Highlights
- •A high level of parathyroid hormone (PTH) was recently identified as a risk factor for falling.
- •High levels of parathyroid hormone had an independent negative association with both static and dynamic balance in this cross-sectional study.
- •Older persons with high concentrations of serum parathyroid hormone are more prone to lose their balance.
Abstract
Objectives
A high level of parathyroid hormone (PTH) was recently identified as a risk factor
for falling. As balance instability is one of the major risk factors for falls, we
aimed to investigate whether high PTH concentrations are associated with poor balance
in older persons.
Study design
Cross-sectional study with 127 community-dwelling older adults (75% female), aged
65–96 years, at the Falls and Fracture Clinic, Western Health-Sunshine Hospital, Melbourne,
Australia. Patients with clinical conditions that could affect balance (e.g. Meniere’s
disease), denosumab users, and those with advanced kidney failure were excluded.
Main outcome measures
We assessed dynamic balance by timed “up and go” (TUG)and four-square step tests,
and by gait parameters; and static balance by posturography on a force platform. Blood
tests provided values of PTH, vitamin D, calcium, albumin, and creatinine. Standard
questionnaires were applied to assess clinical condition, medications and nutritional
status, and to screen for depression.
Results
For dynamic balance, elevated PTH concentrations resulted in increased time to complete
the TUG test (β = 0.13; 95%CI: 0.01–0.26), indicating worse performance. For static
balance, increased PTH was associated with increased instability in the center of
pressure while standing with eyes closed on a hard surface (β = 0.38; 95%CI: 0.03–0.73).
Both models were controlled for vitamin D, renal function, nutritional and depressive
status, age, sex, and number of medications.
Conclusion
Increasing concentrations of PTH in this population of older persons had an independent
negative association with both static and dynamic balance, which could place them
at risk of falls. However, longitudinal studies are still required.
Keywords
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Article info
Publication history
Published online: December 20, 2018
Accepted:
December 19,
2018
Received in revised form:
December 9,
2018
Received:
October 16,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
