Calcaneal broadband ultrasound attenuation predicts physical capability: EPIC-Norfolk prospective population-based study

Sarah Perrott; Kathryn Martin; Victoria L  Keevil; Nicholas J. Wareham; Kay-Tee Khaw; Phyo Kyaw Myint

doi:10.1016/j.maturitas.2023.04.008

Calcaneal broadband ultrasound attenuation predicts physical capability: EPIC-Norfolk prospective population-based study

Sarah Perrott^* (Corresponding Author), Kathryn Martin, Victoria L Keevil, Nicholas J. Wareham, Kay-Tee Khaw, Phyo Kyaw Myint

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Background
Calcaneal ultrasound (broadband ultrasound attenuation – BUA), a marker of bone strength, may predict future physical capability and thus provide a strategy to identify individuals at risk of age-related deterioration of health. This study aims to determine if BUA can predict future physical capability among middle-aged and older adults.

Methods
Summary performance scores (SPS), an objective quantification of physical capability, were devised using participants' measures of standing balance, gait speed and timed chair rises. Associations between BUA and SPS, measured at least six years apart, were investigated using univariable and multivariate sex-specific linear and logistic regression, adjusting for confounders.

Results
5893 participants were included. In men and women, for every five points lower BUA, there was a 0.2-point decrease in SPS. In women, BUA less than one standard deviation below the mean was associated with low physical capability (defined as SPS 3–6); fully adjusted odds ratio (OR) (95 % confidence interval (CI)) 1.35 (1.01–1.84). No association existed among men; OR (95 % CI) 0.84 (0.59–1.19). Significant risk factors for low physical capability in men with baseline low BUA were: older age [OR 5.77]; high BMI [OR 2.85]; lower social class [OR 1.59]; low physical activity [OR 1.64]. Risk factors among women were: older age [OR 5.54]; high BMI [OR 2.08]; lower education [OR 1.42], low physical activity [OR 1.27]; steroid use [OR 2.05]; and stroke [OR 2.74].

Conclusion
BUA may predict future physical capability in older adults. With further validation, BUA could stratify individuals at risk of deterioration in physical health.

Abbreviations
BUAbroadband ultrasound attenuation;SPSsummary performance score2HCsecond health checkBMIbody mass indexSDstandard deviationORodds ratioCIconfidence intervalADLactivity of daily livingEPICEuropean Prospective Investigation into CancerCUBAcalcaneal ultrasound broadband attenuationDEXAdual energy X-ray absorptiometryTDITownsend Deprivation IndexHRThormone replacement therapy

Original language	English
Pages (from-to)	7-15
Number of pages	9
Journal	Maturitas
Volume	173
Early online date	3 May 2023
DOIs	https://doi.org/10.1016/j.maturitas.2023.04.008
Publication status	E-pub ahead of print - 3 May 2023

Keywords

Physical capability
Broadband ultrasound attenuation
Bone strength
Older adults

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.maturitas.2023.04.008Licence: CC BY

Perrott_etal_M_Calcaneal_Broadband_Ultrasound_VoR
© 2023 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Final published version, 817 KBLicence: CC BY

Cite this

@article{3ecb9f7e99e1450cb1384071b66df72c,

title = "Calcaneal broadband ultrasound attenuation predicts physical capability: EPIC-Norfolk prospective population-based study",

