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Age-related loss of proximal femoral strength in elderly men and women: the Age Gene/Environment Susceptibility Study--Reykjavik.

https://arctichealth.org/en/permalink/ahliterature128686
Source
Bone. 2012 Mar;50(3):743-8
Publication Type
Article
Date
Mar-2012
Author
T F Lang
S. Sigurdsson
G. Karlsdottir
D. Oskarsdottir
A. Sigmarsdottir
J. Chengshi
J. Kornak
T B Harris
G. Sigurdsson
B Y Jonsson
K. Siggeirsdottir
G. Eiriksdottir
V. Gudnason
J H Keyak
Author Affiliation
Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94143-0946, USA. thomas.lang@ucsf.edu
Source
Bone. 2012 Mar;50(3):743-8
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging - physiology
Bone Density - physiology
Disease Susceptibility
Female
Femur - physiology - radiography
Hip Fractures - etiology - physiopathology - radiography
Humans
Male
Sex Factors
Abstract
The risk of hip fracture rises rapidly with age, and is particularly high in women. This increase in fracture risk reflects both the age-related change in the risk of falling and decrements in the strength of the proximal femur. To better understand the extent to which proximal femoral density, structure and strength change with age as a function of gender, we have carried out a longitudinal analysis of proximal femoral volumetric quantitative computed tomographic (vQCT) images in men and women, analyzing changes in trabecular and cortical bone properties, and using subject-specific finite element modeling (FEM) to estimate changes in bone strength. In the AGES-Reykjavik Study vQCT scans of the hip were performed at a baseline visit in 2002-2006 and at a second visit 5.05±0.25 years later. From these, 223 subjects (111 men, 112 women, aged 68-87 years) were randomly selected. The subjects were evaluated for longitudinal changes in three bone variables assessed in a region similar to the total femur region quantified by DXA: areal bone mineral density (aBMD), trabecular volumetric bone mineral density (tBMD) and the ratio of cortical to total tissue volume (cvol/ivol). They were also evaluated for changes in bone strength using FEM models of the left proximal femur. Models were analyzed under single-limb stance loading (F(Stance)), which approximates normal physiologic loading of the hip, as well as a load approximating a fall onto the posterolateral aspect of the greater trochanter (F(Fall)). We computed five-year absolute and percentage changes in aBMD, tBMD, cvol/ivol, F(Fall) and F(Stance). The Mann-Whitney Test was employed to compare changes in bone variables between genders and the Wilcoxon Signed Rank Test was used to compare changes in bone strength between loading conditions. Multiple (linear) regression was employed to determine the association of changes in F(Fall) and F(Stance) with baseline age and five-year weight loss. Both men and women showed declines in indices of proximal femoral density and structure (aBMD: men -3.9±6.0%, women -6.1±6.2%; tBMD: men -14.8±20.3%, women -23.9±26.8%; cvol/ivol: men -2.6±4.6%, women -4.7±4.8%, gender difference: p
Notes
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PubMed ID
22178403 View in PubMed
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Do patients receive recommended treatment of osteoporosis following hip fracture in primary care?

https://arctichealth.org/en/permalink/ahliterature169346
Source
BMC Fam Pract. 2006;7:31
Publication Type
Article
Date
2006
Author
Robert J Petrella
Tim J Jones
Author Affiliation
Department of Family Medicine, Schulich School of Medicine, Faculty of Medicine and Dentistry, 1490 Richmond St London, Ontario, N6G 2M3, Canada. petrella@uwo.ca
Source
BMC Fam Pract. 2006;7:31
Date
2006
Language
English
Publication Type
Article
Keywords
Aftercare
Aged
Aged, 80 and over
Bone Density Conservation Agents - classification - therapeutic use
Calcitonin - therapeutic use
Calcium - therapeutic use
Dietary Supplements
Diphosphonates - therapeutic use
Drug Utilization - statistics & numerical data
Estrogen Replacement Therapy - utilization
Family Practice - standards
Female
Guideline Adherence - statistics & numerical data
Hip Fractures - etiology - prevention & control - rehabilitation
Humans
Male
Ontario
Osteoporosis - complications - drug therapy
Primary Health Care - standards
Rehabilitation Centers
Treatment Outcome
Vitamin D - therapeutic use
Abstract
Osteoporosis results in fractures and treatment of osteoporosis has been shown to reduce risk of fracture particularly in those who have had a history of fracture.
A prospective study was conducted using patients admitted to a hip fracture rehabilitation program at a large referral center to evaluate the use of treatments recommended for secondary prevention of osteoporotic fracture between September 1, 2001 and September 30, 2003. The frequency of medication use for the treatment of osteoporosis including estrogen replacement therapy, bisphosponates, calcitonin, calcium and vitamin D therapy was determined on admission, at 6 weeks post discharge and one year following discharge. All patients were discharged to the care of their family physician. All family physicians in the referral region received a copy of the Canadian Consensus recommendations for osteoporosis management 1-3 months prior to the study.
During the study period, 174 patients were enrolled and 121 completed all assessments. Fifty-seven family physicians were identified as caring for 1 or more of the study patients. Only 7 patients had previous BMD, only 5 patients had previously been prescribed a bisphosponate and 14 patients were taking calcium and/or vitamin D. All patients were prescribed 2500 mg calcium, 400 IU vitamin D and 5 mg residronate daily during rehabilitation and at discharge.Following discharge, a significant improvement was seen in all clinical indices of functional mobility, including the functional independence measure (FIM), walking distance, fear of falling score (FFS), and the Berg balance score (BBS). At six weeks a significant (p
Notes
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PubMed ID
16684358 View in PubMed
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[Economic expenditures of different intervention regimes in the prevention of hip fractures].

