File
B. Brahmbhatt1, M. Sheth2
1Ahmedabad Physiotherapy College, Ahmedabad, India, 2SBB College of Physiotherapy, Ahmedabad, India
Background: Falls and fractures are common among the elderly population and post-menopausal women in India. If early identification of people at risk can be done this problem can be minimized.
Purpose: To estimate prevalence of fall risk and fracture risk and prevalence of clinical risk factors(CRF) among middle-aged and elderly population of Gujarat and to find the correlation between fall risk and fracture risk.
Methods: This was an observational study with 500 participants’ men and women, aged 40-80 years. Participants were assessed with Berg Balance Scale(BBS) for balance and risk of fall and the fracture risk assessment tool(FRAX) without bone mineral density(BMD) to evaluate the 10-year probability of risk of Major osteoporotic fracture(MOF) and Hip fracture(HF). Participants were categorized into high, medium and low risk of fall on the basis of BBS score. Prevalence of clinical risk factors and 10-year probability of fracture risk was estimated and the India-specific age-dependent thresholds were used to categorize the participants into safety zone and treatment zone on the basis of FRAX. The statistical analysis was carried out using SPSS-20 and Microsoft excel application. Correlation between variables was analyzed by the Spearman’s Rho correlation. Level of significance was kept at 5%.
Results: 500 participants completed this study,57% males, 43% females with mean age of 56.3±9.7 years. As per the estimated prevalence of fall risk, there were no participants with high risk of fall(0%), few participants with medium risk(8%) and majority of the participants with low risk(92%). As per the estimated prevalence of hip fracture risk and major osteoporotic fracture risk, there were few participants(HF:22%,MOF:24%) in treatment zone and more participants in safety zone(HF:78%,MOF:76%). As per FRAX, the prevalence of clinical risk factors was, previous fracture(34%),parent hip fracture(9%),habit of current tobacco smoking(17%),ever use of glucocorticoids(6%),rheumatoid arthritis(5%),secondary osteoporosis(47%) and high alcohol use(1%). There was a strong negative correlation between 10-year probability of HF risk and BBS score(r=-0.61,p<0.01) and MOF risk and BBS score(r=-0.63, ,p<0.01).
Conclusion(s): There were no participants with high risk of fall, majority of participants had low risk and fewer had moderate risk. The prevalence showed fewer participants in treatment zone and more in safety zone for 10-year probability of fracture risk. The study showed a significant strong positive correlation between fall risk and fracture risk in middle aged and elderly population of Gujarat.
Implications: To the best of authors knowledge,this was the first study estimating prevalence of 10-year probability of fracture risk utilizing age-dependent thresholds of India specific FRAX. As FRAX is easy to use tool, it can be routinely used to identify clinical risk factors and patients at risk for fracture. Early identification is of utmost importance in developing country like India to minimize financial burden. Most people cannot afford costly diagnostic tools to predict risk of fracture. Using FRAX without BMD would help clinicians and patients to plan possible preventive strategies. FRAX can be compared with other assessment tools available. A causal relationship between fall risk and fracture risk can be established in future. Prediction of falls and fractures may be done utilizing this relationship.
Funding, acknowledgements: None
Keywords: Elderly, Balance, Fracture risk
Topic: Health promotion & wellbeing/healthy ageing/physical activity
Did this work require ethics approval? Yes
Institution: Medilink Hospital
Committee: Medilink Ethics Committee
Ethics number: 42812
All authors, affiliations and abstracts have been published as submitted.
