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
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 | |
| Publication status | Published - 1 Jul 2023 |
Bibliographical note
FundingThis 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.
Keywords
- Physical capability
- Broadband ultrasound attenuation
- Bone strength
- Older adults
Access to Document
- 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/)