Evaluation of the impact of 6-month training by whole body vibration on the risk of falls among nursing home residents, observed over a 12-month period: a single blind, randomized controlled trial.
Buckinx, Fanny ; Beaudart, Charlotte ; Maquet, Didier et al
in Aging clinical and experimental research (in press)
BACKGROUND: We have previously shown that short sessions of whole body vibration (WBV) were not able to significantly improve fall risk among nursing home residents but some trends towards an improvement ... [more ▼]
BACKGROUND: We have previously shown that short sessions of whole body vibration (WBV) were not able to significantly improve fall risk among nursing home residents but some trends towards an improvement of motor capacity were observed. OBJECTIVE: The objective of the present study was to evaluate the impact of 6-month training by WBV on functional and motor abilities among nursing home residents observed over a 12-month period. METHODS: Patients were randomized into two groups: the WBV group which received three training sessions every week composed of five series of 15 s of vibration at 30 Hz intensity for a period of 6 months and a control group with normal daily life. The impact of this training on the risk of falls was assessed blindly after 6 and 12 months by the Tinetti Test, the "Timed Up and Go" test and a quantitative evaluation of a 10-s walk performed with a tri-axial accelerometer. The occurrence of falls was also observed. RESULTS: 62 elderly healthy volunteers, (47 women and 15 men, mean age 83.2 +/- 7.9 years) were included in this study. There was no significant difference between the two groups regarding the Tinetti test (p = 0.75), the "Timed Up and Go" test (p = 0.19) and the Locometrix(R) test, except for the step length, measured by dual task (p < 0.01). No significant inter-group difference in the frequency of falls was observed during the 12 months of research. A total of 42 falls were recorded during the first 6 months of experimentation: 24 falls in the treated group and 18 in the control group (p = 0.60). During the next 6 months, 19 falls occurred: 8 falls in the treated group and 11 in the control group (p = 0.52). CONCLUSION: This study failed to establish the effectiveness of low doses of WBV, under the conditions used in our study, on functional and motor abilities of institutionalized elderly patients. However, given the positive results of other studies, further investigations, with modified therapeutic protocols, seem necessary to clarify the effects of WBV in the elderly. [less ▲]Detailed reference viewed: 27 (9 ULg)
Current challenges in the treatment of osteoporosis: an opportunity for bazedoxifene.
Reginster, Jean-Yves ; ;
in Current medical research and opinion (2014)
Abstract Background: Osteoporosis affects millions of postmenopausal women worldwide. Osteoporosis-related fractures can lead to chronic pain, disability, systemic complications, and increased risk of ... [more ▼]
Abstract Background: Osteoporosis affects millions of postmenopausal women worldwide. Osteoporosis-related fractures can lead to chronic pain, disability, systemic complications, and increased risk of recurrent fractures, resulting in increased healthcare costs and mortality. Because currently available therapies have unique benefit/risk profiles, challenges remain in selecting the most appropriate treatment for each osteoporotic woman. Research and Results: Bazedoxifene (BZA), a new selective estrogen receptor modulator, is being developed for postmenopausal osteoporosis. In a 3-year, global, phase 3 study, BZA significantly reduced the risk of new vertebral fractures and nonvertebral fractures in women with higher baseline fracture risk compared with placebo. In 2 extensions of this study, the efficacy of BZA in reducing vertebral fracture risk was sustained over 7 years. BZA improved lumbar spine and total hip bone mineral density compared with placebo at 3 and 5 years, and demonstrated a favorable safety/tolerability profile, with no endometrial or breast stimulation. BZA was cost-effective compared with raloxifene in a 3-year, head-to-head comparative trial. Indirect comparisons further suggest that BZA may be as effective as bisphosphonates in reducing risk of nonvertebral fractures in women at high risk of fracture. BZA demonstrated efficacy and safety for treating postmenopausal osteoporosis over 7 years, particularly in women at a higher fracture risk. Conclusion: Because of its specific pharmacologic profile, BZA may be appropriate for postmenopausal women seeking a tolerable, safe, effective, and cost-effective long-term osteoporosis treatment. [less ▲]Detailed reference viewed: 8 (1 ULg)
Republished: Value of biomarkers in osteoarthritis: current status and perspectives.
