Maturitas · 2004
Osteoporosis assessment strategies for male nursing home residents.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Elliott Mary E, Drinka Paul J, Krause Peggy, Binkley Neil C, Mahoney Jane E
Аннотация
OBJECTIVES: Twenty-five to thirty percent of hip fractures occur in men, and nursing home residents have a 5-10-fold greater fracture risk than community-dwellers. Osteoporosis prevalence in men in long-term care, however, is poorly defined. Our objectives were to determine the prevalence of osteoporosis, as assessed by peripheral bone mineral density (BMD), in a group of institutionalized veterans, and to determine how many men with low BMD had received a prior diagnosis of osteoporosis.
METHODS: Subjects were residents in a 740-bed skilled nursing facility (78% men). Male residents (n = 103) competent to give informed consent underwent bilateral calcaneal and forearm BMD by dual-energy X-ray absorptiometry (DXA). Prior osteoporosis documentation was sought in medical records.
RESULTS: Twenty percent of veterans (95% confidence interval (CI) 12-28%) exhibited calcaneal osteoporosis (T-score < -2.5), and 62% (CI 52-72%) were osteoporotic at the forearm. Forearm and calcaneal BMD were correlated (r = 0.678, P < 0.001). BMD of the left and right forearm, and of left and right calcaneus, were highly correlated (r = 0.880, P < 0.001 and r = 0.931, P < 0.001, respectively). Documentation of osteoporosis existed for one of 20 men with calcaneal osteoporosis and four of 59 men with forearm osteoporosis.
CONCLUSIONS: Osteoporosis was prevalent but poorly documented in institutionalized veterans. Discordance in T-scores between forearm and heel was similar to that reported in other studies. The broad range of T-scores among subjects suggests that peripheral BMD measurement may be useful for clinical fracture risk stratification. Correlation among skeletal sites indicates that measuring a single site may be practical.
METHODS: Subjects were residents in a 740-bed skilled nursing facility (78% men). Male residents (n = 103) competent to give informed consent underwent bilateral calcaneal and forearm BMD by dual-energy X-ray absorptiometry (DXA). Prior osteoporosis documentation was sought in medical records.
RESULTS: Twenty percent of veterans (95% confidence interval (CI) 12-28%) exhibited calcaneal osteoporosis (T-score < -2.5), and 62% (CI 52-72%) were osteoporotic at the forearm. Forearm and calcaneal BMD were correlated (r = 0.678, P < 0.001). BMD of the left and right forearm, and of left and right calcaneus, were highly correlated (r = 0.880, P < 0.001 and r = 0.931, P < 0.001, respectively). Documentation of osteoporosis existed for one of 20 men with calcaneal osteoporosis and four of 59 men with forearm osteoporosis.
CONCLUSIONS: Osteoporosis was prevalent but poorly documented in institutionalized veterans. Discordance in T-scores between forearm and heel was similar to that reported in other studies. The broad range of T-scores among subjects suggests that peripheral BMD measurement may be useful for clinical fracture risk stratification. Correlation among skeletal sites indicates that measuring a single site may be practical.