Ultrasonometric profiling of incidence and risk of osteoporosis in rural women

BACKGROUND: It is estimated that over 200 million people worldwide have osteoporosis. The prevalence of osteoporosis is continuing to escalate with the increasingly aging population. The major complication of osteoporosis is an increase in fragility fractures leading to morbidity, mortality, and decreased quality of life. This investigation profiled the incidence and risk of osteoporosis in adult women from a rural setting using ultrasonic bone scanning technology. METHODS: Between 2001 and 2005, adult female subjects (n = 323) in the age range of 40-87 were drawn from an independent, community dwelling, convenience sample. Bone mineral density T-scores were evaluated using heel ultrasonometry. Demographic and risk factor data, Merck Osteoporosis Evaluation SCORE questionnaire data, and the Osteoporosis Risk Assessment questionnaire data were analyzed. RESULTS: Results of these scans indicate that 25% of the total population had a T-score < or = -1.0, implying a 1.5- to 2.0-fold increase in risk ratio of hip or spinal fracture for each standard deviational decrease. Age at menopause and weight had a positive correlation with T-scores. While the overall scores on the Merck SCORE questionnaire were inversely correlated to T-scores, no significant correlation was found between the Osteoporosis Risk Assessment questionnaire and T-score data. Additionally, women who had taken estrogen had significantly higher T-scores (p = 0.038) than those who had not. CONCLUSION: That approximately 25% of this sample has low bone mass or osteoporosis underscores the importance of early screening in order to develop preventative awareness and provide education on bone health management. This finding has particularly important ramifications, since the sample was rural women, who typically have limited access to diagnostic bone density procedures.     

Effect of Soy Isolate Protein and Resistance Exercises on Muscle Performance and Bone Health of Osteopenic/Osteoporotic Post-Menopausal Women

There are contradictory reports regarding the effect of soy protein isolate on bone health in menopause. The main objective of this study was to assess the influence of soy isolate protein intake and resistance exercises on isokinetic muscle strength, endurance, power, and bone health parameters in osteopenic/osteoporotic postmenopausal women. Sixty osteoporotic sedentary women (mean age 54.55 years) were randomly assigned to three groups: soy isolate protein (Group A), soy?+?exercise group (Group B), and control group (Group C). Group B performed supervised progressive resistance exercises 4 times/week for 12 weeks. Muscle performance was measured by isokinetic dynamometry, and bone health was measured by ultrasound densitometry. Analysis of variance showed significant bone and muscle strength gains (p < .05) both in Group A and B, with the improvements more pronounced in Group B. Significant muscle performance changes, after intervention, were evident and bone strength increases may parallel changes in muscle strength.     

Osteoporosis and Older Women:

Osteoporosis, a metabolic bone disorder, affects four times as many women as men. Each year 1.3 million fractures, primarily of the vertebra, hip, and wrist can be attributed to osteoporosis. Risk factors for the development of this disease include age, sex, body build, family history, race, loss of estrogen, calcium deficiency, sedentary lifestyle, smoking, and the excessive use of alcohol. Three common approaches used in the treatment and prevention of osteoporosis are hormone replacement therapies, nutrition interventions. and exercise programs. These strategies are aimed at maintaining or stabilizing bone mass and preventing further loss. Living with osteoporosis presents older women with a variety of physical, psychological, and social challenges. To maintain a productive and healthy lifestyle, older women must recognize their physical limitations and make adjustments in their daily lives to cope successfully with these changes.     

Relationship between sarcopenia and fracture risks in obese postmenopausal women

It is known that obesity is inversely correlated with fracture risk. It remains unclear if a low muscle mass (sarcopenia) modulates the relationship between obesity and bone mass density. Twenty-seven obese women were matched for total fat mass (+/- 0.5 kg) and age (+/- 4 yrs) and divided in 3 equal groups: class II sarcopenic, class I sarcopenic, and nonsarcopenic. Body composition (DXA) and dietary intake were measured. Our results suggest that obesity may offer some protection against osteoporosis, even in sarcopenic postmenopausal women. However, further studies are needed to examine the actual implication of these results on a clinical standpoint.     