; ; et al
in Postgraduate Medical Journal (2014), 90(1061), 171-8
Osteoarthritis affects the whole joint structure with progressive changes in cartilage, menisci, ligaments and subchondral bone, and synovial inflammation. Biomarkers are being developed to quantify joint ... [more ▼]
Osteoarthritis affects the whole joint structure with progressive changes in cartilage, menisci, ligaments and subchondral bone, and synovial inflammation. Biomarkers are being developed to quantify joint remodelling and disease progression. This article was prepared following a working meeting of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis convened to discuss the value of biochemical markers of matrix metabolism in drug development in osteoarthritis. The best candidates are generally molecules or molecular fragments present in cartilage, bone or synovium and may be specific to one type of joint tissue or common to them all. Many currently investigated biomarkers are associated with collagen metabolism in cartilage or bone, or aggrecan metabolism in cartilage. Other biomarkers are related to non-collagenous proteins, inflammation and/or fibrosis. Biomarkers in osteoarthritis can be categorised using the burden of disease, investigative, prognostic, efficacy of intervention, diagnostic and safety classification. There are a number of promising candidates, notably urinary C-terminal telopeptide of collagen type II and serum cartilage oligomeric protein, although none is sufficiently discriminating to differentiate between individual patients and controls (diagnostic) or between patients with different disease severities (burden of disease), predict prognosis in individuals with or without osteoarthritis (prognostic) or perform so consistently that it could function as a surrogate outcome in clinical trials (efficacy of intervention). Future avenues for research include exploration of underlying mechanisms of disease and development of new biomarkers; technological development; the 'omics' (genomics, metabolomics, proteomics and lipidomics); design of aggregate scores combining a panel of biomarkers and/or imaging markers into single diagnostic algorithms; and investigation into the relationship between biomarkers and prognosis. [less ▲]Detailed reference viewed: 10 (1 ULg)
Correction of vitamin D insufficiency with combined strontium ranelate and vitamin D3 in osteoporotic patients.
; ; et al
in European Journal of Endocrinology (2014), 170(3), 441-50
OBJECTIVE: This study aims to investigate the efficacy and safety of oral fixed-dose combination of strontium ranelate 2 g/vitamin D3 1000 IU daily vs strontium ranelate 2 g daily for correcting vitamin D ... [more ▼]
OBJECTIVE: This study aims to investigate the efficacy and safety of oral fixed-dose combination of strontium ranelate 2 g/vitamin D3 1000 IU daily vs strontium ranelate 2 g daily for correcting vitamin D insufficiency in osteoporosis. DESIGN: A 6-month international, randomized, double-blind, parallel-group, phase 3 study. METHODS: A total of 518 men and postmenopausal women aged >/=50 years with primary osteoporosis (T-score </=-2.5 s.d.) and serum 25-hydroxyvitamin D (25(OH)D) >22.5 nmol/l were included. Patients were allocated to strontium ranelate 2 g/vitamin D3 1000 IU daily (n=413) or strontium ranelate 2 g daily (n=105). The participants received calcium 1 g daily. The primary endpoint was serum 25(OH)D at last post-baseline evaluation during 3 months. RESULTS: Both groups were comparable at baseline. Mean baseline of 25(OH)D was 44.1+/-14.6 nmol/l. After 3 months, the percentage of patients with 25(OH)D >/=50 nmol/l was higher with strontium ranelate/vitamin D3 vs strontium ranelate (84 vs 44%, P<0.001; adjusted between-group odds ratio=6.7; 95% CI, 4.2-10.9). The efficacy of the fixed-dose combination on 25(OH)D was maintained at 6 months (86 vs 40%, P<0.001). Mean 25(OH)D was 65.1 and 49.5 nmol/l, respectively, after 3 months and 66.9 and 45.4 nmol/l after 6 months. Physical performance improved in both groups. Falls were 17 and 20% in the strontium ranelate/vitamin D3 and strontium ranelate groups respectively. Parathyroid hormone levels were inversely correlated with 25(OH)D. No clinically relevant differences in safety were observed. CONCLUSIONS: This study confirms the efficacy and safety of fixed-dose combination of strontium ranelate 2 g/vitamin D3 1000 IU for correction of vitamin D insufficiency in osteoporotic patients. [less ▲]Detailed reference viewed: 6 (1 ULg)
Patients' preferences for osteoporosis drug treatment: a discrete-choice experiment.
