Falls With Fracture : Role of Cognitive Disorders and Comparison With Bone Fragility
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University Hospital, Caen
- Enrollment
- 218
- Locations
- 4
- Primary Endpoint
- Analysis of a global cognitive efficiency score Analysis of bone mineral density
Study Overview
Brief Summary
The purpose of this study is to determine whether cognitive disorders are a risk factor for a fracture after a fall independently of a bone fragility.
Detailed Description
The fall is a major problem in the elderly. After 65 year old, falls represent 84% of daily living accidents and almost half of the post fall injuries are fractures (Ricard and Thélot, 2007). These falls with fracture lead to a loss of autonomy and a high health cost. Their prevention is a crucial focus of research.
Even if it is obvious that subjects with osteoporosis have a higher risk of fracture than those with a normal bone mineral density, recent studies have shown that most victims of fracture post-fall do not comply with the densitometric definition of osteoporosis.
It is well established that the presence of cognitive disorders, frequent in the elderly, is an important risk factor for falls; It might also be a risk factor for fracture after a fall with an unadapted postural or balance control.
The investigators will test this hypothesis on 150 victims of fracture (upper or lower limb) consecutive to a fall from standing height, recruited in the hospitals of Caen and Rouen (France) in the context of their medical follow-up (with blood and dual energy x-ray absorptiometry [DXA] exams). These patients will be matched to 150 control participants (victims of a fall with no fracture, submitted to the same exams).
All the participants are subjects to an in-depth study of cognitive functions, postural and walking tests and to various scales (daily life activities, depression, ...).
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Basic Science
- Masking
- None
Eligibility Criteria
- Ages
- 55 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Affiliation to the social security system
- •For subjects with fracture : victim of a low-energy fracture of the upper or lower limb that was consecutive to a fall from standing height, and who has accepted to realize a DXA exam in the context of the medical follow-up
- •For control subjects : victim of a fall from standing height, with no fracture, matched in terms of age, sex, socio-cultural level and living space with subjects with fracture.
- •Written informed consent
Exclusion Criteria
- •Subject who is deprived of liberty, under supervision or legal guardianship
- •Pathology affecting balance (Parkinson's disease, after-effects of stroke, ...)
- •Important visual impairment : age-related macular degeneration, ...
- •Depressed state
- •Important consumption of alcohol (> 14 drinks per week for women / >21 for men)
- •Subject who is concurrently participating in another clinical study (unless prior notice of the principal investigator)
- •Fall has been caused by a third party (e.g. : pushing), is not from standing height (e.g. : fall from a ladder); fracture is not a low-energy one (e.g. : further a fall during running)
- •For subjects with fracture :
- •The fracture is not consecutive to a fall
- •The fracture is pathological, beyond osteoporosis (e.g. : bone metastases)
- •The last fall responsible for a fracture goes back more than 6 months
- •For control subjects :
- •o The fall goes back more than 12 months
- •The fall has led to a medical consultation
Outcomes
Primary Outcomes
Analysis of a global cognitive efficiency score Analysis of bone mineral density
Time Frame: on the inclusion day and two years after
MMS, MoCA
Secondary Outcomes
- Age(on the inclusion day and over two years)
- Cognitive scores(on the inclusion day and over two years)
- Fracture features(on the inclusion day and over two years)
- fear of falling(on the inclusion day and over two years)
- functional restrictions score(on the inclusion day and over two years)
- Balance and walking parameters(on the inclusion day and over two years)
- handgrip force(on the inclusion day and over two years)
- Daily life scales scores(on the inclusion day and over two years)
- biological data(on the inclusion day and over two years)
- Dual-energy X-ray absorptiometry(on the inclusion day and two years after)
- Degree of depression(on the inclusion day and over two years)