Ultrasound measurements for the prediction of osteoporotic fractures in elderly people

In this prospective study we investigated the predictive value of quantitat ive ultrasound (QUS) measurements and other potential predictors of osteopo rotic fractures in the elderly. During a 1-year period, 710 participants (1 32 men and 578 women), aged 70 years and older (mean age +/- SD: 82.8 +/- 5 .9), were recruited from seven homes and apartment houses for the elderly. QUS measurements (broadband ultrasound attenuation (BUA) and speed of sound (SOS)) were assessed with a clinical bone densitometer. A structured quest ionnaire was used to collect information on other potential predictors. Fol low-up of fractures was done each half year by telephone interviews. During the study period (median follow-up 2.8 years, maximum 3.7 years), 30 parti cipants had a first hip fracture and 54 suffered from a first other nonspin al fracture. Cox regression analyses, adjusted for age and sex, showed that the relative risk (RR) of hip fracture for each standard deviation reducti on was 2.3 (95% CI, 1.4-3.7) for BUA and 1.6 (95% CI, 1.1-2.3) for SOS. Sli ghtly weaker relationships were found for any fracture (BUA: RR, 1.6; 95% C I, 1.2-2.1; SOS: RR, 1.3; 95% CI, 1.0-1.6). Multivariable analyses identifi ed low BUA values and immobility as the strongest predictors for hip fractu res and any fracture. Female gender proved to be the strongest predictor fo r other nonspinal fractures. It can be concluded that QUS measurements can predict the risk for hip fracture and any fracture in elderly people.