Hiligsmann, Mickaël ; ; et al
in Arthritis research & therapy (2014), 16(1), 36
INTRODUCTION: The patient's perspective is becoming increasingly important in clinical and policy decisions. In this study, we aimed to evaluate the preferences of patients with, or at risk of ... [more ▼]
INTRODUCTION: The patient's perspective is becoming increasingly important in clinical and policy decisions. In this study, we aimed to evaluate the preferences of patients with, or at risk of, osteoporosis for medication attributes, and to establish how patients trade between these attributes. METHODS: A discrete choice experiment survey was designed and patients were asked to choose between two hypothetical unlabelled drug treatments (and an opt-out option) that vary in five attributes: efficacy in reducing the risk of fracture, type of potential common side-effects, mode and frequency of administration and out-of-pocket costs. An efficient experimental design was used to construct the treatment option choice sets and a mixed logit panel data model was used to estimate patients' preferences and trade-offs between attributes. RESULTS: A total of 257 patients with, or at risk of, osteoporosis completed the experiment. As expected, patients preferred treatment with higher effectiveness and lower cost. They also preferred either an oral monthly tablet or 6-month subcutaneous injection above weekly oral tablets, 3-month subcutaneous, 3-month intravenous or yearly intravenous injections. Patients disliked being at risk of gastro-intestinal disorders more than being at risk of skin reactions and flu-like symptoms. There was significant variation in preferences across the sample for all attributes except subcutaneous injection. CONCLUSIONS: This study revealed that osteoporotic patients preferred 6-month subcutaneous injection and oral monthly tablet, and disliked gastro-intestinal disorders. Moreover, patients were willing to pay a personal contribution or to trade treatment efficacy for better levels of other attributes. Preferences for treatment attributes varied across patients and this highlights the importance of clinical decision-making taking individual preferences into account to improve osteoporosis care. [less ▲]Detailed reference viewed: 10 (2 ULg)
Cardiovascular safety of strontium ranelate: real-life assessment in clinical practice.
Donneau, Anne-Françoise ; Reginster, Jean-Yves
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (2014), 25Detailed reference viewed: 20 (12 ULg)
Response to Dr Bolland's eLetter: Strontium and cardiovascular events.
in Annals of the rheumatic diseases (2014), 73(2), 9Detailed reference viewed: 6 (2 ULg)
Long-term fracture rates seen with continued ibandronate treatment : pooled analysis of DIVA and MOBILE long-term extension studies
; ; et al
in Osteoporosis International (2014), 25(1), 349-357Detailed reference viewed: 20 (3 ULg)
Osteonecrosis of the jaw in a male osteoporotic patient treated with denosumab
NEUPREZ, Audrey ; ; Rompen, Eric et al
in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (2014), 25
Osteonecrosis of the jaw (ONJ) is a clinical condition associated with long-term exposure to inhibitors of bone resorption, mainly bisphosphonates. Denosumab (DMab) is a human monoclonal antibody of the ... [more ▼]
Osteonecrosis of the jaw (ONJ) is a clinical condition associated with long-term exposure to inhibitors of bone resorption, mainly bisphosphonates. Denosumab (DMab) is a human monoclonal antibody of the receptor activator of nuclear factor kappa-B ligand. It prevents osteoclast-mediated bone resorption and is widely prescribed for the management of postmenopausal osteoporosis. Whereas ONJ has already been reported in women treated with DMab, we report for the first time the development of ONJ, following tooth extraction, in a male patient treated for idiopathic osteoporosis with DMab. Due to the constant increase in DMab prescription, for the management of osteoporosis, in both genders, physicians should be made aware of this potential risk. [less ▲]Detailed reference viewed: 32 (10 ULg)
Romosozumab in Postmenopausal Women with Low Bone Mineral Density.
