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FRAX 指数与老年人身体和认知功能的关系。

Relationship between the FRAX index and physical and cognitive functioning in older people.

机构信息

a Gerencia de Atención Primaria de Salamanca , Salamanca , Spain.

b Internal Medicine Department , Hospital Universitario Río Hortega , Valladolid , Spain.

出版信息

Ann Med. 2018 Sep;50(6):538-543. doi: 10.1080/07853890.2018.1505052. Epub 2018 Sep 7.

Abstract

OBJECTIVE

To assess the relationship between the FRAX index and the Barthel index/MiniMental State Examination in older people.

PATIENTS AND METHODS

Observational descriptive study. Demographic data, comorbidity, dependency and cognitive state, and risk of osteoporotic fracture were collected.

RESULTS

A total of 375 patients were included (60% female) Patients with a low-risk FRAX for hip fractures had a higher Mini-mental (25, 95% CI = 24-27 vs. 22, 95% = 21 to 23, p = .0001), a higher Barthel index (88, 95% CI = 84-93 vs 72, 69 to 76, p = .0001) without differences in the Charlson index. Bivariate analysis showed an inverse association between FRAX and scales but logistic regression showed only female sex (OR 4.4, 95% CI = 2.6-7.6) and the non-dependent Barthel index (OR = 0.104, 95% CI = 0.014-0.792) remained significant and. Barthel index/Mini-mental constructed a significant model capable of predicting a risk of hip fracture of >3% measured by the FRAX index, with an area under the curve of 0.76 (95% CI = 0.7-0.81).

CONCLUSIONS

The FRAX index is related to other markers of geriatric assessment and the association between these variables can predict a risk of hip fracture of >3% measured by the FRAX index. Key messages Geriatric assessment indexes may be as important as the FRAX index, which is based on clinical risk factors, in predicting the fracture risk in older patient.

摘要

目的

评估 FRAX 指数与老年人巴氏量表/简易精神状态检查之间的关系。

患者和方法

观察性描述性研究。收集人口统计学数据、合并症、依赖性和认知状态以及骨质疏松性骨折风险。

结果

共纳入 375 例患者(60%为女性)。低风险 FRAX 髋部骨折患者的 Mini-mental 评分更高(25,95%置信区间=24-27 比 22,95%置信区间=21 至 23,p=0.0001),巴氏量表评分更高(88,95%置信区间=84-93 比 72,69 至 76,p=0.0001),但 Charlson 指数无差异。二变量分析显示 FRAX 与量表呈负相关,但逻辑回归仅显示女性(OR 4.4,95%置信区间=2.6-7.6)和非依赖性巴氏量表(OR=0.104,95%置信区间=0.014-0.792)仍有意义。巴氏量表/简易精神状态构建了一个有意义的模型,能够预测 FRAX 指数测量的 >3%的髋部骨折风险,曲线下面积为 0.76(95%置信区间=0.7-0.81)。

结论

FRAX 指数与其他老年评估标志物相关,这些变量之间的关联可预测 FRAX 指数测量的 >3%的髋部骨折风险。

关键信息

老年评估指标可能与基于临床危险因素的 FRAX 指数一样重要,可用于预测老年患者的骨折风险。

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