al who reported a rate of 109 osteoporotic fractures per 1000 person-years [31]. Our reported rates in the community were higher than the community-based Canadian Multicentre Osteoporosis Study (CaMos) [32] although there are differences in study methodologies with CaMOS relying on patient selfreport.…”

Section: Discussionsupporting

confidence: 71%

Comparative trends in incident fracture rates for all long-term care and community-dwelling seniors in Ontario, Canada, 2002–2012

et al. 2016

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Summary-In this population-based study, we compared incident fracture rates in long-term care (LTC) versus community seniors between 2002 and 2012. Hip fracture rates declined more rapidly in LTC than in the community. An excess burden of fractures occurred in LTC for hip, pelvis, and humerus fractures in men and hip fractures only in women.Introduction-This study compares trends in incident fracture rates between long-term care (LTC) and community-dwelling seniors ≥65 years, 2002-2012.

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Section: Discussionsupporting

confidence: 71%

Comparative trends in incident fracture rates for all long-term care and community-dwelling seniors in Ontario, Canada, 2002–2012

et al. 2016

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“…Furthermore, application of hip protectors in nursing homes by staff may be considered an important cointervention, not available in other group residence settings; this issue could be another contributor to clinical heterogeneity of pooled analyses of mixed populations. The nursing home population was of greatest clinical interest, as this population is known to be at extremely high risk for osteoporosis [14][15][16], falls [17], cognitive impairment (leading to falls and hip fracture) [16], and hip fracture [18][19][20].…”

Section: Selection Of Trials For Inclusion and Data Abstractionmentioning

confidence: 99%

Hip protectors decrease hip fracture risk in elderly nursing home residents: a Bayesian meta-analysis

Sawka

Boulos

Beattie

et al. 2007

Journal of Clinical Epidemiology

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Objective-To design a Bayesian random effects model for pooling binary outcome data from cluster randomized trials (CRTs) with individually randomized trials (IRTs) and then use this model to determine if hip protectors decrease the risk of hip fracture in elderly nursing home residents.Study Design and Setting-Eight electronic databases were searched; abstracts and papers were reviewed in duplicate. Randomized controlled trials of hip protectors in nursing homes were included. The pooled mean odds ratio (OR) of a hip fracture in an individual allocated to hip protectors with 95% credibility interval (CRI) was calculated. CIHR Author Manuscript CIHR Author Manuscript CIHR Author ManuscriptResults-We included four trials of 1,922 individuals (including three CRTs). The pooled OR of an elderly nursing home resident sustaining one or more hip fractures with hip protector allocation was 0.40 (95% CRI 0.25, 0.61). The model was robust in multiple sensitivity analyses assuming alternative intracluster correlation coefficient values. Conclusion-TheBayesian approach may be used in meta-analyses of IRTs and CRTs. Using this approach, we have determined that hip protectors decrease the risk of hip fracture in elderly nursing home residents. Methodologic limitations of the included trials and a possible herd effect in CRTs may have influenced these results.

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“…Studies from the USA report osteoporosis prevalence of 4.3%-13% and 15.4%-51% in men and women over 50 years of age, respectively [29,30] . The prevalence of osteoporosis in Korea is 7.3% in men and 38% in women over 50 years of age [20] .…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies did not take such factors into account, and most of them pooled healthy subjects into the control group. Furthermore, quite high prevalence values concerning overall osteoporosis and vit D deficiency levels are given by numerous epidemiological studies [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] . The condition is defined as a pandemic of osteoporosis and vit D deficiency by several sources [20,25] .…”

Section: Introductionmentioning

confidence: 99%

Association of Benign Paroxysmal Positional Vertigo with Osteoporosis and Vitamin D Deficiency: A Case Controlled Study

Karataş¹,

Yüceant²,

Yüce³

et al. 2017

Int Adv Otol

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OBJECTIVE:Benign paroxysmal positional vertigo (BPPV) is a common type of vertigo caused by the peripheral vestibular system. The majority of cases are accepted as idiopathic. Calcium metabolism also plays a primary role in the synthesis/absorption of otoconia made of calcium carbonate and thus might be an etiological factor in the onset of BPPV. In this study, we aimed to investigate the role of osteoporosis and vitamin D in the etiology of BPPV by comparing BPPV patients with hospital-based controls. MATERIALS and METHODS:This is a case-control study comparing the prevalence of osteoporosis and vitamin D deficiency in 78 BPPV patients and 78 hospital-based controls. The mean T-scores and serum vitamin D levels were compared. The risk factors of osteoporosis, physical activity, diabetes mellitus, body mass index, and blood pressure were all compared between the groups. To avoid selection bias, the groups were stratified as subgroups according to age, sex, and menopausal status. RESULTS:In this study, the rates of osteoporosis and vitamin D deficiency detected in BPPV patients were reasonably high. But there was no significant difference in mean T-scores and vitamin D levels, osteoporosis, and vitamin D deficiency prevalence between the BPPV group and controls. CONCLUSION:The prevalence of osteoporosis and vitamin D deficiency is reasonably high in the general population. Unlike the general tendencies in the literature, our study suggests that osteoporosis and vitamin D deficiency are not risk factors for BPPV; we conclude that the coexistence of BPPV with osteoporosis and vitamin D deficiency is coincidental.

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Low Bone Mineral Density and Risk of Fracture in White Female Nursing Home Residents

Abstract: Our data indicate that low BMD and independence in transfer are significant predictors of osteoporotic fracture in white female nursing home residents. JAMA. 2000;284:972-977

Cited by 155 publications

References 33 publications

Comparative trends in incident fracture rates for all long-term care and community-dwelling seniors in Ontario, Canada, 2002–2012

Comparative trends in incident fracture rates for all long-term care and community-dwelling seniors in Ontario, Canada, 2002–2012

Hip protectors decrease hip fracture risk in elderly nursing home residents: a Bayesian meta-analysis

Association of Benign Paroxysmal Positional Vertigo with Osteoporosis and Vitamin D Deficiency: A Case Controlled Study

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