; ; et al
in The New England journal of medicine (2014)
Background Sclerostin is an osteocyte-derived inhibitor of osteoblast activity. The monoclonal antibody romosozumab binds to sclerostin and increases bone formation. Methods In a phase 2, multicenter ... [more ▼]
Background Sclerostin is an osteocyte-derived inhibitor of osteoblast activity. The monoclonal antibody romosozumab binds to sclerostin and increases bone formation. Methods In a phase 2, multicenter, international, randomized, placebo-controlled, parallel-group, eight-group study, we evaluated the efficacy and safety of romosozumab over a 12-month period in 419 postmenopausal women, 55 to 85 years of age, who had low bone mineral density (a T score of -2.0 or less at the lumbar spine, total hip, or femoral neck and -3.5 or more at each of the three sites). Participants were randomly assigned to receive subcutaneous romosozumab monthly (at a dose of 70 mg, 140 mg, or 210 mg) or every 3 months (140 mg or 210 mg), subcutaneous placebo, or an open-label active comparator - oral alendronate (70 mg weekly) or subcutaneous teriparatide (20 mug daily). The primary end point was the percentage change from baseline in bone mineral density at the lumbar spine at 12 months. Secondary end points included percentage changes in bone mineral density at other sites and in markers of bone turnover. Results All dose levels of romosozumab were associated with significant increases in bone mineral density at the lumbar spine, including an increase of 11.3% with the 210-mg monthly dose, as compared with a decrease of 0.1% with placebo and increases of 4.1% with alendronate and 7.1% with teriparatide. Romosozumab was also associated with large increases in bone mineral density at the total hip and femoral neck, as well as transitory increases in bone-formation markers and sustained decreases in a bone-resorption marker. Except for mild, generally nonrecurring injection-site reactions with romosozumab, adverse events were similar among groups. Conclusions In postmenopausal women with low bone mass, romosozumab was associated with increased bone mineral density and bone formation and with decreased bone resorption. (Funded by Amgen and UCB Pharma; ClinicalTrials.gov number, NCT00896532 .). [less ▲]Detailed reference viewed: 20 (4 ULg)
Le tradipraticien est un acteur crédible dans l'offre des soins en territoire périurbain: Résultats d'une étude menée dans la commune de Kisenso à Kinshasa, Congo
Manzambi Kuwekita, Joseph ; ; Bruyère, Olivier et al
Conference (2013, December 19)
Cette étude examine la perception des tradipraticiens par les populations, afin d’envisager leur intégration dans les politiques de développement de Kisenso par des focus groupes en juillet 2013. 100% de ... [more ▼]
Cette étude examine la perception des tradipraticiens par les populations, afin d’envisager leur intégration dans les politiques de développement de Kisenso par des focus groupes en juillet 2013. 100% de participants reconnaissent l’existence de tradipraticiens et les avoir déjà consultés, 80% déclarent avoir expérimenté la guérison totale. Le recours au tradipraticien est justifié par l’efficacité des soins, le type de maladie, la compétence, la proximité et la possibilité de paiement à crédit. Pour 70% des participants, le tradipraticien doit améliorer les conditions d’hygiène dans la manipulation des produits. La quasi-totalité des tradipraticiens ne sont pas autorisés à fonctionner, dû notamment au coût d’actes administratifs pour l’obtention de l’autorisation et la peur de s’ouvrir aux intellectuels. 20% d’entre eux disent collaborer avec la biomédecine pour les soins de "mbasu", 20% se déclarent spécialistes en ostéologie, 20% dans les soins de "mbasu" et 60% disent tout soigner. Si l’on veut intégrer les tradipraticiens dans les politiques de développement local, on devra supprimer le coût d’actes administratifs, leur accorder des formations, intégrer les soins traditionnels dans les paquets d’activités et leur accorder le statut d’agent de l’Etat. [less ▲]Detailed reference viewed: 27 (8 ULg)
