Original investigation
Published: 2018-09-15

Frailty status and the risk of fractures in older people: the Pro.V.A. Longitudinal study

Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy
Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy
Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy
Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy
National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy
National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy
Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy
National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy; Department of Medicine (DIMED), Medical Clinic I, University of Padua, Italy
Department of Cardiac, Thoracic and Vascular Sciences, Biostatistics, Epidemiology and Public Health Unit, University of Padua, Italy
National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy
Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy; National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy;
Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy
Frailty Bone fractures Older age Prospective study

Abstract

Background and aims. Frailty has been associated with an increased risk of fractures in older people, but
the mechanisms behind this relationship have yet to be fully elucidated. We aimed to investigate which frailty
criteria were more closely associated with the risk of fractures in community-dwelling older people.
Methods. This study analyzed data from 2,113 older men and women enrolled in the Progetto Veneto Anziani
(ProVA) study and with no fractures at baseline. Frailty was assessed at baseline and defined as the presence
of at least three out of five Fried criteria, pre-frailty was the presence of one or two criteria, while non-frailty
was the presence of none of the criteria. Fractures after a mean 4-year follow-up were assessed on the basis
of medical records, self-reports, and radiographic examinations.
Results. At follow-up, we identified 233 (11%) new cases of fracture, with an age- and gender-specific incidence
rate of 22/1000 person-years (95% CI: 11-36). Compared with the non-frail, frail and pre-frail individuals
carried a significant 59% (OR = 1.59, 95% CI: 1.31-1.93) and 21% (OR = 1.21, 95% CI: 1.09-1.34) higher risk
of fractures, respectively. Among the frailty determinants, slow gait raised the likelihood of fractures by 56%,
physical inactivity by 46%, exhaustion by 32%, and weakness by 31%. No significant associations with unintentional
weight loss emerged after adjusting for potential confounders.
Conclusions. Frailty may predict the occurrence of fractures in older people, probably through mechanisms
mediated by impaired physical performance and exhaustion. Slow gait seems to be the most relevant factor in
increasing the risk of fractures in advanced age.

Affiliations

C. Trevisan

Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy

B.M. Zanforlini

Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy

A. Bertocco

Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy

M. Mazzochin

Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy

S. Maggi

National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy

M. Noale

National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy

M. De Rui

Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy

S. Zambon

National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy; Department of Medicine (DIMED), Medical Clinic I, University of Padua, Italy

E. Perissinotto

Department of Cardiac, Thoracic and Vascular Sciences, Biostatistics, Epidemiology and Public Health Unit, University of Padua, Italy

G. Crepaldi

National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy

E. Manzato

Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy; National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy;

G. Sergi

Department of Medicine (DIMED), Geriatrics Division, University of Padua, Italy

Copyright

© Società Italiana di Gerontologia e Geriatria (SIGG) , 2018

How to Cite

[1]
Trevisan, C., Zanforlini, B., Bertocco, A., Mazzochin, M., Maggi, S., Noale, M., De Rui, M., Zambon, S., Perissinotto, E., Crepaldi, G., Manzato, E. and Sergi, G. 2018. Frailty status and the risk of fractures in older people: the Pro.V.A. Longitudinal study. JOURNAL OF GERONTOLOGY AND GERIATRICS. 66, 3 (Sep. 2018), 119-126.
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