Background: This study evaluated the variability of physical performance and risk of fall in elderly women affected by severe osteoporosis and hypovitaminosis D. Falls are quite frequent in the eldest and are a key factor for morbility and mortality so that 72% of all deceases due to falls are related to elderly people.
Methods: We have studied women ≥75. 32 were affected by severe osteoporosis with vertebral fractures (mean number 1.4) and hypovitaminosis D (mean value 25-idrossicolecalciferol 18 ng/ml). Subjects were treated with Denosumab 60 mg and calcifediol 1.5 mg. The design of the study included at T0-T24:1) spine and hip DEXA densitometry; 2) spine X-ray with morphometry; 3) Blood tests (Calcium, Vitamin D,Parathormone); 4) Short Physical Performance Battery; 5) Tinetti balance and gait Scale (TS). The Short Physical Performance Battery (SPPB) combines a balance test following 3 different positions on increasing difficulty, a 4-metre walking path and a repeated stand-up exercise from a chair. Self-sufficient elderly subject, with reduced physical performance and with a score between 5 and 9 can be considered frail and at high risk of disability. The Tinetti Scale is a predictive index for falls that catalogues subjects according to the following scores: ≤1 nonwalking people; 2 < 19 walking people with a high risk of fall; ≥20 walking people with a low risk of fall. Cognitive functions were assessed through MMSE whose score was adapted to age and grade of education. Comorbidity was also evaluated.
Results: At T0 we considered:1)Short Physical Performance Battery Geriatric, mean score 7 in 76.7% subjects (p<0.05);2)Tinetti balance and gait scale:mean score 8 (higt risk of fall) 85.2% subjects (p<0.5);mean score 1 (non walking) 14.8% subjects (p<0.5). At T12 we evaluated:1) Short Physical Performance Battery, mean score 9 in 63.6% subjects (p<0.05);2) Tinetti balance and gait scale, mean score 14 (high risk of fall) 91.7% subjects (p<0.5), mean score 1 (non walking) 8.3% subjects (p<0.5). At T12 in all subjects we also detected no new vertebral fractures through spine X-rays and morphometry.
Conclusion: The study evaluated the incidence of vertebral fractures in the spine region in elderly women affected by severe osteoporosis and hypovitaminosis D. Since a reduced physical performance and an increase in the risk of fall indicate fraility in the elderly affected by severe osteoporosis and hypovitaminosis D, we evaluated, after Denosumab treatment, the variations in the severity markers.
Disclosure: The authors declared no competing interests.