Les acteurs non étatiques jouent un rôle déterminant dans le fonctionnement des services publics en territoires périurbains
Manzambi Kuwekita, Joseph ; Bruyère, Olivier ; REGINSTER, Jean-Yves et al
Poster (2013, December 19)
Cette étude répertorie les acteurs étatiques et non étatiques qui offrent des services publics aux populations en territoire périurbain en vue d’améliorer leur intégration dans les politiques de ... [more ▼]
Cette étude répertorie les acteurs étatiques et non étatiques qui offrent des services publics aux populations en territoire périurbain en vue d’améliorer leur intégration dans les politiques de développement local de la commune périurbaine de Kisenso à Kinshasa, par des focus groups en juillet 2013. La question de recherche était : « quels sont les acteurs étatiques et non étatiques qui offrent les services publics en territoire périurbain, leurs rapports avec l’administration publique et comment envisager leur intégration dans les politiques de développement local » ? Les principaux résultats de cette étude montrent qu’à Kisenso, 5 acteurs étatiques et 75 acteurs non étatiques opèrent dans la commune de Kisenso, essentiellement dans les domaines suivants : santé, éducation, justice, social, environnement, énergie, PME, etc. en ce qui concerne les rapports qu’entretiennent les acteurs non étatiques avec l’Etat, (i) tous sont reconnus par la Commune car ils détiennent des autorisations délivrées par les instances de niveau national, (ii) ils ne rendent pas compte à la commune de leurs activités de manière formelle parce la loi ne les y oblige pas. 109 structures de santé sont fonctionnelles. Néanmoins, environ une trentaine d’ONGs transmettent leurs rapports d’activités à la Commune en fin d’année. De même, les acteurs non étatiques évoluant dans le secteur des soins de santé transmettent tous leurs rapports épidémiologiques, mais seulement 15/109 (soit 13,7%) rapportent sur les activités (SNIS). À la question de savoir pourquoi la population recourt aux services offerts par les différents acteurs, cette étude montre que les choix des populations pour un service ou un autre sont motivés essentiellement par la qualité de ces services, la compétence du personnel, l’efficacité, l’accueil, les coûts accessibles, l’accueil et la proximité du service avec le ménage. Quant à la manière d’intégrer les acteurs non étatiques dans les politiques de développement local, les acteurs ont proposé le processus suivant : (i) inventorier les structures et/ou les acteurs œuvrant dans la zone de santé et/ou la commune, (ii) faire les états des lieux pour identifier leur degré de fonctionnement, (iii) accorder les autorisations aux structures qui remplissent les conditions de fonctionnement, (iv) aider celles qui ne remplissent pas ces conditions à les remplir par la formation du personnel, la subvention des structures, etc.). Les résultats de cette recherche suggèrent que si l’on veut éviter que certains acteurs continuent à opérer dans la clandestinité pour des raisons d’ordre financier, à l’instar de tradipraticiens, ils devraient être exonérés de toutes taxes. Les résultats de cette recherche montrent que si l’on veut intégrer les acteurs non étatiques dans les politiques de développement local, les différentes autorités municipales devraient les associer, en amont, aux activités organisées telles la formation et la supervision, sans que cela ne leur soit facturé ; leur demander ensuite de rapporter sur leurs activités ne devrait plus entraîner de résistance. [less ▲]Detailed reference viewed: 21 (8 ULg)
Validity and Reliability of the French version of the STarT Back Screening Tool for patients with low back pain.
