Impact of non-hip fractures in elderly women: a narrative review

Introduction Studies show trabecular bone score (TBS) may provide information regarding bone quality independent of bone mineral density (BMD) in type 2 diabetes (DM2) patients. We analyzed our Southeast Asian severe osteoporotic hip fracture patients to study these differences. Methods We conducted a retrospective cross-sectional analysis of subjects admitted to Changi General Hospital, Singapore with severe osteoporotic hip fractures from 2014–2017 who had BMD performed. Electronic records were reviewed and subjects were classified as having diabetes according to the WHO 2019 criteria. DM2 patients were classified according to their HbA1c into well controlled (HbA1c < 7%) and poorly controlled (HbA1c ≥ 7%) DM2. Results Elderly patients with hip fractures present with average femur neck T scores at the osteoporotic range, however those with DM2 had higher BMD and TBS values compared to non DM2 patients. These differences were statistically significant in elderly women—poorly controlled elderly DM2 women with hip fracture had the highest total hip T-score (-2.57 ± 0.86) vs (-2.76 ± 0.96) in well controlled DM2 and (-3.09 ± 1.01) in non DM2 women with hip fracture, p < 0.001. In contrast, TBS scores were lower in poorly controlled DM2 women with hip fracture compared to well controlled DM2 women with hip fracture (1.22 ± 0.11) vs (1.24 ± 0.09), but these were still significantly higher compared to non DM2 women with hip fracture (1.19 ± 0.10), p < 0.001. In elderly men with hip fractures, univariate analysis showed no statistically significant differences in TBS or hip or LS BMD between those with poorly controlled DM2, well controlled DM2 and non DM2. The differences in TBS and BMD remained significant in all DM2 women with hip fractures even after adjustments for potential confounders. Differences in TBS and BMD in poorly controlled DM2 men with hip fractures only became significant after accounting for potential confounders. However, upon inclusion of LS BMD into the multivariate model these differences were attenuated and remained significant only between elderly women with well controlled DM2 and non DM2 women with hip fractures. Conclusions Elderly patients with DM2 and severe osteoporosis present with hip fractures at a higher BMD and TBS values compared to non DM2 patients. These differences were significant after adjustment for confounders in all DM2 women and poorly controlled DM2 men with hip fractures, TBS differences were attenuated with the inclusion LS BMD. Further studies are needed to ascertain differences in BMD and TBS in older Southeast Asian DM2 patients with variable glycemic control and severe osteoporosis.

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Treated knitted fabric for hip protective pads for elderly women. Part II. Performance relevant to thermal comfort

Textile Research Journal ◽

10.1177/0040517519845687 ◽

2019 ◽

Vol 89 (23-24) ◽

pp. 5006-5013 ◽

Cited By ~ 1

Author(s):

Wiah Wardiningsih ◽

Olga Troynikov

Keyword(s):

Thermal Comfort ◽

Hip Fractures ◽

Isopropyl Alcohol ◽

Elderly Women ◽

Treatment Method ◽

Closed Cell ◽

Spacer Fabric ◽

Spacer Fabrics ◽

Tetraisopropyl Titanate ◽

Cell Foam

This paper describes Part II of a study of hip protective pads made from spacer fabric treated with shear thickening fluid (STF). Hip fractures are a substantial contributor to morbidity and mortality in the elderly, and incidence is rising worldwide. Hip protective pads reduce fractures, but wearing adherence is poor. Pads made from breathable and comfortable fabrics can increase adherence and prevent more hip fractures. In this research, warp-knitted spacer fabrics were treated with STF using one of two methods. Treatment I involved STF and room temperature vulcanizing (RTV) silicone, while treatment II consisted of STF and a mixture of isopropyl alcohol and tetraisopropyl titanate. In Part I, STF-treated knitted spacer fabric was shown to have significantly greater force attenuation capacity than untreated fabric and comparable to force attenuation capacity of closed cell foam. In Part II, the effects on performance relevant to the thermal comfort of the wearer of each treatment method, the amount of STF used, and layering were assessed using a sweating guarded hot plate, and comparisons made between treated fabrics and with closed cell foam. Treatments I and II produced pads with significantly different permeability index and mass compared to closed cell foam. Treatment II produced pads with high force attenuation capacity, suitable permeability indexes, and low mass – preferred characteristics in hip protective pads. The study concluded that knitted spacer fabrics treated with STF, isopropyl alcohol, and tetraisopropyl titanate are potentially useful materials for hip protective pads.

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