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2010 | 64 | 1-2 | 16-21
Article title

Skeletal status in subjects with poor visual acuity in independent and institutionalized subjects

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Stan szkieletu u osób z niedowidzeniem mieszkających samodzielnie oraz w domach opieki
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AIM The aim of the study was to evaluate skeletal status in subjects with poor vision. MATERIAL AND METHODS Skeletal status was assessed in a group of subjects with poor visual acuity living independently in general community or institutionalized in a nursing home. A group of 91 subjects (47 females - 29 living independently and 18 from nursing home and 44 males - 19 and 25, respectively) were studied. Mean age was 61.3+/-16.8 y. in females and 61.4+/-10.9 y. in males. Binocular visual acuity was evaluated using a Snellen acuity chart. Skeletal status was assessed by dual-energy X-ray absorptiometry at the calcaneus and forearm using PIXI (Lunar, USA) which measures bone mineral density (BMD) and by quantitative ultrasound at hand phalanges using DBM Sonic 1200 (IGEA, Italy) measuring Amplitude-dependent Speed of Sound (Ad-SoS [m/s]). RESULTS Binocular visual acuity was 0.179+/-0.2 in females and 0.09+/-0.14 in males and was signifi cantly lower in males (p<0.01). A visual acuity did not correlate with skeletal variables in either of sexes and was signifi - cantly lower in males from nursing home in comparison to males living independently (p<0.001) what was not observed in females. Z-scores were used in order to obtain age-adjusted comparisons of skeletal variables between subjects living independently and in nursing home. In females Z-scores for forearm (-0.304+/-0.92 vs –1.044+/-0.74, p<0.01) and calcaneus (-0.017+/-0.97 vs –1.38+/-0.63, p<0.00001) were signifi cantly higher in individuals living independently than in nursing home, and Z-score for Ad-SoS did not diff er signifi cantly. In males no signifi cant diff erences in Z-scores were noted. CONCLUSION The results of the study suggest that in both genders fracture risk in institutionalized subjects may be increased; in females due to aff ected skeletal status, and in males as a consequence of poor vision.
CEL PRACY Celem pracy była ocena stanu szkieletu u osób z niedowidzeniem. MATERIAŁ I METODY Stan szkieletu oceniano w grupie osób żyjących samodzielnie oraz mieszkańców domów pomocy społecznej (DPS). Zbadano 91 osób (47 kobiet – 29 mieszkających samodzielnie i 18 z DPS -ów oraz 44 mężczyzn – odpowiednio 19 i 25). Średni wiek to 61,3+/-16,8 u kobiet i 61,4+/-10,9 lat u mężczyzn. Obuoczną ostrość wzroku badano przy pomocy tablicy Snellena. Badania szkieletu obejmowały pomiar densytometryczny przy pomocy dwuwiązkowej absorpcjometrii rentgenowskiej (DXA) pięty i przedramienia (Lunar, USA) oraz pomiar metodą ultradźwiękową paliczków dłoni DBM Sonic 1200 (IGEA, Italy), mierząc prędkość fali ultradźwiękowej zależnej od amplitudy (Amplitude-dependent Speed of Sound (Ad-SoS [m/s]). WYNIKI Obuoczna ostrość wzroku wyniosła 0,179+/-0,2 u kobiet i 0,09+/-0,14 u mężczyzn i była istotna statystycznie mniejsza u mężczyzn (p<0,01). Ostrość wzroku nie korelowała z parametrami szkieletowymi i była istotnie niższa u mężczyzn z DPS-ów w porównaniu do mężczyzn żyjących samodzielnie (p<0,001), czego nie zanotowano u kobiet. Z-score, jako parametr niezależący od wieku zastosowano dla porównania. U kobiet Z-score przedramienia (-0,304+/-0,92 versus –1,044+/-0,74, p<0,01) i pięty (-0,017+/-0,97 versus –1,38+/-0,63, p<0,00001) były istotnie wyższe u kobiet żyjących samodzielnie względem kobiet z DPS-ów, a Z-score dla Ad-SoS nie różnił się. U mężczyzn brak było różnic ze względu na miejsce zamieszkania. WNIOSKI Wyniki pracy sugerują, że u kobiet i mężczyzn żyjących w domach opieki społecznej ryzyko złamań może być zwiększone; u kobiet w wyniku zaburzeń szkieletu, a u mężczyzn w efekcie niedowidzenia.