Bruyère, Olivier ; ; Beaudart, Charlotte et al
in Spine (2013)
Study Design. Observational prospective study.Objective. Our objective was to assess the reliability and validity of the French version of the Keele STarT Back Screening Tool (SBST).Summary of Background ... [more ▼]
Study Design. Observational prospective study.Objective. Our objective was to assess the reliability and validity of the French version of the Keele STarT Back Screening Tool (SBST).Summary of Background Data. The SBST is a recently validated tool developed to identify subgroups of patients with low back pain (LBP) to guide early secondary prevention in primary care.Methods. Outpatients with LBP aged 18 years or more, attending a rehabilitation centre, a back school, a private physiotherapy unit or a fitness centre were included. Patients were assessed through the SBST, Roland-Morris Disability Questionnaire (RMDQ), Orebro Musculoskeletal Pain Screening Questionnaire (OMPSQ), Medical Outcomes Survey Short Form 36 (SF-36) questionnaire, and a pain visual analogic scale (VAS). Test-retest reliability was assessed with Kappa score or the intraclass correlation coefficient (ICC), internal consistency of the psychological subscale with the Cronbach alpha coefficient, construct validity with the Spearman's correlation coefficient, and floor and ceiling effects by percentage frequency of lowest or highest possible score achieved by respondents.Results. 108 patients with LBP were included. The test-retest reliability of the SBST total score was excellent with an ICC of 0.90 (0.81-0.95). The Cronbach alpha coefficient was 0.73 showing a good internal consistency for the psychological subscale. High Spearman's correlation coefficients of 0.74 between SBST and RMDQ, and 0.74 between the SBST and OMPSQ were observed. As expected, low to moderate correlations were observed between the SBST total score and some dissimilar measures of the SF-36. The lowest possible SBST score was observed for 8 patients (7.4%) whereas only three patients (2.8%) had the highest possible SBST score.Conclusion. The French version of the SBST is a reliable and valid questionnaire consistent with the original English version. Therefore, this new version may help French-speaking clinicians and scientists to stratify patients with LBP. [less ▲]Detailed reference viewed: 19 (3 ULg)
Micro-crédit, Augmentation du pouvoir d’achat et Amélioration des conditions de vie des populations précaires en milieu urbain africain : Résultats d’une expérience menée dans la zone de santé de Bandalungwa à Kinshasa, Congo.
Manzambi Kuwekita, Joseph ; Gosset, Christiane ; Guillaume, Michèle et al
in Psychologie et Société Nouvelle (2013), XII(3), 3-14
Purchasing power increase, improvement of living conditions and health funding of vulnerable people in African urban areas: the case of the health zone of Bandalungwa, Kinshasa (Congo) Through a survey ... [more ▼]
Purchasing power increase, improvement of living conditions and health funding of vulnerable people in African urban areas: the case of the health zone of Bandalungwa, Kinshasa (Congo) Through a survey, the study analyses the living improvement possibilities for microentrepreneurs, by the improvement of their purchasing power through microcredits provided by the Programme National d’Appui à la Protection Sociale (PNPS), in the health zone of Bandalungwa (Kinshasa). The credits were affected to wheat flour, starches, fresh food, fruits and vegetables, small restoration, smoked fish, clothing, electronic devices. Main results suggest that 68% of the microentrepreneurs financed by the program have declared improved living conditions. This improvement was associated to access to health care, children schooling, household’s access to food, loan reimbursement, and rent payment. The bivariate analysis has shown that those who had invested the whole credit in the funded activity experienced living improvement. To help vulnerable people in increasing their purchasing power, the loans should be linked to projects that are helpful to the households, and avoid that households use the credit in unsuitable ways, which could maintain them in a high level of debt. [less ▲]Detailed reference viewed: 27 (5 ULg)
