Wrist fractures in elderly women lead to significant functional decline
MedWire News: The long-term debilitating effect of wrist fractures in elderly women has been highlighted in a study published in the British Medical Journal.
"The effect of a wrist fracture on clinically important functional decline was as significant as that of other established risk factors for functional decline such as falls, diabetes, and arthritis," report Beatrice Edwards (Northwestern University, Chicago, Illinois, USA) and co-authors.
The researchers followed-up 6107 women participating in the Study of Osteoporotic Fractures for an average of 7.6 years for risk fracture. The women were all aged 65 years or older and had no history of hip or wrist fracture.
In all, 268 women sustained wrist fractures during the study and were followed-up for an average of 6.3 years.
During this time, 15% of these women developed clinically important functional decline, defined as a 5-point or greater reduction in total functional difficulty score (maximum 15 points available ). Points are given according to ease of performing five activities of daily living, with 0 points awarded for no difficulty and 3 points for inability to complete a task.
Analysis showed that women who sustained wrist fractures were a significant 48% more likely to experience clinically significant functional decline than those without the injury, after adjusting for age, body mass index, health status, baseline functional status, lifestyle, comorbidity, and neuromuscular function.
The researchers note that women who had experienced falls, or who had arthritis, or diabetes mellitus had a respective 58%, 48%, and 36% increased risk for significant functional decline than those without.
"This study suggests that measures to prevent wrist fractures may reduce functional decline in older women," write Edwards et al.
They recommend that primary prevention should include diagnosis and treatment of low bone mass and osteoporosis, prevention of falls, vitamin D supplementation, and home safety, while prompt rehabilitation after wrist fracture may result in improved long-term functional outcomes.
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By Lynda Williams