https://arctichealth.org/en/permalink/ahliterature200414
Source
Ugeskr Laeger. 1999 Sep 20;161(38):5327-8
Publication Type
Article
Date
Sep-20-1999

Evaluation of osteoporosis treatment in seniors after hip fracture.

https://arctichealth.org/en/permalink/ahliterature190351
Source
Osteoporos Int. 2002 Mar;13(3):205-10
Publication Type
Article
Date
Mar-2002
Author
A G Juby
C M De Geus-Wenceslau
Author Affiliation
Department of Medicine, University of Alberta Hospital, Edmonton, Canada. ajuby@cha.ab.ca
Source
Osteoporos Int. 2002 Mar;13(3):205-10
Date
Mar-2002
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Calcium - administration & dosage
Canada
Chi-Square Distribution
Diagnostic Errors
Diphosphonates - administration & dosage
Female
Hip Fractures - etiology - rehabilitation
Humans
Male
Osteoporosis - complications - diagnosis - drug therapy
Retrospective Studies
Vitamin D - administration & dosage
Abstract
A retrospective chart review was carried out on all consecutive patients over 65 years of age admitted to a tertiary care teaching hospital with a diagnosis of a new hip fracture. A further chart review occurred after discharge from post-surgery rehabilitation. The primary objective was to evaluate the prevalence of osteoporosis diagnosis and treatment in both phases of the study. Secondary objectives included evaluation of the mortality rates, length of stay, prevalence of osteoporosis investigation, and prevalence of osteoporosis diagnosis based on the clinical subspecialty involved. There were 311 patients evaluated in the initial phase, and 226 after rehabilitation. The mortality rate was 5.8% (10% for men, 4% for women; p
PubMed ID
11991439 View in PubMed
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Excessive dietary intake of vitamin A is associated with reduced bone mineral density and increased risk for hip fracture.

https://arctichealth.org/en/permalink/ahliterature61869
Source
Ann Intern Med. 1998 Nov 15;129(10):770-8
Publication Type
Article
Date
Nov-15-1998
Author
H. Melhus
K. Michaëlsson
A. Kindmark
R. Bergström
L. Holmberg
H. Mallmin
A. Wolk
S. Ljunghall
Author Affiliation
University Hospital, Uppsala, Sweden. Hakan.Melhus@medicin.uu.se
Source
Ann Intern Med. 1998 Nov 15;129(10):770-8
Date
Nov-15-1998
Language
English
Publication Type
Article
Keywords
Adult
Aged
Bone Density - drug effects
Case-Control Studies
Confounding Factors (Epidemiology)
Cross-Sectional Studies
Diet
Female
Food Habits
Hip Fractures - etiology
Humans
Linear Models
Middle Aged
Multivariate Analysis
Osteoporosis - complications - physiopathology
Questionnaires
Vitamin A - adverse effects
Abstract
BACKGROUND: The highest incidence of osteoporotic fractures is found in northern Europe, where dietary intake of vitamin A (retinol) is unusually high. In animals, the most common adverse effect of toxic doses of retinol is spontaneous fracture. OBJECTIVE: To investigate whether excessive dietary intake of vitamin A is associated with decreased bone mineral density and increased risk for hip fracture. DESIGN: A cross-sectional study and a nested case-control study. SETTING: Two counties in central Sweden. PARTICIPANTS: For the cross-sectional study, 175 women 28 to 74 years of age were randomly selected. For the nested case-control study, 247 women who had a first hip fracture within 2 to 64 months after enrollment and 873 age-matched controls were selected from a mammography study cohort of 66,651 women 40 to 76 years of age. MEASUREMENTS: Retinol intake was estimated from dietary records and a food-frequency questionnaire. Bone mineral density was measured with dual-energy x-ray absorptiometry. Hip fracture was identified by using hospital discharge records and was confirmed by record review. RESULTS: In multivariate analysis, retinol intake was negatively associated with bone mineral density. For every 1-mg increase in daily intake of retinol, risk for hip fracture increased by 68% (95% CI, 18% to 140%; P for trend, 0.006). For intake greater than 1.5 mg/d compared with intake less than 0.5 mg/d, bone mineral density was reduced by 10% at the femoral neck (P = 0.05), 14% at the lumbar spine (P = 0.001), and 6% for the total body (P = 0.009) and risk for hip fracture was doubled (odds ratio, 2.1 [CI, 1.1 to 4.0]). CONCLUSION: High dietary intake of retinol seems to be associated with osteoporosis.
Notes
Comment In: Ann Intern Med. 1999 Sep 7;131(5):39210475894
PubMed ID
9841582 View in PubMed
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Excess mortality following hip fracture: impact of self-perceived health, smoking, and body mass index. A NOREPOS study.