Critères de retour sur le terrain après plastie LCA chez le footballeur professionnel
Croisier, Jean-Louis ; ; Bruyère, Olivier et al
in European Journal of Sports Medicine (2013, September), 1(1),Detailed reference viewed: 47 (6 ULg)
Evaluation de l'impact d'un entraînement de six mois par vibrotonie corporelle sur le risque de chute des patients résidant en maison de repos, observé pendant une période de 12 mois
Buckinx, Fanny ; Beaudart, Charlotte ; Demonceau, Marie et al
in Cahiers de l'Année Gérontologique (Les) (2013, September), 5(1-2), 119-120Detailed reference viewed: 40 (15 ULg)
Caractéristiques cliniques des sujets répondeurs à la vibrotonie corporelle totale
Beaudart, Charlotte ; Buckinx, Fanny ; Maquet, Didier et al
in Cahiers de l'Année Gérontologique (Les) (2013, September), 5(1-2), 118-119Detailed reference viewed: 24 (10 ULg)
Importance du déficit en vitamine D chez les femmes françaises ostéoporotiques et ostéopéniques âgées de plus de 80 ans
Bruyère, Olivier ; Slomian, Justine ; Beaudart, Charlotte et al
in Cahiers de l'Année Gérontologique (Les) (2013, September), 5(1-2), 75Detailed reference viewed: 31 (18 ULg)
Les effets d'une supplémentation en vitamine D sur la force musculaire : une méta-analyse d'essais randomisés contrôlés
Beaudart, Charlotte ; Buckinx, Fanny ; Rabenda, Véronique et al
in Cahiers de l'Année Gérontologique (Les) (2013, September), 5(1-2), 38Detailed reference viewed: 27 (10 ULg)
Risk of hip fracture in community-dwelling and institutionalized osteoporotic patients: A 3-year study.
Bruyère, Olivier ; Hiligsmann, Mickaël ; Zegels, Brigitte et al
in International Journal of Gerontology (2013), 7(3), 167-70
Background and aims: It has been previously suggested that the incidence of hip fracture is higher among people living in nursing homes than among community-dwelling people. However, it is not clear ... [more ▼]
Background and aims: It has been previously suggested that the incidence of hip fracture is higher among people living in nursing homes than among community-dwelling people. However, it is not clear whether this is a consequence of nursing home residency or of the greater age of the residents. We have examined the relationship between the place of residence and hip fracture incidence, in a prospective 3- year study. Methods: Women from nine countries included in this study were part of the placebo group of a randomized controlled trial having assessed the long-term effect of a new antiosteoporotic drug. All women were osteoporotic and received placebo and vitamin D during the 3 years of follow-up. All the institutionalized (nursing home, medical house) women (n ¼ 217) were included in this post hoc analysis and three noninstitutionalized age- and country-matched controls were included (n ¼ 651). Results: The mean (and standard deviation) age of the patients was 80.4 (5.6) years in the institutionalized women and 80.2 (5.8) years in the noninstitutionalized women (p ¼ 0.87). After 3 years of followup, 37 fractures occurred: 12 (5.5%) in institutionalized women and 25 (3.8%) in noninstitutionalized women. The difference between the two groups was not statistically significant (p ¼ 0.29). After controlling for age, body mass index, femoral neck bone mineral density and prevalent nonvertebral fracture, the residence status of the patient (institutionalized vs. noninstitutionalized) was not significantly associated with hip fracture incidence (p ¼ 0.63). Conclusions: We suggest that living in an institutionalized place is not an independent risk factor for hip fracture for osteoporotic women receiving calcium and vitamin D. [less ▲]Detailed reference viewed: 42 (21 ULg)