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.
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, ...). These exams will take half a day, with a two-year follow up (in which the participant will have to note new falls and new medical treatments)
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
218
several tests are given in each domain
routine analyses in rheumatology such blood count and 25OH-D
Looking for osteoporosis
University Hospital
Caen, France
Dr Alain Daragon
Rouen, France
Analysis of a global cognitive efficiency score Analysis of bone mineral density
MMS, MoCA
Time frame: on the inclusion day and two years after
Age
Time frame: on the inclusion day and over two years
Cognitive scores
Mainly tests of memory, attention and executive functions
Time frame: on the inclusion day and over two years
Fracture features
Location and severity
Time frame: on the inclusion day and over two years
Balance and walking parameters
Tinetti scale, TUG and dual-tasks
Time frame: on the inclusion day and over two years
handgrip force
using a dynamometer
Time frame: on the inclusion day and over two years
Daily life scales scores
Mainly IADL
Time frame: on the inclusion day and over two years
fear of falling
ABC-scale
Time frame: on the inclusion day and over two years
functional restrictions score
Lequesne score
Time frame: on the inclusion day and over two years
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Degree of depression
MADRS
Time frame: on the inclusion day and over two years
biological data
25OHD
Time frame: on the inclusion day and over two years
Dual-energy X-ray absorptiometry
bone mineral densitometry
Time frame: on the inclusion day and two years after