Ankle-brachial index, risk of clinical fractures, mortality and low bone mass in nursing home residents
Abstract
OBJECTIVE: To assess whether the ankle-brachial index is related to functional impairment, clinical fractures and mortality in nursing home residents, and whether this effect is associated or not with low bone mass.
PATIENTS AND METHODS: Prospective, observational, non-interventional cohort study in non-dependent nursing home residents. The following determinations were made: BUN, creatinine, cholesterol, triglycerides, calcium, phosphorous 25-hydroxyvitamin D, parathyroid hormone and cystatin C in blood and microalbuminuria in urine. Bone mass was determined by measuring the peripheral densitometry of the calcaneus. The Katz Index of independence, the Tinetti Balance and Gait evaluation and functional tests were administered. The ankle-brachial index was measured and patients divided into three groups (ankle-brachial index > 1.40, 1.40-0.90, and < 0.90). Clinical fractures and general and vascular mortality were measured for 20 months.
RESULTS: Seventy-two patients were included. There was an inverse relationship between age and the ankle-brachial index (p = 0.022) but no association with bone mass, biochemical tests, clinical fractures and the degree of independence. There was increased mortality in patients with increased or reduced ABI.
CONCLUSIONS: An altered ankle-brachial index is a marker of vascular mortality in elderly nursing home residents.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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