Serum Parathyroid Hormone Levels Predict Falls in Older Adults with Diabetes Mellitus

Authors

  • Denise K. Houston PhD,

    1. From the *Sticht Center on Aging††Department of Cancer Biology, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee#Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MarylandClinical Research Branch, National Institute on Aging, Baltimore, Maryland**Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
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  • Ann V. Schwartz PhD,

    1. From the *Sticht Center on Aging††Department of Cancer Biology, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee#Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MarylandClinical Research Branch, National Institute on Aging, Baltimore, Maryland**Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
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  • Jane A. Cauley DrPH,

    1. From the *Sticht Center on Aging††Department of Cancer Biology, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee#Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MarylandClinical Research Branch, National Institute on Aging, Baltimore, Maryland**Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
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  • Frances A. Tylavsky DrPH,

    1. From the *Sticht Center on Aging††Department of Cancer Biology, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee#Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MarylandClinical Research Branch, National Institute on Aging, Baltimore, Maryland**Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
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  • Eleanor M. Simonsick PhD,

    1. From the *Sticht Center on Aging††Department of Cancer Biology, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee#Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MarylandClinical Research Branch, National Institute on Aging, Baltimore, Maryland**Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
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  • Tamara B. Harris MD,

    1. From the *Sticht Center on Aging††Department of Cancer Biology, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee#Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MarylandClinical Research Branch, National Institute on Aging, Baltimore, Maryland**Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
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  • Nathalie De Rekeneire MD,

    1. From the *Sticht Center on Aging††Department of Cancer Biology, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee#Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MarylandClinical Research Branch, National Institute on Aging, Baltimore, Maryland**Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
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  • Gary G. Schwartz PhD,

    1. From the *Sticht Center on Aging††Department of Cancer Biology, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee#Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MarylandClinical Research Branch, National Institute on Aging, Baltimore, Maryland**Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
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  • Stephen B. Kritchevsky PhD,

    1. From the *Sticht Center on Aging††Department of Cancer Biology, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee#Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MarylandClinical Research Branch, National Institute on Aging, Baltimore, Maryland**Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
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  • for the Health, Aging and Body Composition Study

    1. From the *Sticht Center on Aging††Department of Cancer Biology, Wake Forest University, Winston-Salem, North CarolinaDepartment of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CaliforniaDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee#Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MarylandClinical Research Branch, National Institute on Aging, Baltimore, Maryland**Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
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  • Portions of this work were presented in abstract form at the Gerontological Society of America Annual Meeting, Dallas, Texas, November 18, 2006.

Address correspondence to Denise K. Houston, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157. E-mail: dhouston@wfubmc.edu

Abstract

OBJECTIVES: To examine the association between serum parathyroid hormone (PTH) levels and incident falls in older adults with diabetes mellitus.

DESIGN: Longitudinal analysis of incident falls over 1 year in a substudy of participants with diabetes mellitus in the Health, Aging and Body Composition Study.

SETTING: Pittsburgh, Pennsylvania, and Memphis, Tennessee.

PARTICIPANTS: Well-functioning, community-dwelling black and white adults aged 70 to 79 with diabetes mellitus (N=472).

MEASUREMENTS: Measured baseline serum PTH. Self-report of falls over the subsequent 12 months. Baseline physical performance and self-reported demographic, behavioral, and health status measures including kidney function, chronic conditions, and medication use.

RESULTS: One-third (30.3%) of participants reported falling over 1 year of follow-up. Mean baseline serum PTH was 53.5±30.0 pg/mL in nonfallers and 62.6±46.2 pg/mL in fallers (P=.01). For every 1 standard deviation (36 pg/mL) increment in baseline serum PTH, there was approximately a 30% greater likelihood of reporting a fall in the subsequent year, after adjusting for age, sex, race, field center, alcohol consumption, body mass index, physical activity, and winter or spring season (adjusted odds ratio (aOR)=1.30, 95% confidence interval (CI)=1.06–1.59). Further adjustment for kidney function, chronic conditions, medication and supplement use, and physical performance attenuated the association slightly (aOR=1.26, 95% CI=1.01–1.58). A trend remained after additional adjustment for reported falls in the previous year.

CONCLUSION: Higher serum PTH was associated with incident falls in older, well-functioning men and women with diabetes mellitus. Further investigation aimed at understanding the underlying mechanism for the association between serum PTH and falls is needed.

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