Osteoporosis

The Relationship between Frailty and Osteoporosis in Women over 70 Y. Oliel*, T. Resnick*, S. Sternberg**, J. Menczel***, & A. Woloski-Wruble* * Hadassah and Hebrew University School of Nursing in the Faculty of Medicine, Jerusalem, Israel ** Maccabi Health Services, Jerusalem, Israel *** Herzog Hospital, Jerusalem, Israel

Objective

Main Variables

To determine the relationship between osteoporosis and frailty in Israeli women over the age of 70.

Methods and Materials DESIGN: Descriptive correlational study. SETTING: Community dwelling Israeli women. INSTRUMENTS: Frailty: Cardiovascular Health Study (CHS) Index (Fried et al., 2001)

Vulnerable Elders Survey (VES-13) Questionnaire

Osteoporosis

Frailty

• Diminished bone mass, disruption of microscopic bone structure, and bone fragility. • Prevalence in Israel - more than 150 thousand women, aged 65 years or older (Israel Health Ministry, 2003)

• Sign of vulnerability and may be a good marker for frailty (Rolland et al., 2008)

• Connected to molecular changes in the cells and characterized by a syndrome of shrinking (sarcopenia and weight loss), weakness, and exhaustion. • Prevalence: 10-25% of the elderly; up to 45% in those over 85 years of age (Fried & Walston, 2003)

• The pre-frail are at high risk of developing the full frailty syndrome

(Saliba et al., 2001)

Osteoporosis: bone mineral density (BMD), measured by dual energy X-ray absorptiometry (DXA)

(Fried et al., 2001)

Sample characteristics • A convenience sample of women, from one of the health care organizations • N = 137 • Mean age - 76 years (range 70-95)

Osteoporosis in women

• Most reported good financial status

Cycle of Frailty (Ahmed et al., 2006)

• Most reported 10th grade or higher education • Average cognitive and functional status - at the upper limits

Results Variable

n

Yes (%)

Pre-diagnosed osteoporosis

137 65 (47.4) 72 (52.6)

With osteoporosis, on medication 65

This study did not support a direct association between frailty and osteoporosis, though it provides important insight into the challenges related to conducting research with this age group.

No (%)

35 (54.8) 30 (46.2)

Fell during previous year

137 42 (30.7) 95 (69.3)

Fracture during previous year

137 9 (6.6)

Almost half of the subjects reported being previously diagnosed with osteoporosis.

128 (93.4)

VES-13 CHS Index

Normal

Frail

Total

Robust

47 (34.31%)

2 (1.46%)

49 (35.77%)

Pre-Frail

51 (37.23%)

22 (16.06%) 73 (53.28%)

Frail

3 (2.19%)

12 (8.76%)

Total

101 (73.72%)

36 (26.28%) 137 (100%)

15 (10.95%)

Discussion

A correlation of 0.61 (p