abstract = "BackgroundCalcaneal ultrasound (broadband ultrasound attenuation – BUA), a marker of bone strength, may predict future physical capability and thus provide a strategy to identify individuals at risk of age-related deterioration of health. This study aims to determine if BUA can predict future physical capability among middle-aged and older adults.MethodsSummary performance scores (SPS), an objective quantification of physical capability, were devised using participants' measures of standing balance, gait speed and timed chair rises. Associations between BUA and SPS, measured at least six years apart, were investigated using univariable and multivariate sex-specific linear and logistic regression, adjusting for confounders.Results5893 participants were included. In men and women, for every five points lower BUA, there was a 0.2-point decrease in SPS. In women, BUA less than one standard deviation below the mean was associated with low physical capability (defined as SPS 3–6); fully adjusted odds ratio (OR) (95 % confidence interval (CI)) 1.35 (1.01–1.84). No association existed among men; OR (95 % CI) 0.84 (0.59–1.19). Significant risk factors for low physical capability in men with baseline low BUA were: older age [OR 5.77]; high BMI [OR 2.85]; lower social class [OR 1.59]; low physical activity [OR 1.64]. Risk factors among women were: older age [OR 5.54]; high BMI [OR 2.08]; lower education [OR 1.42], low physical activity [OR 1.27]; steroid use [OR 2.05]; and stroke [OR 2.74].ConclusionBUA may predict future physical capability in older adults. With further validation, BUA could stratify individuals at risk of deterioration in physical health.AbbreviationsBUAbroadband ultrasound attenuation;SPSsummary performance score2HCsecond health checkBMIbody mass indexSDstandard deviationORodds ratioCIconfidence intervalADLactivity of daily livingEPICEuropean Prospective Investigation into CancerCUBAcalcaneal ultrasound broadband attenuationDEXAdual energy X-ray absorptiometryTDITownsend Deprivation IndexHRThormone replacement therapy",

keywords = "Physical capability, Broadband ultrasound attenuation, Bone strength, Older adults",

author = "Sarah Perrott and Kathryn Martin and Keevil, {Victoria L} and Wareham, {Nicholas J.} and Kay-Tee Khaw and Myint, {Phyo Kyaw}",

note = "Funding This work was supported by funding from the Medical Research Council (Grant/Award Numbers: MR/N003284/1, MC-UU_12015/1) and Cancer Research UK (Grant/Award Number: C864/A14136), with additional support from the Stroke Association, British Heart Foundation, Department of Health, Europe Against Cancer Programme Commission of the European Union, Food Standards Agency, Research into Ageing, AAcknowledgements We are grateful to all the participants who have been part of the project and to the many members of the study teams at the University of Cambridge who have enabled this research. We would also like to acknowledge the principal investigators and staff of the EPIC-Norfolk study. The EPIC-Norfolk study (DOI 10.22025/2019.10.105.00004) was funded by the Medical Research Council, Grant number (MR/N003284/1 and MC-UU_12015/1) and Cancer Research UK, Grant number (C864/A14136).cademy of Medical Sciences and Wellcome Trust. ",

year = "2023",

month = may,

day = "3",

doi = "10.1016/j.maturitas.2023.04.008",

language = "English",

volume = "173",

pages = "7--15",

journal = "Maturitas",

issn = "0378-5122",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Calcaneal broadband ultrasound attenuation predicts physical capability

T2 - EPIC-Norfolk prospective population-based study

AU - Perrott, Sarah

AU - Martin, Kathryn

AU - Keevil, Victoria L

AU - Wareham, Nicholas J.

AU - Khaw, Kay-Tee

AU - Myint, Phyo Kyaw

N1 - Funding This work was supported by funding from the Medical Research Council (Grant/Award Numbers: MR/N003284/1, MC-UU_12015/1) and Cancer Research UK (Grant/Award Number: C864/A14136), with additional support from the Stroke Association, British Heart Foundation, Department of Health, Europe Against Cancer Programme Commission of the European Union, Food Standards Agency, Research into Ageing, AAcknowledgements We are grateful to all the participants who have been part of the project and to the many members of the study teams at the University of Cambridge who have enabled this research. We would also like to acknowledge the principal investigators and staff of the EPIC-Norfolk study. The EPIC-Norfolk study (DOI 10.22025/2019.10.105.00004) was funded by the Medical Research Council, Grant number (MR/N003284/1 and MC-UU_12015/1) and Cancer Research UK, Grant number (C864/A14136).cademy of Medical Sciences and Wellcome Trust.