https://arctichealth.org/en/permalink/ahliterature291349
Source
Osteoporos Int. 2017 Mar; 28(3):881-887
Publication Type
Journal Article
Date
Mar-2017
Author
S M Solbakken
H E Meyer
H Stigum
A J Søgaard
K Holvik
J H Magnus
T K Omsland
Author Affiliation
Institute of Health and Society, Department of Community Medicine, University of Oslo, PO Box 1130 Blindern, N-0318, Oslo, Norway. s.m.solbakken@studmed.uio.no.
Source
Osteoporos Int. 2017 Mar; 28(3):881-887
Date
Mar-2017
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Body mass index
Case-Control Studies
Cohort Studies
Databases, Factual
Female
Health status
Hip Fractures - etiology - mortality
Humans
Male
Middle Aged
Norway - epidemiology
Osteoporotic Fractures - etiology - mortality
Risk factors
Self Concept
Sensitivity and specificity
Smoking - mortality
Survival Analysis
Abstract
Self-perceived health, smoking, and body mass index measured years before the hip fracture predicted excess post-hip fracture mortality, and even hip fracture patients with the most favorable levels of these risk factors had higher mortality than subjects who did not fracture.
This study aimed to investigate the impact of pre-fracture self-perceived health, smoking, and body mass index (BMI) on excess post-hip fracture mortality using matched peers without hip fracture as reference.
The study was based on the Cohort of Norway (CONOR) consisting of 10 regional health studies (1994-2003) and the NOREPOS hip fracture database (1994-2008). A matched cohort design was used to compare survival between hip fracture patients and subjects without fracture (matched on gender, age at participation in CONOR, and study site). Subjects aged =60 years were included. Hazard ratios were estimated using stratified Cox regression. Age-standardized mortality was also calculated.
Overall, hip fracture patients (N = 3177) had a 2.26-fold (95 % CI 2.13, 2.40) increased mortality compared to matched subjects (N = 20,282). The highest excess mortality was found in hip fracture patients reporting poor health (HR 4.08, 95 % CI 3.17, 5.26) and daily smoking (HR 3.25, 95 % CI 2.89, 3.66) and in patients with BMI
Notes
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PubMed ID
27714442 View in PubMed
Less detail

Factors associated with mortality after hip fracture.

https://arctichealth.org/en/permalink/ahliterature72160
Source
Osteoporos Int. 2000;11(3):228-32
Publication Type
Article
Date
2000
Author
H E Meyer
A. Tverdal
J A Falch
J I Pedersen
Author Affiliation
National Health Screening Service, Oslo, Norway. haameyer@online.no
Source
Osteoporos Int. 2000;11(3):228-32
Date
2000
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Case-Control Studies
Female
Hand Strength
Hip Fractures - etiology - mortality
Humans
Male
Mental Competency
Norway - epidemiology
Osteoporosis - complications
Risk factors
Skinfold thickness
Abstract
There is a well-known excess mortality subsequent to hip fracture, which is probably restricted to subgroups of hip fracture patients with reduced health status. We studied the association between risk factors and death in 248 hip fracture patients and 248 controls originally enrolled in a population-based case-control study. This cohort was followed for 3 1/2 years with respect to total mortality. A markedly increased mortality was found in hip fracture patients passing a mental status test at a low score [relative risk (RR) = 2.3, 95% confidence interval (CI) 1.4-3.7], in hip fracture patients reporting two or more selected chronic diseases (RR = 3.3, 95% CI 1.8-6.1), in hip fracture patients not walking outdoors before the fracture (RR = 3.2, 95% CI 2.0-5.1) and in hip fracture patients in the lower half of handgrip strength distribution (RR = 2.3, 95% CI 1.6-3.4), all compared with the control group. In contrast, hip fracture patients without these risk factors did not have increased mortality compared with the control group. This study suggests that otherwise healthy and fit patients do not have increased mortality subsequent to hip fracture. The excess mortality is restricted to persons with reduced mental status, reduced somatic health and low physical ability. Special attention should be paid to patients with such risk factors in the treatment and rehabilitation period.
Notes
Comment In: Osteoporos Int. 2001;12(6):516-711446569
PubMed ID
10824238 View in PubMed
Less detail

