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多种慢性病对社区居住老年人脆性骨折的影响:岛根县社区健康与老龄化研究

Effect of Multimorbidity on Fragility Fractures in Community-Dwelling Older Adults: Shimane CoHRE Study.

作者信息

A Garu, Yano Shozo, Sheik Abdullah Md, Yu Aorigele, Okuyama Kenta, Takeda Miwako, Kohno Kunie, Yamasaki Masayuki, Isomura Minoru, Nabika Toru, Nagai Atsushi

机构信息

Department of Neurology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan.

Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo 693-8501, Japan.

出版信息

J Clin Med. 2021 Jul 22;10(15):3225. doi: 10.3390/jcm10153225.

Abstract

Fragility fractures (FFxs), which are a common musculoskeletal injury in older adults, is associated with an increased frequency of falls. Both FFxs and falls may result from drugs, habits, and co-occurring diseases. We aimed to evaluate the effects of various diseases on the risk of FFx. This retrospective study included 1420 individuals aged ≥60 years. We evaluated the history of clinical FFx and diseases using a detailed questionnaire and a health examination. The risk of comorbidities was assessed using the Age-Adjusted Charlson Comorbidity (AAC) Index. We performed binary logistic regression analysis to determine the risk of FFx and falls after adjusting for covariates. In elderly men, the incidence of FFx positively correlated with rheumatoid arthritis and parent's hip fracture. For elderly women, the incidence of FFx positively correlated with rheumatoid arthritis and antihypertensive drugs but was inversely associated with dyslipidemia and antilipidemic drugs. The FFX risk of older adults with an AAC Index ≥6 was higher than those with an AAC Index of 1-3. In addition, the AAC Index and falls were independently and strongly associated with a higher risk of FFx. Taken together, multimorbidity increases the risk of clinical FFx independent of falls in the community-dwelling elderly population.

摘要

脆性骨折(FFxs)是老年人常见的肌肉骨骼损伤,与跌倒频率增加有关。FFxs和跌倒都可能由药物、习惯及并发疾病引起。我们旨在评估各种疾病对FFx风险的影响。这项回顾性研究纳入了1420名年龄≥60岁的个体。我们通过详细问卷和健康检查评估临床FFx病史和疾病情况。使用年龄调整的查尔森合并症(AAC)指数评估合并症风险。我们进行二元逻辑回归分析,以确定在调整协变量后FFx和跌倒的风险。在老年男性中,FFx的发生率与类风湿关节炎和父母髋部骨折呈正相关。对于老年女性,FFx的发生率与类风湿关节炎和抗高血压药物呈正相关,但与血脂异常和抗血脂药物呈负相关。AAC指数≥6的老年人发生FFx的风险高于AAC指数为1 - 3的老年人。此外,AAC指数和跌倒与FFx的较高风险独立且密切相关。综上所述,在社区居住的老年人群中,多种合并症增加了临床FFx的风险,且与跌倒无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa8e/8348412/713ecef01e51/jcm-10-03225-g001.jpg

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