PY - 2023/5/3

Y1 - 2023/5/3

N2 - BackgroundCalcaneal ultrasound (broadband ultrasound attenuation – BUA), a marker of bone strength, may predict future physical capability and thus provide a strategy to identify individuals at risk of age-related deterioration of health. This study aims to determine if BUA can predict future physical capability among middle-aged and older adults.MethodsSummary performance scores (SPS), an objective quantification of physical capability, were devised using participants' measures of standing balance, gait speed and timed chair rises. Associations between BUA and SPS, measured at least six years apart, were investigated using univariable and multivariate sex-specific linear and logistic regression, adjusting for confounders.Results5893 participants were included. In men and women, for every five points lower BUA, there was a 0.2-point decrease in SPS. In women, BUA less than one standard deviation below the mean was associated with low physical capability (defined as SPS 3–6); fully adjusted odds ratio (OR) (95 % confidence interval (CI)) 1.35 (1.01–1.84). No association existed among men; OR (95 % CI) 0.84 (0.59–1.19). Significant risk factors for low physical capability in men with baseline low BUA were: older age [OR 5.77]; high BMI [OR 2.85]; lower social class [OR 1.59]; low physical activity [OR 1.64]. Risk factors among women were: older age [OR 5.54]; high BMI [OR 2.08]; lower education [OR 1.42], low physical activity [OR 1.27]; steroid use [OR 2.05]; and stroke [OR 2.74].ConclusionBUA may predict future physical capability in older adults. With further validation, BUA could stratify individuals at risk of deterioration in physical health.AbbreviationsBUAbroadband ultrasound attenuation;SPSsummary performance score2HCsecond health checkBMIbody mass indexSDstandard deviationORodds ratioCIconfidence intervalADLactivity of daily livingEPICEuropean Prospective Investigation into CancerCUBAcalcaneal ultrasound broadband attenuationDEXAdual energy X-ray absorptiometryTDITownsend Deprivation IndexHRThormone replacement therapy

AB - BackgroundCalcaneal ultrasound (broadband ultrasound attenuation – BUA), a marker of bone strength, may predict future physical capability and thus provide a strategy to identify individuals at risk of age-related deterioration of health. This study aims to determine if BUA can predict future physical capability among middle-aged and older adults.MethodsSummary performance scores (SPS), an objective quantification of physical capability, were devised using participants' measures of standing balance, gait speed and timed chair rises. Associations between BUA and SPS, measured at least six years apart, were investigated using univariable and multivariate sex-specific linear and logistic regression, adjusting for confounders.Results5893 participants were included. In men and women, for every five points lower BUA, there was a 0.2-point decrease in SPS. In women, BUA less than one standard deviation below the mean was associated with low physical capability (defined as SPS 3–6); fully adjusted odds ratio (OR) (95 % confidence interval (CI)) 1.35 (1.01–1.84). No association existed among men; OR (95 % CI) 0.84 (0.59–1.19). Significant risk factors for low physical capability in men with baseline low BUA were: older age [OR 5.77]; high BMI [OR 2.85]; lower social class [OR 1.59]; low physical activity [OR 1.64]. Risk factors among women were: older age [OR 5.54]; high BMI [OR 2.08]; lower education [OR 1.42], low physical activity [OR 1.27]; steroid use [OR 2.05]; and stroke [OR 2.74].ConclusionBUA may predict future physical capability in older adults. With further validation, BUA could stratify individuals at risk of deterioration in physical health.AbbreviationsBUAbroadband ultrasound attenuation;SPSsummary performance score2HCsecond health checkBMIbody mass indexSDstandard deviationORodds ratioCIconfidence intervalADLactivity of daily livingEPICEuropean Prospective Investigation into CancerCUBAcalcaneal ultrasound broadband attenuationDEXAdual energy X-ray absorptiometryTDITownsend Deprivation IndexHRThormone replacement therapy

KW - Physical capability

KW - Broadband ultrasound attenuation

KW - Bone strength

KW - Older adults

U2 - 10.1016/j.maturitas.2023.04.008

DO - 10.1016/j.maturitas.2023.04.008

M3 - Article

C2 - 37146366

VL - 173

SP - 7

EP - 15

JO - Maturitas

JF - Maturitas

SN - 0378-5122

ER -

Calcaneal broadband ultrasound attenuation predicts physical capability: EPIC-Norfolk prospective population-based study

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this