Fragility and elderly and exercise

INTRODUCTION: Reduced bone mineral density and increased risk of falls are related with Alzheimer disease, and these increase likelihood of bone osteoporotic fractures causing serious complications such as disability, fear of falling, loss autonomy, decreased quality of life, and anticipated mortality in elderly patients. Gait and balance disturb are 2 factors to favor falls in elderly, and in patients with cognitive impairment, the risk of falls increases to double. Exercise and Mediterranean diet produce beneficial effects for aging, cognitive decline, and are widely recommended to reduce the effects of osteoporosis, fall risk, and related fragility fractures...

Activity of estrogen, a sex steroid hormone, is not only limited to the reproductive organs but also involves other organs and tissues, including skeletal muscle. In postmenopausal women, estrogen decline causes endocrine and metabolic dysfunction, leading to a predisposition to osteoporosis, metabolic syndrome, and decreased muscle mass and strength. The decline in skeletal muscle mass often associates with sarcopenia, a popular condition observed in fragile elder people. In addition, varying estrogen levels associated with the menstrual phases may modulate exercise performance in women...

Objectives: With the increase in the life expectancy of older adults, the scoring diagnosis of osteoporosis has been highly reported hence rising the incidence of fragility fractures due to decrease in bone mineral density (BMD), thereby significantly impacting the quality of life and health status of elderly population. The aim of this study is to identify the impact of different exercise regimes in improving the BMD among osteoporotic females. Methodology: A trial was conducted on 93 diagnosed postmenopausal osteoporotic females aged 50-75 years screened on the basis of physical activity readiness-questionnaire and YOU form randomly divided equally into three groups', that is, aerobic, anaerobic, and osteoanabolic exercises using an envelope method...

Osteoporosis and fragility fractures have become major global public health concerns, and they can be prevented by maximizing peak bone mass during childhood and adolescence with weight-bearing physical activity, which can result in stronger and healthier bones that significantly decrease the risk of osteoporosis and fragility fractures in adulthood and the elderly years. From a public health perspective, implementing weight-bearing physical activity for children and adolescents is best achieved with school-based exercise interventions, and a review of school-based exercise interventions was conducted to determine their effectiveness in increasing bone mineral density (BMD) and/or bone mineral content (BMC)...

Fragility fractures are estimated to affect 3 million people annually in the United States. As they are associated with a significant mortality rate, the prevention of these fractures should be a priority for orthopedists. At-risk patients include the elderly and those with thyroid disease, diabetes, hypertension, and heart disease. Osteoporosis is diagnosed by the presence of a fragility fracture or by dual-energy x-ray absorptiometry (DXA) in the absence of a fragility fracture. In 2011, the United States Preventive Services Task Force (USPSTF) recommended that all women ≥65 years should be screened for osteoporosis by DXA...

BACKGROUND: The mean age of people undergoing dialysis therapy has been on the rise because of improved survival in this patient population, as well as the reduced availability of transplants for elderly patients. Aging in Japanese dialysis patients is more rapid than those in the United States and Europe. Frailty is generally considered as an age-related fragile state, and a condition in which the individual is in a vulnerable state at increased risk of adverse health outcomes and/or dying when exposed to a stressor...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...