Relationship Between Sarcopenia and Fracture Risks in Obese Postmenopausal Women

ABSTRACT

It is known that obesity is inversely correlated with fracture risk. It remains unclear if a low muscle mass (sarcopenia) modulates the relationship between obesity and bone mass density. Twenty-seven obese women were matched for total fat mass (± 0.5 kg) and age (± 4 yrs) and divided in 3 equal groups: class II sarcopenic, class I sarcopenic, and nonsarcopenic. Body composition (DXA) and dietary intake were measured. Our results suggest that obesity may offer some protection against osteoporosis, even in sarcopenic postmenopausal women. However, further studies are needed to examine the actual implication of these results on a clinical standpoint.     

Effects of Customized Balance Exercises on Older Women Whose Balance Ability Has Deteriorated With Age

Falls represent a major public health problem for older adults, and loss of balance (LOS) abilities is one of the primary causes of falls. Previous studies have shown that balance training is effective in improving physical function and decreasing risk of falls. However, little attention has been given specifically to balance training in older adults with very poor balance. The purpose of this study was to determine the effect of a 12-week customized balance exercise program on LOS for community-dwelling older women with poor balance ability. Twenty-four older women with poor balance (composite maximum excursion [MXEcomp] score of less than 70% based on Limits of Stability) were divided into an exercise group and control group. After 12 weeks of balance exercises, mean MXEcomp improved (p < .05) from 58.6% to 79.0% in the exercise group. EPEcomp (composite endpoint excursion), RTcomp (composite reaction time), SVcomp3 (composite sway velocity on thick foam with the eyes open), UG (up and go) also improved, but the functional reach and other static balance indexes did not change. These results indicated that balance training allows older adults with poor balance to improve dynamic balance ability and potentially reduce risk for falls.     

Sarcopenia and decreased muscle strength in the elderly woman: resistance training as a safe and effective intervention

A principle component of age-related weakness and frailty in women is sarcopenia. This decrease in skeletal muscle mass is a progressive syndrome that will affect the quality of life for elderly women by decreasing the ability to perform many activities of daily living. Strength training is known to be an effective means of increasing muscular strength and size in many populations, and can be utilized successfully to significantly improve muscle strength, muscle mass and functional mobility in elderly women up to the age of 96 years. Such exercise can minimize the syndrome of physical frailty due to decreased muscle mass and strength. Any rehabilitation or exercise program for the elderly woman would benefit from the inclusion of such a training regime.     

Sarcopenia and Decreased Muscle Strength in the Elderly Woman: Resistance Training as a Safe and Effective Intervention

ABSTRACT

A principle component of age-related weakness and frailty in women is sarcopenia. This decrease in skeletal muscle mass is a progressive syndrome that will affect the quality of life for elderly women by decreasing the ability to perform many activities of daily living. Strength training is known to be an effective means of increasing muscular strength and size in many populations, and can be utilized successfully to significantly improve muscle strength, muscle mass and functional mobility in elderly women up to the age of 96 years. Such exercise can minimize the syndrome of physical frailty due to decreased muscle mass and strength. Any rehabilitation or exercise program for the elderly woman would benefit from the inclusion of such a training regime.     

Long-term effects of back extensor strengthening exercises on quality of life in women with osteoporosis

The aim of the present study was to evaluate the long-term effect of back extensor strengthening exercises on health-related quality of life (QOL) in women with osteoporosis. In this randomized clinical trial, 183 women with osteoporosis were treated with pharmacotherapy and weight-bearing and balance-training exercises. The case group additionally performed back extensor exercises at home. Patients filled out the Persian version of the Short Form (SF-36) QOL questionnaire at baseline and 6 months post treatment. At the end, all physical and mental parameters of the SF-36 questionnaire improved significantly in the case group, except for one subscale of mental health, compared to the control group. In the control group, only some physical health dimensions (bodily pain, role limitation, physical function, vitality), and mental health status as a mental health subscale improved. In conclusion, considering a major impact of back extensor exercises on improving QOL in women with osteoporosis over the long term, these exercises should be prescribed in routine management of these patients.     

