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older and fragility

Stephanie S G Brown, Shinjini Basu, Heather C Whalley, Peter C Kind, Andrew C Stanfield
The FMR1 premutation confers a 40-60% risk for males of developing a neurodegenerative disease called the Fragile X-associated Tremor Ataxia Syndrome (FXTAS). FXTAS is a late-onset disease that primarily involves progressive symptoms of tremor and ataxia, as well as cognitive decline that can develop into dementia in some patients. At present, it is not clear whether changes to brain function are detectable in motor regions prior to the onset of frank symptomatology. The present study therefore aimed to utilize an fMRI motor task for the first time in an asymptomatic premutation population...
2018: NeuroImage: Clinical
Ana M Rodrigues, Mónica Eusébio, Maria José Santos, Nélia Gouveia, Viviana Tavares, Pedro S Coelho, Jorge M Mendes, Jaime C Branco, Helena Canhão
Using a large population database, we showed that fragility fractures were highly prevalent in senior women and were associated with significant physical disability. However, treatment rates were low because osteoporosis treatment was not prescribed or not agreed to by the majority of women with prevalent fragility fractures. PURPOSE: The purpose of the study is to estimate prevalence of fragility fractures (FF), risk factors, and treatment rates in senior women and to assess impact of FF on physical function and quality of life...
March 7, 2018: Archives of Osteoporosis
Inbal Goldshtein, Allison Martin Nguyen, Anne E dePapp, Sofia Ish-Shalom, Julie M Chandler, Gabriel Chodick, Varda Shalev
This study analyzed data on 87,224 osteoporotic patients with up to 18 years of computerized medical history. Patients with osteoporosis and type 2 diabetes had higher bone density yet more fractures than non-diabetic osteoporotic patients. Fracture incidence among the diabetic patients was associated with retinopathy and cardiovascular disease, but not with diabetes duration. PURPOSE: Little is known about the association between type 2 diabetes mellitus (T2DM) and fragility fractures or the mechanism(s) involved...
March 3, 2018: Archives of Osteoporosis
Rodrigo J Valderrábano, Joy Y Wu
Under physiologic conditions hematopoiesis takes place in the bone marrow, and the skeleton provides the structural and supportive network necessary for normal hematopoiesis. Chronic disorders affecting hematopoiesis such as sickle cell anemia and thalassemia demonstrate striking skeletal phenotypes including bone loss and increased fracture risk. There is mounting evidence that anemia in older populations may also be associated with bone fragility. Given the interconnectedness of bone and hematopoietic cells, it is important to review the potential clinical implications and opportunities for therapeutic intervention...
February 21, 2018: Bone
Jonathan A Mitchell, Alessandra Chesi, Shana E McCormack, Diana L Cousminer, Heidi J Kalkwarf, Joan M Lappe, Vicente Gilsanz, Sharon E Oberfield, John A Shepherd, Andrea Kelly, Struan F A Grant, Babette S Zemel
PURPOSE: To determine if replacing time spent in high and low impact physical activity (PA) predicts changes in pediatric bone mineral density (BMD) and content (BMC). METHODS: We analyzed data from the longitudinal Bone Mineral Density in Childhood Study (N=2,337 with up to 7 visits). The participants were aged 5-19 years at baseline, 51.2% were female and 80.6% were non-Black. Spine, total hip, and femoral neck areal BMD (aBMD) and total body less head (TBLH) BMC Z-scores were calculated...
February 20, 2018: Medicine and Science in Sports and Exercise
Chunyuan Qiu, Priscilla H Chan, Gary L Zohman, Heather A Prentice, Jessica J Hunt, Diana C LaPlace, Vu T Nguyen, Glenn R Diekmann, Gregory B Maletis, Vimal Desai
OBJECTIVES: To determine the impact of anesthesia type on in-hospital mortality and morbidity for geriatric fragility hip fracture surgery. DESIGN: Retrospective cohort study. SETTING: Integrates health care delivery system across 38 facilities in the United States. PATIENTS/PARTICIPANTS: We identified 16,695 patients 65 years of age and older who underwent emergent hip fracture repairs between 2009 and 2014 through the Kaiser Permanente hip fracture registry and excluded pathologic or bilateral fractures...
March 2018: Journal of Orthopaedic Trauma
C-H Wu, I-J Kao, W-C Hung, S-C Lin, H-C Liu, M-H Hsieh, S Bagga, M Achra, T-T Cheng, R-S Yang
Fracture liaison services (FLS), implemented in different ways and countries, are reported to be a cost-effective or even a cost-saving secondary fracture prevention strategy. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards. This study summarizes the economic impact and cost-effectiveness of FLS implemented to reduce subsequent fractures in individuals with osteoporosis. This systematic review identified studies reporting economic outcomes for FLS in osteoporotic patients aged 50 and older through a comprehensive search of MEDLINE, EMBASE, Cochrane Central, and PubMed of studies published January, 2000 to December, 2016...
