Among older adults, distal radius fractures (DRF) are a common injury usually sustained after falling on an outstretched hand. Past studies have shown that adults with low bone mineral density, associated with malnutrition, are at a higher risk for DRF, and likewise, those with a previous DRF are at a higher risk for subsequent falls. Thus, this retrospective cohort study attempts to bridge the relationship between nutritional status and outcomes after DRF in older adults.
- The prevalence for malnutrition in the older adult population is generally between 13.5-17.9%
- 229 participants were enrolled. Participants were 65+ years old who underwent surgical treatment and rehabilitation after a DRF, and they were placed into the malnutrition or nutrition group based upon their nutritional score on the Geriatric Nutritional Risk Index (GNRI)
- 198 adults were placed in the normal nutrition group and 31 adults were placed in the malnutrition group
- GNRI was calculated based on the level of serum albumin relative to each participant’s body weight.
- Functional outcomes for performing and activities of daily living (ADL’s) and wrist function were measured using the Barthel Index (BI) and Mayo wrist score.
- Those in the malnutrition group had a lower functional status (BI score), greater number of subsequent falls, and greater degree of post-surgical complications compared to the normal group at 1 year follow-up.
- Nutritional status (GNRI) was significantly correlated to the number of subsequent falls and level of functional gains made (BI efficacy), and serum albumin levels additionally have the ability to determine the probability of subsequent falls.
- No relationship was significantly found relating to wrist function (Mayo wrist score)
- Bone mineral density was not significantly correlated to any of the outcome measures; however, researchers hypothesize that this may be due to the high proportion of participants who were taking medication to address decreased BMD prior to this study.
From this study, we can conclude that nutritional status, as determined by serum albumin levels, plays a role in the functional outcomes and risk of subsequent falls for older adults who have sustained a distal radius fracture. Serum albumin is important in maintaining muscle synthesis and skeletal muscle mass, and researchers hypothesize that the effects of low albumin levels lead to decreased balance and walking ability thus resulting in greater risk for falls. At Physical Therapy First, your physical therapist can discuss ways to incorporate nutrition and create an individualized falls avoidance program to initiate a safe exercise plan that can improve your balance, improve your walking ability, and increase your strength.
Nagai T, Tanimoto K, Tomizuka Y, Uei H, Nagoaka M. Nutrition status and functional prognosis among elderly patients with distal radius fracture: a retrospective cohort study. Journal of Orthopaedic Surgery and Research 2020; 15(133): 1-7.