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BMC Musculoskeletal Disorders

, 15:185

Epidemiology of musculoskeletal disorders

Abstract

BackgroundTo investigate the association between frailty index FI of deficit accumulation and risk of falls, fractures, death and overnight hospitalizations in women aged 55 years and older.

MethodsThe data were from the Global Longitudinal Study of Osteoporosis in Women GLOW Hamilton Cohort. In this 3-year longitudinal, observational cohort study, women N = 3,985 aged ≥55 years were enrolled between May 2008 and March 2009 in Hamilton, Canada. A FI including co-morbidities, activities of daily living, symptoms and signs, and healthcare utilization was constructed using 34 health deficits at baseline. Relationship between the FI and falls, fractures, death and overnight hospitalizations was examined.

ResultsThe FI was significantly associated with age, with a mean rate of deficit accumulation across baseline age of 0.004 or 0.021 on a log scale per year. During the third year of follow-up, 1,068 31.89% women reported at least one fall. Each increment of 0.01 on the FI was associated with a significantly increased risk of falls during the third year of follow-up odds ratio OR: 1.02, 95% confidence interval CI: 1.02-1.03. The area under the curve AUC of the predictive model was 0.69 95% CI: 0.67-0.71. Results of subgroup and sensitivity analyses indicated the relationship between the FI and risk of falls was robust, while bootstrap analysis judged its internal validation. The FI was significantly related to fractures hazard ratio HR: 1.02, 95% CI: 1.01-1.03, death OR: 1.05, 95% CI: 1.03-1.06 during the 3-year follow-up period and overnight hospitalizations incidence rate ratio IRR: 1.02, 95% CI: 1.02-1.03 for an increase of 0.01 on the FI during the third year of follow-up. Measured by per standard deviation SD increment of the FI, the ORs were 1.21 and 1.40 for falls and death respectively, while the HR was 1.17 for fractures and the IRR was 1.18 for overnight hospitalizations respectively.

ConclusionThe FI of deficit accumulation increased with chronological age significantly. The FI was associated with and predicted increased risk of falls, fractures, death and overnight hospitalizations significantly.

KeywordsFrailty Falls Fracture Death Hospitalization AbbreviationsFIFrailty index

GLOWGlobal Longitudinal Study of Osteoporosis in Women

ADLActivities of daily living

SDStandard deviation

ANOVAAnalysis of variance

BMIBody mass index

ROCReceiver operating characteristic

AUCArea under the curve

CIConfidence interval

OROdds ratio

HRHazard ratio

IRRIncidence rate ratio.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2474-15-185 contains supplementary material, which is available to authorized users.

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Autor: Guowei Li - George Ioannidis - Laura Pickard - Courtney Kennedy - Alexandra Papaioannou - Lehana Thabane - Jonathan D Adac

Fuente: https://link.springer.com/







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