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Fragility and elderly and exercise

Wing-Hoi Cheung, Wan-Yiu Shen, David Lok-Kwan Dai, Kin Bong Lee, Tracy Y Zhu, Ronald Man-Yeung Wong, Kwok-Sui Leung
OBJECTIVE: To investigate the effectiveness and cost of an 18-month multi-disciplinary Comprehensive Fragility Fracture Management Program (CFFMP) for fragility hip fracture patients. DESIGN: Prospective cohort study. PATIENTS: Elderly patients with hip fracture were recruited at their first postoperative follow-up in 2 district hospitals. The intervention group comprised patients from the hospital undergoing CFFMP, and the control group comprised patients from another hospital undergoing conventional care...
February 28, 2018: Journal of Rehabilitation Medicine
Takayuki Tsuda
Fragility fractures in the elderly is an ongoing concern for orthopaedic surgeons. A 50-year-old woman has a 40% chance of having a vertebral compression fracture in her lifetime. The incidence of vertebral fractures, reported to be more than 10 times higher than that of femoral fractures, is estimated as 1-1.5 million per year in Japan. Vertebral fractures often occur without a fall, whereas the majority of nonvertebral fractures are the consequence of falls; the site of the nonvertebral fracture appears to be dictated by the type of fall...
November 2017: Current Orthopaedic Practice
Blanka Koščak Tivadar
Good cognitive abilities (CA) enable autonomy, improve social inclusion and act preventively. Regular physical activity (PA) reduces the risk of developing Alzheimer's disease (AD) and, at the same time, it reduces the decline of CA and stimulates neurogenesis. So PA in connection with cognitive training, nutrition and social interaction has a positive effect on general CA and the central nervous system, the central executor, memory and attention, and reduces the likelihood of developing dementia. Our objective was to examine which sort and intensity of PA is preferred...
May 10, 2017: Biogerontology
Sumit Kane, Matilda Rial, Anthony Matere, Marjolein Dieleman, Jacqueline E W Broerse, Maryse Kok
BACKGROUND: In South Sudan, women disproportionately bear the burden of morbidity and mortality related to sexual and reproductive health, with a maternal mortality ratio of 789 deaths per 100,000 live births. DESIGN: A qualitative study was conducted to analyze how gendered social relations among the Fertit people affect women's ability to exercise control over their reproductive lives and thereby their sexual and reproductive health. Transcripts of 5 focus group discussions and 44 semi-structured interviews conducted with purposefully selected community members and health personnel were analyzed using Connell's relational theory of gender...
2016: Global Health Action
Richard Eastell, Terence W O'Neill, Lorenz C Hofbauer, Bente Langdahl, Ian R Reid, Deborah T Gold, Steven R Cummings
Osteoporosis is a metabolic bone disorder that is characterized by low bone mass and micro-architectural deterioration of bone tissue. Fractures of the proximal femur, the vertebrae and the distal radius are the most frequent osteoporotic fractures, although most fractures in the elderly are probably at least partly related to bone fragility. The incidence of fractures varies greatly by country, but on average up to 50% of women >50 years of age are at risk of fractures. Fractures severely affect the quality of life of an individual and are becoming a major public health problem owing to the ageing population...
September 29, 2016: Nature Reviews. Disease Primers
Zahra Alsadat Hejazi, Forough Namjooyan, Marjan Khanifar
BACKGROUND: A systemic skeletal disease is characterized by low bone mass and micro-architectural deterioration with a consequent increase in bone fragility and susceptibility to fracture. Asia has the highest increment in the elderly population; therefore, osteoporotic fracture should be a noticeable health issue. The incidence rate of hip fractures in Asia could rise to 45% by the year 2050. Complementary and alternative medicine (CAM) is a group of various medical and health care systems, practices, and products that are not presently considered as part of formal medicine...