February 19, 2018: Osteoporosis International
Lana J Williams, Michael Berk, Jason M Hodge, Mark A Kotowicz, Amanda L Stuart, Vinoomika Chandrasekaran, Jasmine Cleminson, Julie A Pasco
Selective serotonin reuptake inhibitors (SSRIs) have been shown to have a clinically significant impact on bone metabolism. To explore this further, we aimed to determine whether these agents are associated with serum markers of bone turnover utilising a population-based sample of men (n = 1138; 20-96 year) participating in the Geelong Osteoporosis Study. Blood samples were obtained and the bone resorption marker, C-telopeptide (CTx) and formation marker, type 1 procollagen amino-terminal-propeptide (PINP) were measured...
February 13, 2018: Calcified Tissue International
Mattia Morri, Paolo Chiari, Cristiana Forni, Antonella Orlandi Magli, Domenica Gazineo, Natalia Franchini, Lorenzo Marconato, Tiziana Giamboi, Andrea Cotti
OBJECTIVE: to identify the factors associated with recovering autonomy in the activities of daily living DESIGN: A prospective cohort study SETTING: The orthopedic and orthogeriatric departments of 2 regional hospitals PARTICIPANTS: Patients 65 years of age or older with a diagnosis of fragility hip fracture. There were 840 eligible patients. Forty-three patients were excluded and 55 were lost. Seven hundred and forty-two consecutive patients was enrolled at the time of hospitalization and 727 at follow-up...
February 10, 2018: Archives of Physical Medicine and Rehabilitation
Konstantinos I Alexiou, Andreas Roushias, Sokratis E Varitimidis, Konstantinos N Malizos
Fractures due to fragility of the bone around the hip joint have become a major public health issue, presenting with an increasing incidence due to the growth of the elderly population. The purpose of this review was to evaluate the impact of hip fractures on the quality of life (QoL), health status (HS), functioning, and psychological parameters, and factors influencing the outcome and the appropriate interventions for improvement of elderly patients. A systematic electronic search of the relevant literature was carried out using the CINAHL, Cochrane, EMBASE, Medline (OvidSP), and PubMed databases spanning the time period from their establishment up to January 2017...
2018: Clinical Interventions in Aging
Ryan Shickman, Jessica Famula, Flora Tassone, Maureen Leehey, Emilio Ferrer, Susan M Rivera, David Hessl
BACKGROUND: Fragile X premutation carriers are at increased risk for fragile X-associated tremor ataxia syndrome (FXTAS), but to date we know little about prediction of onset and rate of progression and even less about treatment of this neurodegenerative disease. Thus, the longitudinal study of carriers, and the identification of potential biomarkers and prodromal states, is essential. Here we present results of baseline assessments from an ongoing longitudinal project. METHODS: The cohort consisted of 73 men, 48 with the fragile X mental retardation 1 (FMR1) premutation (55-200 cytosine-cytosine-guanine or CGG repeats) and 25 well-matched controls (< 40 repeats) aged between 40 and 75 years...
February 1, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
Cristina Eller-Vainicher, Serena Palmieri, Elisa Cairoli, Giovanni Goggi, Alfredo Scillitani, Maura Arosio, Alberto Falchetti, Iacopo Chiodini
OBJECTIVES: To determine the effect of denosumab, which is used in primary osteoporosis (PO), in primary hyperparathyroidism (PHPT)-related osteoporosis. DESIGN: Retrospective, longitudinal study. SETTING: Outpatient osteoporosis clinic. PARTICIPANTS: Older women with PHPT (78.6 ± 5.5) (n = 25) and PO (78.8 ± 5.2) (n = 25) matched on age, body mass index, familial history of hip fracture, femoral bone mineral density (BMD), and personal history of fragility fractures...
January 24, 2018: Journal of the American Geriatrics Society
Lauren A Burt, Sarah L Manske, David A Hanley, Steven K Boyd
The aim of this prospective study was to use high-resolution peripheral quantitative computed tomography (HR-pQCT) to determine if baseline skeletal parameters can predict incident fragility fracture in women and, secondly, to establish if women that fracture lose bone at a faster rate than those who do not fracture. Women older than 60 years who experienced a fragility fracture during the 5-year follow-up period (incident fracture group, n = 22) were compared with those who did not experience a fragility fracture during the study (n = 127)...
