MedWire News: A self-reported measure of frailty may make it easier to identify individuals at risk for osteoporosis than traditional measures, US researchers suggest.
While the relationship between frailty and fracture risk is well documented, there is less evidence for a link between frailty and bone mineral density (BMD), observe Tamara Vokes and co-workers from the University of Chicago in Illinois.
To investigate further, the team assessed whether the Vulnerable Elders Survey (VES-13) for frailty predicts BMD in elderly patients.
The VES-13 is easier to administer than conventional performance-based frailty tests, and is based on age, general health, and self-reported functional impairment in six physical activities and five activities of daily living, Vokes et al explain in the journal Osteoporosis International.
The team administered the VES-13 to 230 ambulatory and community dwelling individuals aged 65 years or older, and measured their calcaneal BMD using dual X-ray absorptiometry (DXA). The individuals were followed-up 6 years later for fragility fractures and survival.
Analysis showed that increasing modified frailty score, not scoring for age or using an absolute score cutoff for frailty, was significantly associated with lower BMD in the participants, even after adjusting for age, weight, gender and race.
The modified score was also better at predicting 6-year rates of survival than the original version.
Moreover, patients with the highest frailty score differed from similar individuals with the lowest score by a calcaneal BMD of 1.4 T-score units, translating to a 2–3-fold increased risk for fracture, the team reports.
“We show that a self-reported frailty measure can be used to predict calcaneal BMD, which is currently used as a screening tool to identify individuals who are at risk for osteoporosis,” Vokes et al summarize.
“Because calcaneal and central DXA machines are not readily available in many clinics, the VES-13 can provide clinicians with a simple screening tool for identifying community-dwelling elderly individuals who should be screened for osteoporosis more aggressively than expected based on their usual clinical characteristics.”
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