Ankle-brachial index, risk of clinical fractures, mortality and low bone mass in nursing home residents.

OBJECTIVE To assess whether the ankle-brachial index is related to functional impairment, clinical fractures and mortality in nursing home residents, and whether this effect is associated or not with low bone mass. PATIENTS AND METHODS Prospective, observational, non-interventional cohort study in non-dependent nursing home residents. The following determinations were made: BUN, creatinine, cholesterol, triglycerides, calcium, phosphorous 25-hydroxyvitamin D, parathyroid hormone and cystatin C in blood and microalbuminuria in urine. Bone mass was determined by measuring the peripheral densitometry of the calcaneus. The Katz Index of independence, the Tinetti Balance and Gait evaluation and functional tests were administered. The ankle-brachial index was measured and patients divided into three groups (ankle-brachial index > 1.40, 1.40-0.90, and < 0.90). Clinical fractures and general and vascular mortality were measured for 20 months. RESULTS Seventy-two patients were included. There was an inverse relationship between age and the ankle-brachial index (p = 0.022) but no association with bone mass, biochemical tests, clinical fractures and the degree of independence. There was increased mortality in patients with increased or reduced ABI. CONCLUSIONS An altered ankle-brachial index is a marker of vascular mortality in elderly nursing home residents.