Official Positions for FRAX® clinical regarding falls and frailty: can falls and frailty be used in FRAX®? From Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®

Tahir Masud, Neil Binkley, Steven Boonen, Marian T Hannan, FRAX(®) Position Development Conference Members

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Risk factors for fracture can be purely skeletal, e.g., bone mass, microarchitecture or geometry, or a combination of bone and falls risk related factors such as age and functional status. The remit of this Task Force was to review the evidence and consider if falls should be incorporated into the FRAX® model or, alternatively, to provide guidance to assist clinicians in clinical decision-making for patients with a falls history. It is clear that falls are a risk factor for fracture. Fracture probability may be underestimated by FRAX® in individuals with a history of frequent falls. The substantial evidence that various interventions are effective in reducing falls risk was reviewed. Targeting falls risk reduction strategies towards frail older people at high risk for indoor falls is appropriate. This Task Force believes that further fracture reduction requires measures to reduce falls risk in addition to bone directed therapy. Clinicians should recognize that patients with frequent falls are at higher fracture risk than currently estimated by FRAX® and include this in decision-making. However, quantitative adjustment of the FRAX® estimated risk based on falls history is not currently possible. In the long term, incorporation of falls as a risk factor in the FRAX® model would be ideal.
OriginalsprogEngelsk
TidsskriftJournal of Clinical Densitometry
Vol/bind14
Udgave nummer3
Sider (fra-til)194-204
Antal sider11
ISSN1094-6950
DOI
StatusUdgivet - 2011

Fingeraftryk

Joints
Advisory Committees
History
Social Adjustment
Risk Reduction Behavior

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title = "Official Positions for FRAX{\circledR} clinical regarding falls and frailty: can falls and frailty be used in FRAX{\circledR}? From Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX{\circledR}",
abstract = "Risk factors for fracture can be purely skeletal, e.g., bone mass, microarchitecture or geometry, or a combination of bone and falls risk related factors such as age and functional status. The remit of this Task Force was to review the evidence and consider if falls should be incorporated into the FRAX{\circledR} model or, alternatively, to provide guidance to assist clinicians in clinical decision-making for patients with a falls history. It is clear that falls are a risk factor for fracture. Fracture probability may be underestimated by FRAX{\circledR} in individuals with a history of frequent falls. The substantial evidence that various interventions are effective in reducing falls risk was reviewed. Targeting falls risk reduction strategies towards frail older people at high risk for indoor falls is appropriate. This Task Force believes that further fracture reduction requires measures to reduce falls risk in addition to bone directed therapy. Clinicians should recognize that patients with frequent falls are at higher fracture risk than currently estimated by FRAX{\circledR} and include this in decision-making. However, quantitative adjustment of the FRAX{\circledR} estimated risk based on falls history is not currently possible. In the long term, incorporation of falls as a risk factor in the FRAX{\circledR} model would be ideal.",
keywords = "Accidental Falls, Aged, Algorithms, Bone Density, Diagnosis, Computer-Assisted, Female, Fractures, Bone, Frail Elderly, Humans, Male, Models, Statistical, Osteoporotic Fractures, Risk Assessment, Risk Factors",
author = "Tahir Masud and Neil Binkley and Steven Boonen and Hannan, {Marian T} and {FRAX({\circledR}) Position Development Conference Members}",
note = "Copyright {\circledC} 2011 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.",
year = "2011",
doi = "10.1016/j.jocd.2011.05.010",
language = "English",
volume = "14",
pages = "194--204",
journal = "Journal of Clinical Densitometry",
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Official Positions for FRAX® clinical regarding falls and frailty: can falls and frailty be used in FRAX®? From Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®. / Masud, Tahir; Binkley, Neil; Boonen, Steven; Hannan, Marian T; FRAX(®) Position Development Conference Members.

I: Journal of Clinical Densitometry, Bind 14, Nr. 3, 2011, s. 194-204.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Official Positions for FRAX® clinical regarding falls and frailty: can falls and frailty be used in FRAX®? From Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®

AU - Masud, Tahir

AU - Binkley, Neil

AU - Boonen, Steven

AU - Hannan, Marian T

AU - FRAX(®) Position Development Conference Members

N1 - Copyright © 2011 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

PY - 2011

Y1 - 2011

N2 - Risk factors for fracture can be purely skeletal, e.g., bone mass, microarchitecture or geometry, or a combination of bone and falls risk related factors such as age and functional status. The remit of this Task Force was to review the evidence and consider if falls should be incorporated into the FRAX® model or, alternatively, to provide guidance to assist clinicians in clinical decision-making for patients with a falls history. It is clear that falls are a risk factor for fracture. Fracture probability may be underestimated by FRAX® in individuals with a history of frequent falls. The substantial evidence that various interventions are effective in reducing falls risk was reviewed. Targeting falls risk reduction strategies towards frail older people at high risk for indoor falls is appropriate. This Task Force believes that further fracture reduction requires measures to reduce falls risk in addition to bone directed therapy. Clinicians should recognize that patients with frequent falls are at higher fracture risk than currently estimated by FRAX® and include this in decision-making. However, quantitative adjustment of the FRAX® estimated risk based on falls history is not currently possible. In the long term, incorporation of falls as a risk factor in the FRAX® model would be ideal.

AB - Risk factors for fracture can be purely skeletal, e.g., bone mass, microarchitecture or geometry, or a combination of bone and falls risk related factors such as age and functional status. The remit of this Task Force was to review the evidence and consider if falls should be incorporated into the FRAX® model or, alternatively, to provide guidance to assist clinicians in clinical decision-making for patients with a falls history. It is clear that falls are a risk factor for fracture. Fracture probability may be underestimated by FRAX® in individuals with a history of frequent falls. The substantial evidence that various interventions are effective in reducing falls risk was reviewed. Targeting falls risk reduction strategies towards frail older people at high risk for indoor falls is appropriate. This Task Force believes that further fracture reduction requires measures to reduce falls risk in addition to bone directed therapy. Clinicians should recognize that patients with frequent falls are at higher fracture risk than currently estimated by FRAX® and include this in decision-making. However, quantitative adjustment of the FRAX® estimated risk based on falls history is not currently possible. In the long term, incorporation of falls as a risk factor in the FRAX® model would be ideal.

KW - Accidental Falls

KW - Aged

KW - Algorithms

KW - Bone Density

KW - Diagnosis, Computer-Assisted

KW - Female

KW - Fractures, Bone

KW - Frail Elderly

KW - Humans

KW - Male

KW - Models, Statistical

KW - Osteoporotic Fractures

KW - Risk Assessment

KW - Risk Factors

U2 - 10.1016/j.jocd.2011.05.010

DO - 10.1016/j.jocd.2011.05.010

M3 - Journal article

C2 - 21810525

VL - 14

SP - 194

EP - 204

JO - Journal of Clinical Densitometry

JF - Journal of Clinical Densitometry

SN - 1094-6950

IS - 3

ER -