Factors predisposing to periprosthetic fracture after hip arthroplasty: a case (n = 31)-control study.

https://arctichealth.org/en/permalink/ahliterature181086
Source
Acta Orthop Scand. 2004 Feb;75(1):16-20
Publication Type
Article
Date
Feb-2004
Author
Roope Sarvilinna
Heini S A Huhtala
Roope T Sovelius
Pekka J Halonen
Juha K Nevalainen
K Jorma K Pajamäki
Author Affiliation
Medical School, University of Tampere, Tampere, Finland. sarvilinna@yahoo.com
Source
Acta Orthop Scand. 2004 Feb;75(1):16-20
Date
Feb-2004
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - adverse effects
Body mass index
Case-Control Studies
Female
Finland
Hip Fractures - etiology - surgery
Hip Prosthesis - adverse effects
Humans
Joint Diseases - complications - surgery
Male
Middle Aged
Postoperative Complications
Reoperation - adverse effects
Risk factors
Sex Factors
Abstract
We compared retrospectively 31 patients with a periprosthetic fracture to 31 patients in a control group. The Finnish Arthroplasty Register was used to count all periprosthetic fractures treated by revision arthroplasty in Finland and in Tampere University Hospital district during the years 1990-1999. We used the date of the previous operation to find the control group patients operated on at the same time in the same hospital district. No other selection or matching criteria were used. The type of prosthesis, complications, age, BMI, cementation and primary diagnosis were compared. We found that patients who had a fracture as the primary diagnosis ran a 4.4 (95%CI = 1.4-14) times higher risk of periprosthetic fracture than those operated on for other reasons.
PubMed ID
15022800 View in PubMed
Less detail
Source
Ugeskr Laeger. 1993 May 17;155(20):1521-2
Publication Type
Article
Date
May-17-1993
Author
M. Schroll
Source
Ugeskr Laeger. 1993 May 17;155(20):1521-2
Date
May-17-1993
Language
Danish
Publication Type
Article
Keywords
Accidental Falls - statistics & numerical data
Aged
Denmark - epidemiology
Female
Femoral Neck Fractures - etiology - prevention & control
Hip Fractures - etiology - prevention & control
Humans
Male
Notes
Comment On: Ugeskr Laeger. 1991 Aug 26;153(35):2427-91688366
PubMed ID
8316981 View in PubMed
Less detail

Fall scenarios In causing older women's hip fractures.

https://arctichealth.org/en/permalink/ahliterature120432
Source
Scand J Occup Ther. 2013 Jan;20(1):21-8
Publication Type
Article
Date
Jan-2013
Author
Mona-Lisa Hägvide
Tore J Larsson
Lena Borell
Author Affiliation
Tallhöjden Health Care Clinic, Center for Family and Community Medicine, Huddinge, Sweden. mona-lisa.hagvide@sll.se
Source
Scand J Occup Ther. 2013 Jan;20(1):21-8
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Accidental Falls - prevention & control
Aged
Aged, 80 and over
Architecture as Topic
Environmental Monitoring - methods
Female
Hip Fractures - etiology - prevention & control - rehabilitation
Humans
Interior Design and Furnishings
Middle Aged
Occupational Therapy - methods
Risk factors
Sweden
Abstract
Falls and fall-related injuries among older women constitute a major public health problem with huge costs for the society and personal suffering. The aim of this study was to describe and illustrate how a number of circumstances, conceptualized as a scenario, that were related to the individual, the environment, and the ongoing occupation contributed to a fall that led to a hip fracture among women. The sample included 48 women over 55 years old.
Interviews were conducted during home visits and the analysis provided a descriptive picture of circumstances in the shape of a scenario related to the risk of falling. A number of scenarios were developed based on the data and named to provide an understanding of the interplay between the individual, the environment, and the ongoing occupation at the time of the fall.
By applying the concept of a scenario, occupational therapists can increase the awareness of fall risks among older people, and are relevant also for interior designers, architects, and town planners to consider when designing the local environment as well as furniture and other objects.
PubMed ID
23003676 View in PubMed
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41 records – page 1 of 5.