May 2016: Iranian Journal of Medical Sciences
André J Scheen
INTRODUCTION: Inhibitors of sodium-glucose cotransporters type 2 (SGLT2) offer a new opportunity for the management of type 2 diabetes mellitus. These agents reduce hyperglycemia by decreasing the renal glucose threshold and thereby increasing urinary glucose excretion. Subsequent reduction of glucotoxicity improves beta-cell sensitivity to glucose and tissue insulin sensitivity. AREAS COVERED: This article analyzes the efficacy and safety data of canagliflozin, dapagliflozin and empagliflozin in randomized controlled trials of 24 - 104 weeks duration, compared with placebo or an active comparator, in patients treated with diet/exercise, metformin, dual oral therapy or insulin...
2015: Expert Opinion on Drug Safety
Lee B Meakin, Chinedu Udeh, Gabriel L Galea, Lance E Lanyon, Joanna S Price
Bones adapt their structure to their loading environment and so ensure that they become, and are maintained, sufficiently strong to withstand the loads to which they are habituated. The effectiveness of this process declines with age and bones become fragile fracturing with less force. This effect in humans also occurs in mice which experience age-related bone loss and reduced adaptation to loading. Exercise engenders many systemic and local muscular physiological responses as well as engendering local bone strain...
December 2015: Bone
Yvonne van Mourik, Loes C M Bertens, Maarten J M Cramer, Jan-Willem J Lammers, Johannes B Reitsma, Karel G M Moons, Arno W Hoes, Frans H Rutten
BACKGROUND: Reduced exercise tolerance and dyspnea are common in older people, and heart failure (HF) and chronic obstructive pulmonary disease (COPD) are the main causes. We want to determine the prevalence of previously unrecognized HF, COPD, and other chronic diseases in frail older people using a near-home targeted screening strategy. METHODS: Community-dwelling frail persons aged ≥65 years underwent a 2-step screening strategy. First, they received a questionnaire inquiring about dyspnea and exercise tolerance...
November 2014: Journal of the American Board of Family Medicine: JABFM
Sadaoki Sakai, Miho Suzuki, Yoshihito Tashiro, Keisuke Tanaka, Satoshi Takeda, Ken Aizawa, Michinori Hirata, Kenji Yogo, Koichi Endo
Bone fractures markedly reduce quality of life and life expectancy in elderly people. Although osteoporosis increases bone fragility, fractures frequently occur in patients with normal bone mineral density. Because most fractures occur on falling, preventing falls is another focus for reducing bone fractures. In this study, we investigated the role of vitamin D receptor (VDR) signaling in locomotive ability. In the rotarod test, physical exercise enhanced locomotive ability of wild-type (WT) mice by 1.6-fold, whereas exercise did not enhance locomotive ability of VDR knockout (KO) mice...
January 2015: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
F Jakob, L Seefried, M Schwab
BACKGROUND: Osteoporosis is an age-associated disease, which is influenced by genetic, epigenetic and environmental factors. AIM: This article examines the evidence for specific aspects in osteoporosis diagnosis and management in higher age groups. MATERIAL AND METHODS: The study was based on extraction of data from literature databases and from the guidelines of the "Dachverband Osteologie" (DVO, Governing Body for Osteology). RESULTS: Age is a high risk factor for osteoporosis...
July 2014: Der Internist
Finbarr C Martin
Falls and fragility fractures are common, dangerous, and important public health challenges. They are best understood as geriatric syndromes with close relation to frailty and other aging-related health problems. They are associated with many risk factors, in all health domains - physical, psychological, social, and environmental. At a population level, the challenge is to improve the health and well-being of all older people to reduce the incidence of falls. At a clinical level, the challenge is to assess the individual risk factors and apply evidence-based individually tailored, multifactorial interventions...
March 2011: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
Marleen Huijben-Schoenmakers, Arno Rademaker, Erik Scherder
OBJECTIVE: To increase autonomous practice time of patients on the stroke unit of a nursing home. INTERVENTION: Nurses stimulated and coached patients with the help of four interventions (muscle strengthening, sitting balance and reach, getting up from a chair, walking) from the evidence-based Clinical Nursing Rehabilitation Stroke Guidelines. DESIGN: An observational study. Practice time of elderly stroke patients in this study was compared with the time observed in our previous study in the same setting...