Oxidative stress levels are reduced in postmenopausal women with exercise training regardless of hormone replacement therapy status

This study investigated whether postmenopausal women on HRT would experience a greater reduction in oxidative stress after 24 weeks of aerobic exercise training compared to postmenopausal women not on HRT. Plasma thiobarbituric acid reactive substances (TBARS), an indicator of oxidative stress, was measured in 48 previously sedentary postmenopausal women on HRT (n = 21) and not on HRT (n = 27) before and after 24 weeks of aerobic exercise training. Baseline levels of TBARS differed significantly between groups after controlling for age, BMI, and fasting blood glucose (P = 0.03). There was a significant reduction in TBARS after 24 weeks of training in the overall group. When analyzed separately, both postmenopausal women on HRT and those not on HRT had a significant reduction in TBARS; however, there was no significant difference between groups (-0.71 +/- 0.14 nmol/ml in non-HRT users vs. -0.50 +/- 0.16 nmol/ml in HRT users; P = 0.33) even after controlling for age, BMI, and baseline levels of TBARS. Our results showed that aerobic exercise training significantly decreased oxidative stress in postmenopausal women; however, both HRT users and non-HRT users benefited equally.     

Risk factors associated with osteoporosis in Hispanic women

This study examined risk factors for osteoporosis in Hispanic women. Factors examined included ethnicity, gender, age, height, weight, family and personal history of fractures, height loss, exercise, diet, time since menopause or hysterectomy, hormone replacement therapy (HRT), calcium supplementation, hypertension, thyroid disease, diabetes, arthritis, chemotherapy, family history of breast cancer, use of water pills, fosamax, steroids, alcohol, and smoking. Most results found parallel those found in the Caucasian population. Heavier patients had greater bone density, as well as patients who exercised and those using HRT. Older patients had lower bone density as did diabetic patients. Results not anticipated were higher bone density in patients not taking calcium supplements, and in patients who consumed alcohol.     

The effect of protein diets in postmenopausal women with osteoporosis: Systematic review of randomized controlled trials

The main objective of this systematic review was to examine the effectiveness of protein supplementation through diet or dietary supplements on osteoporosis in postmenopausal women as evidenced by randomized controlled trials (RCTs). Five RCTs were included using dietary protein (N = 2), protein supplements (N = 2), and proteins through diet and supplements (N = 1). A total of 677 postmenopausal woman were included, all diagnosed with osteoporosis (T score < –2.5) and aged between 50 and 80 years. Results have found that combined protein administration through diet, mainly from animal sources and supplemental proteins (whey proteins, 86 g/d PRO including 6 g WPI), for a short period of time (up to 12 months) may positively affect osteoporosis in postmenopausal women. In addition, a positive effect can also be achieved by the single administration of a 250 mg/d supplement in which 10 g was WPI for a six-month period. In this review, it is shown that both combined administration of proteins through diet and supplements and single administration through protein supplements may reduce the risk of fracture in postmenopausal osteoporotic women. In contrast, dietary proteins alone, in doses similar to and/or higher than the RDA values, may not have any positive effect on treating osteoporosis.     

Use of quantitative ultrasound as bone mineral density evaluation in an Italian female population living with HIV: A real-life experience

This is a multicenter cross-sectional study where we aimed to detect the rate of osteopenia/osteoporosis in an HIV female population (WLWHIV) by means of “heel quantitative ultrasound” (QUS) measurement. We enrolled 273 patients, mean age 48.1 years, 36% menopausal, 96% on combination antiretroviral therapy (cART). Calcaneal measure of bone mass index by QUS revealed osteopenia and osteoporosis in 76 (27.8%) and 16 (5.9%) WLWHIV. Our data underline the correlation between low QUS parameters and traditional risk factors for osteoporosis rather than with cART exposure, thus suggesting the crucial importance of detection and correction of traditional risk factors for osteoporosis in WLWHIV.     

