Bone Abstracts

Objectives: Postural balance and gait speed are risk factors for falls and hip fractures independent of bone mineral density (BMD). The standard risk assessment tool, FRAX, does however not include any estimate of fall risk. Identifying high-risk individuals correctly is be of great clinical importance why further improvement of FRAX would be clinically valuable. The primary aim of this study was to see if one-leg standing time, the maximum number of steps on a line or gait speed could improve the predictive ability of FRAX for hip fractures.

Material and methods: One-leg standing time with eyes open, the number of consecutive steps on a straight line without stepping beside and gait speed over 15+15 m the line, was measured at baseline in 351 women aged between 69 and 79 years. Fracture data for the following 10 years was obtained from health care registers.

Results: Gait speed was the most valuable addition to FRAX. If 5% hip fracture risk was used as cut-off, categorical NRI was 0.24. The area under curve (AUC) for the receiver operating characteristic (ROC) increased from 0.59 to 0.71 for hip fractures when gait speed was added to FRAX. The risk of a hip fracture was increased 8.3 if gait speed was <0.8 m/s compared to ≧0.8 m/s (HR 8.3, 95% CI 3.62–18.98). This HR was independent of FRAX-risk.

Conclusion: Gait speed could be a valuable addition to FRAX and it seems to be more valuable than tests of postural balance in that aspect.