June 2013: Clinical Rehabilitation
Katrin Balzer, Martina Bremer, Susanne Schramm, Dagmar Lühmann, Heiner Raspe
BACKGROUND: An ageing population, a growing prevalence of chronic diseases and limited financial resources for health care underpin the importance of prevention of disabling health disorders and care dependency in the elderly. A wide variety of measures is generally available for the prevention of falls and fall-related injuries. The spectrum ranges from diagnostic procedures for identifying individuals at risk of falling to complex interventions for the removal or reduction of identified risk factors...
2012: GMS Health Technology Assessment
Marco Yc Pang
Due to various physical impairments, individuals with chronic diseases often live a sedentary lifestyle, which leads to physical de-conditioning. The associated muscle weakness, functional decline and bone loss also render these individuals highly susceptible to falls and fragility fractures. There is an urgent need to search for safe and effective intervention strategies to prevent fragility fractures by modifying the fall-related risk factors and enhancing bone health. Whole body vibration (WBV) therapy has gained popularity in rehabilitation in recent years...
November 18, 2010: World Journal of Orthopedics
Sundar Srinivasan, Ted S Gross, Steven D Bain
Physical exercise is thought to hold promise as a non-invasive countermeasure against skeletal fragility arising from post-menopausal and age-related osteoporosis. Importantly, mechanical loading and exercise are capable of increasing bone size via periosteal expansion, which by far, is the most effective means of strengthening the structure of a given bone. The focus of this review was to therefore explore whether exercise has the potential to increase periosteal modeling and bone size in the senescent skeleton...
July 2012: Ageing Research Reviews
Eugene McCloskey
While fractures at the spine, wrist and hip are regarded as classical osteoporotic fractures, all fragility fractures in the elderly should be considered as osteoporotic once pathological fracture (e.g. metastatic disease) has been excluded. The assessment of fracture risk should take account of specific risk factors in addition to bone mineral density (BMD). The WHO has produced FRAX, a well validated tool that estimates the probability of a major osteoporotic fracture in the next 10 years. The algorithm is specifically designed for primary care...
January 2011: Practitioner
Yohei Otaka
Fall-related fracture in elderly is one of the big issues in our aging society. A major cause of fractures in elderly is fall. Therefore, the prevention of falls is essential for the prevention of fractures in elderly. Various risk factors of falls such as physical fragility, cognitive decline and visual problem have been reported. The effective way for prevention of falls is the modification of the risk factors for falls. Especially, exercise has been known effective. In addition to prevention of falls, we should explore the appropriate approach to modify fall direction, defensive reaction, local shock absorption, which are closely related to fall-related fracture risk...
April 2010: Clinical Calcium
M Pfeifer, C Hinz, H W Minne
Medical training therapy (MTT) plays a decisive role in maintenance and development of musculoskeletal health of humans in all phases of life. In childhood and adolescence it can contribute to the highest possible so-called peak bone mass and thus avoid or delay the appearance of osteoporosis for as long as possible, in view of increased life expectations. In young adults targeted MTT is well suited to improve performance and to maintain the maximum developed bone mass. The latter is also true for perimenopausal and postmenopausal women in whom MTT can compensate for the loss of bone mass due to hormone deficiency in comparison to those not in training...
April 2010: Der Orthopäde
Brian J Gates, Travis E Sonnett, Cristina A K Duvall, Erin K Dobbins
BACKGROUND: Fractures are a significant problem in geriatric patients, and understanding the evidence for benefit and possible harm of osteoporosis treatments is critical to appropriate management of this patient population. OBJECTIVE: The purpose of this article was to review the evidence and treatment considerations related to use of the approved osteoporosis treatments in the United States across the continuum of ages in the geriatric population. METHODS: MEDLINE and the Web of Science were searched to find English-language articles published from 2000 through July 2009...
December 2009: American Journal of Geriatric Pharmacotherapy
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