Should age influence the choice of quantitative bone assessment technique in elderly women? The EPIDOS study.

Details

Serval ID
serval:BIB_368192B4770A
Type
Article: article from journal or magazin.
Collection
Publications
Title
Should age influence the choice of quantitative bone assessment technique in elderly women? The EPIDOS study.
Journal
Osteoporosis International
Author(s)
Schott A.M., Kassaï Koupaï B., Hans D., Dargent-Molina P., Ecochard R., Bauer D.C., Bréart G., Meunier P.J.
ISSN
0937-941X
Publication state
Published
Issued date
2004
Peer-reviewed
Oui
Volume
15
Number
3
Pages
196-203
Language
english
Abstract
In a prospective cohort of 7,598 women aged 75 and over, we analyzed the effect of age on the ability of femoral neck bone mineral density (BMD) and of ultrasound (BUA and SOS) of the calcaneus to predict hip fracture. Unadjusted regression analysis showed that the risk of hip fracture was increased 1.7 times for one standard deviation increase in age (3.7 years). Overall, for a decrease of one standard deviation in quantitative bone measures, the risk was significantly increased by 2.2 times for BMD (1.9-2.5), 1.8 for BUA (1.6-2.1), and 1.9 for SOS (1.6-2.2). However the average relative risk associated with a decrease in BMD tends to diminish with advancing age, meaning that a smaller part of the risk is explained by BMD in the very elderly. This is confirmed by the areas under the ROC curves (AUC) of BMD that are significantly better before 80 years (0.75 [0.73-0.76]) than after (0.65 [0.63-0.67] in group 80-84 years and 0.65 [0.61-0.68] in group >/=85). On the other hand, as the absolute risk increases exponentially with age, the number of hip fractures attributable to a low BMD is still important in the very elderly, the risk difference between the lowest and the highest quartile of BMD is 25 hip fractures / 1,000 woman-years in the group >/=85 compared with 16 in the two other groups. Thus, after 80, quantitative assessment of bone may still be of interest for clinical decisions. Compared with quantitative ultrasound parameters, the ability of BMD to predict hip fracture was significantly superior to that of BUA and SOS only before the age of 80 (AUC of BMD 0.75 [0.73-0.76], BUA 0.67 [0.66-0.69], SOS 0.67 [0.65-0.69]). For patients older than 80, we did not observe significant differences in AUC between DXA and QUS to predict hip fracture.
Keywords
Absorptiometry, Photon, Age Factors, Aged, Aged, 80 and over, Bone Density, Calcaneus, Epidemiologic Methods, Female, Femur Neck, Hip Fractures, Humans, Mass Screening
Pubmed
Create date
02/03/2009 12:33
Last modification date
20/08/2019 13:24
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