Ross Ryan D, Shah Raj C, Leurgans Sue E, Buchman Aron S, Bennett David A
Department of Cell & Molecular Medicine Rush University Medical Center Chicago IL USA.
Department of Orthopedic Surgery Rush University Medical Center Chicago IL USA.
JBMR Plus. 2020 Aug 14;4(9):e10390. doi: 10.1002/jbm4.10390. eCollection 2020 Sep.
Age-related bone loss is common in older adults. However, the association of low bone mass with incident disability and mortality is not well established. A sample of 738 participants in the Rush Memory and Aging Project (MAP) was evaluated at baseline for bone mineral density (BMD) using quantitative ultrasound at the calcaneus. An annual interview assessed basic activities of daily living (BADL), instrumental activities of daily living (IADL), mobility disability, and history of hip fracture. The associations between baseline BMD and risk of death; incident BADL, IADL, and mobility disability; and hip fracture were investigated using Cox hazard models, adjusting for age, sex, education, race, and body mass index (BMI). The robustness of our findings was evaluated by adjusting for confounding factors and health conditions including joint pain, musculoskeletal medications, smoking status, motor function, global cognition, falls, cardiovascular events, and diabetes. Participants were on average (mean ± SD) 80.9 ± 7.0 years old, 72% female, and 3.8% black, with a baseline BMI of 27.3 ± 5.4 kg/m, and a baseline of BMD of 0.44 ± 0.14 g/cm. In models adjusted for age, sex, education, race, and BMI, lower BMD was associated with a higher rate of death (hazard ratio [HR] 1.20; 95% confidence interval [CI], 1.08-1.33), incident BADL disability (HR 1.20; 95% CI, 1.05-1.37), and hip fracture (HR 2.57; 95% CI, 1.72-3.82), but not of IADL disability (HR 1.00; 95% CI, 0.85-1.17) or mobility disability (HR 1.13; 95% CI, 0.97-1.32). The association between BMD and mortality was not significant in fully adjusted models, but the BMD and BADL associations remained significant in models adjusting for both demographic variables and BMD-modifying health conditions. BMD is associated with incident disability in older adults. © 2020 The Authors. published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
年龄相关性骨质流失在老年人中很常见。然而，低骨量与新发残疾和死亡率之间的关联尚未明确确立。对拉什记忆与衰老项目（MAP）中的738名参与者进行了样本研究，在基线时使用跟骨定量超声评估骨矿物质密度（BMD）。每年进行一次访谈，评估日常生活基本活动（BADL）、日常生活工具性活动（IADL）、行动能力残疾以及髋部骨折史。使用Cox风险模型研究基线BMD与死亡风险、新发BADL、IADL和行动能力残疾以及髋部骨折之间的关联，并对年龄、性别、教育程度、种族和体重指数（BMI）进行调整。通过对包括关节疼痛、肌肉骨骼药物、吸烟状况、运动功能、整体认知、跌倒、心血管事件和糖尿病等混杂因素和健康状况进行调整，评估我们研究结果的稳健性。参与者的平均年龄（均值±标准差）为80.9±7.0岁，女性占72%，黑人占3.8%，基线BMI为27.3±5.4kg/m²，基线BMD为0.44±0.14g/cm²。在对年龄、性别、教育程度、种族和BMI进行调整的模型中，较低的BMD与较高的死亡率（风险比[HR]1.20；95%置信区间[CI]，1.08 - 1.33）、新发BADL残疾（HR 1.20；95% CI，1.05 - 1.37）和髋部骨折（HR 2.57；95% CI，1.72 - 3.82）相关，但与IADL残疾（HR 1.00；95% CI，0.85 - 1.17）或行动能力残疾（HR 1.13；95% CI，0.97 - 1.32）无关。在完全调整的模型中，BMD与死亡率之间的关联不显著，但在对人口统计学变量和影响BMD的健康状况进行调整的模型中，BMD与BADL之间的关联仍然显著。BMD与老年人的新发残疾相关。© 2020作者。由Wiley Periodicals LLC代表美国骨与矿物质研究学会出版。
