Relationship between the FRAX index and physical and cognitive functioning in older people

Ann Med. 2018 Sep;50(6):538-543. doi: 10.1080/07853890.2018.1505052. Epub 2018 Sep 7.

Abstract

Objective: To assess the relationship between the FRAX index and the Barthel index/MiniMental State Examination in older people.

Patients and methods: Observational descriptive study. Demographic data, comorbidity, dependency and cognitive state, and risk of osteoporotic fracture were collected.

Results: A total of 375 patients were included (60% female) Patients with a low-risk FRAX for hip fractures had a higher Mini-mental (25, 95% CI = 24-27 vs. 22, 95% = 21 to 23, p = .0001), a higher Barthel index (88, 95% CI = 84-93 vs 72, 69 to 76, p = .0001) without differences in the Charlson index. Bivariate analysis showed an inverse association between FRAX and scales but logistic regression showed only female sex (OR 4.4, 95% CI = 2.6-7.6) and the non-dependent Barthel index (OR = 0.104, 95% CI = 0.014-0.792) remained significant and. Barthel index/Mini-mental constructed a significant model capable of predicting a risk of hip fracture of >3% measured by the FRAX index, with an area under the curve of 0.76 (95% CI = 0.7-0.81).

Conclusions: The FRAX index is related to other markers of geriatric assessment and the association between these variables can predict a risk of hip fracture of >3% measured by the FRAX index. Key messages Geriatric assessment indexes may be as important as the FRAX index, which is based on clinical risk factors, in predicting the fracture risk in older patient.

Keywords: Barthel Index; Charlson Index; FRAX; Mini-Mental State Examination; hip fracture.

Publication types

  • Observational Study

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Bone Density / physiology*
  • Cognition / physiology*
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / physiopathology
  • Female
  • Geriatric Assessment / methods*
  • Geriatric Assessment / statistics & numerical data
  • Hip Fractures / etiology
  • Hip Fractures / physiopathology
  • Hip Fractures / prevention & control
  • Humans
  • Male
  • Neuropsychological Tests / statistics & numerical data
  • Osteoporosis / complications
  • Osteoporosis / diagnosis*
  • Osteoporosis / physiopathology
  • Osteoporotic Fractures / etiology
  • Osteoporotic Fractures / physiopathology
  • Osteoporotic Fractures / prevention & control
  • Risk Assessment / methods
  • Risk Factors