Exercise self-regulation among older women participating in a heart disease-management intervention

Using behavioral self-regulation processes may facilitate exercise among older women with heart disease. Data from women in a heart disease-management program (n = 658, mean 73 years), was used to explore associations among exercise self-regulation components (i.e., choosing to improve exercise and observing, judging, and reacting to one's behavior) and exercise capacity. General linear models showed that choosing exercise predicted higher exercise self-regulation scores postprogram and 8 months later. In turn, these scores predicted greater improvements in exercise capacity concurrently and 8 months later. Interaction analyses revealed that the effect of self-regulation on exercise capacity was stronger among women who chose to work on exercise.     

Exercise Self-Regulation Among Older Women Participating in a Heart Disease-Management Intervention

Using behavioral self-regulation processes may facilitate exercise among older women with heart disease. Data from women in a heart disease-management program (n = 658, mean 73 years), was used to explore associations among exercise self-regulation components (i.e., choosing to improve exercise and observing, judging, and reacting to one's behavior) and exercise capacity. General linear models showed that choosing exercise predicted higher exercise self-regulation scores postprogram and 8 months later. In turn, these scores predicted greater improvements in exercise capacity concurrently and 8 months later. Interaction analyses revealed that the effect of self-regulation on exercise capacity was stronger among women who chose to work on exercise.     

Healthy postmenopausal women- physical activity and forearm bone mineral density: the Nord-Trøndelag health survey

The aim of this study was to analyze the association between Physical Activity (PA) and forearm bone mineral density (BMD) in healthy postmenopausal women. During 1984-1986, a population-based health survey (HUNT-1) was conducted in Nord-Tr?ndelag county, Norway. The second follow-up survey (HUNT-2) was conducted during 1995-1997. The subjects consist of all healthy postmenopausal women (N = 2,924). Higher intensity of recreational PA in HUNT-1 was associated with higher BMD ultradistally (slope = +0.0084, p = 0.0009). The summary score of duration, frequency and intensity of recreational PA in HUNT-1 was associated with lower risk of being below the 20th percentile ultradistally (OR = 0.90, p = 0.01, after adjustment for covariates). The trends for mean distal and ultradistal BMD and percent low BMD lacked statistical significance when we used the PA score that combined the recreational and occupational PA in HUNT-1 and HUNT-2. CONCLUSION: Higher intensity of prior recreational PA (HUNT-1) was associated with a protective effect on BMD measured in the forearm (HUNT- 2).     

A comparison of three physical activity programs for health and fitness tested with older women: Benefits of aerobic activity,aqua fitness,and strength training

ABSTRACT

Inactivity has been associated with decreased quality of life of older people, and many physical activity programs are encouraged. However, the heterogeneity of the different exercise programs available is well recognized. The objective was to compare three physical activity programs (strength training, aqua fitness, and aerobic exercise) to discern the differences in the benefits achieved by each of them in older women over a period of 6 months. For that, a double-blind randomized trial sorted 347 women over 50 years old into three groups of exercise programs; they completed three sessions of evaluation that included the measurement of weight and body mass index and used the Senior Fitness Test (SFT) and SF-12 questionnaire. A t-test for related samples compared the evolution of each group, and ANOVA statistic was used to compare the effect of the different exercise programs. The results showed that women should consider performing aerobic activity up to age 60. After that age, aerobic activity or strength training can provide greater benefits.     

Quality of life and sexual function in postmenopausal women

This study examined the relationship between quality of life (QoL) and sexual function among postmenopausal women. As a cross-sectional study, it was conducted among 405 postmenopausal women selected using a multistage sampling method. The data-collection tools were the Female Sexual Function Index (FSFI) questionnaire, the WHO Quality of Life-BREF (WHOQOL-BREF) questionnaire, and a researcher-administered questionnaire. Sexual dysfunction was observed in 61% of the participants. The total scores of FSFI had a positive correlation with the WHOQOL-BREF total scores and all QoL domain scores. Therefore, sexual function needs to be covered by health-care packages aiming to improve postmenopausal women’s QoL.