January 24, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Rathi Ravindrarajah, Nisha C Hazra, Judith Charlton, Stephen H D Jackson, Alex Dregan, Martin C Gulliford
OBJECTIVE: This study aimed to estimate the association of frailty with incidence and mortality of fractures at different sites in people aged over 80 years. DESIGN: Cohort study. SETTING: UK family practices from 2001 to 2014. PARTICIPANTS: 265 195 registered participants aged 80 years and older. MEASUREMENTS: Frailty status classified into 'fit', 'mild', 'moderate' and 'severe' frailty. Fractures, classified into non-fragility and fragility, including fractures of femur, pelvis, shoulder and upper arm, and forearm/wrist...
January 21, 2018: BMJ Open
M A Kelly, B McGowan, M J McKenna, K Bennett, J J Carey, B Whelan, C Silke
BACKGROUND: We analysed hospital admissions and bed occupancy for fragility fractures in Ireland over a 15-year period to assess fracture admission trends and to project admissions over the next three decades. METHODS: We used the Hospital In-Patient Enquiry (HIPE) scheme to extract data on fracture admissions to Irish hospitals between 2000 and 2014 inclusive. We calculated absolute numbers and age-standardised rates of hospitalisations for men and women ≥ 50 years for each osteoporotic-type fracture...
January 20, 2018: Irish Journal of Medical Science
Gonçalo Nunes, Ana Teresa Barata, Carla Adriana Santos, Marta Patita, Jorge Fonseca
BACKGROUND AND AIMS: Bowel preparation for colonoscopy induces a semi-fasting state, with a potential negative impact on fragile patients. The present study aims to quantify nutritional deficiency during colonoscopy preparation. METHODS: This was an observational and cross-sectional study. A convenience sample was obtained that included adults that underwent colonoscopy after bowel preparation with Klean-Prep® according to the center protocol. Anthropometric evaluation was performed and nutritional deficiency was calculated via the quantification of energy and protein intake during the 48 hours prior to the examination which was compared with the individuals' needs...
January 15, 2018: Revista Española de Enfermedades Digestivas
Elisa A Marques, Martine Elbejjani, Vilmundur Gudnason, Gunnar Sigurdsson, Thomas Lang, Sigurdur Sigurdsson, Thor Aspelund, Kristin Siggeirsdottir, Lenore Launer, Gudny Eiriksdottir, Tamara B Harris
This study aimed to explore the relationships of several indicators of cigarette smoking habits (smoking status, pack-years, age at smoking initiation and smoking cessation) with quantitative computed tomographic (QCT)-derived proximal femur bone measures (trabecular vBMD, integral vBMD and the ratio of cortical to total tissue volume (cvol/ivol)) and with subsequent change in these measures over the next five years. A total of 2673 older adults (55.9% women), aged 66-92 years at baseline from the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, who had two QCT scans of the hip were studied...
January 10, 2018: Bone
Scott J Lee, Peter M Graffy, Ryan D Zea, Timothy J Ziemlewicz, Perry J Pickhardt
We sought to determine if vertebral trabecular attenuation values measured on routine body CT scans obtained for a variety of unrelated indications can predict future osteoporotic fractures at multiple skeletal sites. For this HIPAA-compliant and IRB-approved retrospective cohort study, trabecular attenuation of the first lumbar vertebra was measured in 1966 consecutive older adults who underwent chest and/or abdominal CT at a single institution over the course of one year. New pathologic fragility fractures that occurred after a patient's CT study date were identified through an electronic health record database query using ICD-9 codes for vertebral, hip, and extremity fractures...
January 3, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
M Gosch, U Stumpf, C Kammerlander, W Böcker, H J Heppner, S Wicklein
Osteoporosis is defined as a systemic bone disease with decreased bone strength and an increased susceptibility for fractures. Older people in particular face an increased risk of fractures. These kind of fractures are usually caused by an inadequate trauma and are the so-called fragility fractures. In older adults immediate fracture stabilization and early mobilization have become the standard procedure after a fragility fracture. Treatment of the underlying osteoporosis often plays a minor role in clinical practice...
January 5, 2018: Zeitschrift Für Gerontologie und Geriatrie
Gülen Eda Utine, Pelin Özlem Şimşek-Kiper, Özlem Akgün-Doğan, Gizem Ürel-Demir, Yasemin Alanay, Dilek Aktaş, Koray Boduroğlu, Ergül Tunçbilek, Mehmet Alikaşifoğlu
OBJECTIVE: To determine frequency of fragile X associated premature ovarian insufficiency (FXPOI) among Turkish premutation carriers. STUDY DESIGN: FMR1 premutation is the single most common genetic cause of POI (FXPOI). Fragile X Registry at Hacettepe University has been reviewed for the frequency of FXPOI among female premutation carriers. Since 1991 when FMR1 testing was available, 760 individuals from 243 families have been registered. Actual data on menstrual status of female premutation carriers were gathered and analysed...
December 16, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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