Physical description
  • Dept. of Pathomorphology 3 Maja 13/15 Street, 41-800 Zabrze, Poland tel./ fax +48322714994,
  • Metabolic Bone Diseases Unit, Department and Clinic of Internal Diseases, Diabetology and Nephrology, Medical University of Silesia in Katowice
  • Department of Ophtalomology, Sosnowiec
  • Department of Nephrology, Hospital in Raciborz
  • KCR S.A., Warszawa
  • Department and Clinic of Pediatrics, Medical University of Silesia in Katowice
  • 1. Ivers R.Q., Optom B., Cumming R.G., Mitchell P, Attebo K. Visual impairment and falls in older adults: The Blue Mountains Eye Study. J Am Geriatr Soc 1998;46:58-64.
  • 2. Klein B.E.K., Klein R, Lee K.E. Cruickshanks KJ. Performance-based and self-assessed measures of visual function as related to history of falls, hip fractures, and measured gait time. Ophthamology 1998:105:160-164.
  • 3. Tinetti M.E., Williams T.F., Mayewski R. Fall risk index for elderly patients based on number of chronic disabilities. Am J Med 1986:80:429-434.
  • 4. Felson D.T., Anderson J.J., Hannan M.T., Milton R.C., Wilson P.W.F., Douglas P.K., Impaired vision and hip fracture. The Framingham Study. J Am Geriatr Soc 1989:37:495-500.
  • 5. Cummings S.R., Nevitt M.C., Browner WS. et al. Risk factors for hip fracture in white women. NEJM 1995;332:767-773.
  • 6. Dargent-Molina P., Favier F., Grandjean H. et al. Fall-related factors and risk of hip fracture: the EPIDOS prospective study. Lancet 1996:348:145-149.
  • 7. Ivers R.Q., Norton R., Cummings R.G., Butler M., Campbell A.J., Visual impairment and risk of hip fracture. Am J Epidemiol 2000;152:633-639.
  • 8. Lamourex E., Gadqil S., Pesudovs K., et al. The relationship between visual function, duration and main causes of vision loss and falls in older people with low vision. Graefes Arch Clin Exp Ophthtalmol 2010;248:527-33.
  • 9. Miazgowski T., Krzyzanowska-Swinarska B., Ogonowski J., Noworyta-Zietara M. Czy cukrzyca typu 2 predysponuje do osteoporotycznych złamań kości? Endokrynol Pol. 2008;59:224-9.
  • 10. National Osteoporosis Foundation. Osteoporosis: review of the evidence for prevention, diagnosis, and treatment and cost-eff ectiveness analysis. Osteoporos Int 1998;8(suppl.4):S1-S88.
  • 11. Pluijm S.M.F., Graafmans W.C., Bouter L.M., Lips P. Ultrasound measurements for the prediction of osteoporotic fractures in elderly people. Osteoporos Int 1999;9:550- 556.
  • 12. Drozdzowska B., Pluskiewicz W. The ability of quantitative ultrasound at the calcaneus to identify postmenopausal women with diff erent types of nontraumatic fractures. Ultrasound Med Biol 2002;28:1491-1497.
  • 13. Pluskiewicz W., Drozdzowska B. Ultrasound measurements of proximal phalanges in Polish early postmenopausal women. Osteoporos Int 1998;8:578-583.
  • 14. Wűster C, Albanese C, de Aloysio D et al. Phalangeal osteosonogrammetry study: age-related changes, diagnostic sensitivity, and discrimination power. J Bone Miner Res 2000;15:1603-1614.
  • 15. Mele R., Masci G., Ventura V., de Aloysio D., Bicocchi M., Cadossi R., Three-year longitudinal study with quantitative ultrasound at the hand phalanx in a female population. Osteoporos Int 1997;7:550- 557.
  • 16. March LM, Cameron ID, Cumming RG. et al. Mortality and morbidity after hip fracture: can evidence based clinical pathways make a diff erence. J Rheumatol 2000;27:2227-31.
  • 17. Sainz-Gomez C, Fernandez-Robredo P, Salinas-Alaman A. et al. Prevalence and causes of bilateral and visual impairment among institutionalized elderly people in Pamplona, Spain. Eur J Ophthalmol 2010;20:442-50.
  • 18. Damian J., Pastor-Barriuso R., Valderrama- Gama E. Factors associated with selfrated health in older people living in institutions. BMC Geriatr 2008;27:8-5.
  • 19. Zochling J., Sitoh Y.Y., Lau T.C. et al. Quantitative ultrasound of the calcaneus and falls risk in the institutionalized elderly: sex diff erences and relationship to vitamin D status. Osteoporos Int 2002;13:882- 887.
  • 20. Krieg M.A., Thiebaud D., Burckhardt P. Quantitative ultrasound of bone in institutionalized elderly women: a cross-sectional and longitudinal study. Osteoporos Int 1996;6:189-195.
  • 21. Schott A.M., Weill-Engerer S., Hans D., Duboef F., Delmas P.D., Meunier P.J. Ultrasound discriminates patients with hip fracture equally well as dual-energy X-ray absorptiometry and independently of bone mineral density. J Bone Miner Res 1995:10:243-9.
  • 22. Espallargues M., Sampietro-Colom L., Estrada M.D., Sola M., del Rio L., Setoain J. Identifying bone-mass-related risk factors for fracture to guide bone densitometry measurements: a systemic review of the literature. Osteoporos Int 2001;12:811-822.
  • 23. Berdeaux G, Brezin A.P., Fagnani F., Lafuma A., Mesbah M. Self-reported visual impairment and mortality: a French nationwide perspective. Ophthalmic Epidemiol 2007;14:80-7.
  • 24. Haran M.J., Cameron I.D., Ivers R.Q., et al. Eff ect on falls of providing single lens distance vision glasses to multifocal glasses wearers: VISIBLE randomised controlled trial. BMJ 2010;340:c2265.doi:10.1136/ bmj.c2265.
  • 25. Timmis M.A., Johnson L., Elliott D.B., Buckley J.G. Use of single-vision distance spectacles improves landing control during step descent in well-adapted multifocal lens-wearers. Invest Ophthalmol Vis Sci 2010;51(8):3903-8.
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