High Prevalence of Vertebral Fracture in a Very Elderly Community-Dwelling: "Longevous Project".

Autor: Bastos LA; Department of Medicine, Discipline of Geriatrics and Gerontology, Federal University of São Paulo, Sao Paulo, Brazil., Tavares DRB; Department of Medicine, Discipline of Geriatrics and Gerontology, Federal University of São Paulo, Sao Paulo, Brazil; Department of Evidence-Based Medicine, Brazilian Cochrane Centre, Federal University of São Paulo, Sao Paulo, Brazil., Okazaki JEF; Department of Medicine, Discipline of Geriatrics and Gerontology, Federal University of São Paulo, Sao Paulo, Brazil; Department of Evidence-Based Medicine, Brazilian Cochrane Centre, Federal University of São Paulo, Sao Paulo, Brazil. Electronic address: erikafrazao@gmail.com., Gazoni FM; Department of Medicine, Discipline of Geriatrics and Gerontology, Federal University of São Paulo, Sao Paulo, Brazil; Department of Evidence-Based Medicine, Brazilian Cochrane Centre, Federal University of São Paulo, Sao Paulo, Brazil., Fonte FK; Department of Medicine, Discipline of Geriatrics and Gerontology, Federal University of São Paulo, Sao Paulo, Brazil., Maeda SS; Department of Medicine, Discipline of Endocrinology, Federal University of São Paulo, Sao Paulo, Brazil., Lazaretti-Castro M; Department of Medicine, Discipline of Endocrinology, Federal University of São Paulo, Sao Paulo, Brazil., Cendoroglo MS; Department of Medicine, Discipline of Geriatrics and Gerontology, Federal University of São Paulo, Sao Paulo, Brazil., Santos FC; Department of Medicine, Discipline of Geriatrics and Gerontology, Federal University of São Paulo, Sao Paulo, Brazil.
Jazyk: angličtina
Zdroj: Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry [J Clin Densitom] 2020 Jul - Sep; Vol. 23 (3), pp. 497-502. Date of Electronic Publication: 2019 May 17.
DOI: 10.1016/j.jocd.2019.05.004
Abstrakt: Introduction: Vertebral fractures (VF) are associated with poorer quality of life, morbidity, and mortality in aging, and are the main risk factors for new VF or fractures in other sites. Thus, to explore them in the elderly is important, especially considering the very elderly individuals (age ≥ 80), who belong to the fastest growing population in the world, a portion that is still very little studied.
Objective: To evaluate the prevalence, specific characteristics and associations of VFs in a very elderly population.
Method: Observational, descriptive, and analytical cross-sectional study of the "Longevous Project" - São Paulo, Brazil, an ongoing prospective cohort that includes elderly of both gender, aged 80 yr or more. For the diagnosis of VF 2 methods were used VFA ("VF Assessment) by bone densitometry and X-ray, by 2 independent physicians, and using the Genant semiquantitative technique. The VFs by VFA were correlated with demographic, anthropometric, clinical, laboratory, and densitometric data. Statistical tests applied were qui-square and ANOVA.
Results: We analyzed data of 125 individuals with a mean age of 86.7 ± 4.1 yr and majority of female (71.2%). The prevalence of osteoporosis and osteopenia was 35.5% and 47.6%, respectively. A higher prevalence of VF was verified by VFA (30.4%) than by X-ray (20.8%), besides the majority was considered severe, 52.6% and 57.7%, by VFA and X-ray, respectively. A concordance index between the 2 methods was considered regular for the diagnosis of VF (Kappa = 0.419), and good for the VF severity (Kappa = 0.743). The VF were significantly associated to bone densitometry analysis VF (p = 0.05), and its severity was significantly correlated with total hip BMD (p = 0.049) and glomerular filtration rate (p = 0.017).
Conclusion: This study observed a high prevalence of VF in a very elderly population, being the great majority severe fractures and suggests that VFA might be more effective to detect VF in oldest-old individuals.
(Copyright © 2019 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE