Physical performance and subsequent disability and survival in older adults with malignancy: results from the health, aging and body composition study.

Objectives: To evaluate objective physical performance measures as predictors of survival and subsequent disability in older patients with cancer.

Design: Longitudinal cohort study.

Setting: Health, Aging and Body Composition (Health ABC) Study.

Markers of atherosclerosis and inflammation for prediction of coronary heart disease in older adults.

Although both inflammatory and atherosclerosis markers have been associated with coronary heart disease (CHD) risk, data directly comparing their predictive value are limited. The authors compared the value of 2 atherosclerosis markers (ankle-arm index (AAI) and aortic pulse wave velocity (aPWV)) and 3 inflammatory markers (C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha)) in predicting CHD events. Among 2,191 adults aged 70-79 years at baseline (1997-1998) from the Health, Aging, and Body Composition Study cohort, the authors examined adjudicated incident myocardial infarction or CHD death ("hard" events) and "hard" events plus hospitalization for angina or coronary revascularization (total CHD events).

Association of osteocalcin and abdominal aortic calcification in older women: the study of osteoporotic fractures.

Osteocalcin (OC) is produced by osteoblasts and vascular smooth muscle cells. In animal models, serum OC levels are strongly correlated with vascular calcium content, however, the association of OC with vascular calcification in humans is uncertain. The Study of Osteoporotic Fractures (SOF) enrolled community-living women, age > or =65 years.

Drug burden index score and functional decline in older people.

Background: The Drug Burden Index (DBI), a measure of exposure to anticholinergic and sedative medications, has been independently associated with physical and cognitive function in a cross-sectional analysis of community-dwelling older persons participating in the Health, Aging and Body Composition study. Here we evaluate the association between DBI and functional outcomes in Health, Aging and Body Composition study participants over 5 years.

Methods: DBI was calculated at years 1 (baseline), 3, and 5, and a measure of the area under the curve for DBI (AUCDB) over the whole study period was devised and calculated.

Subclinical hypothyroidism and functional mobility in older adults.

Background: Health risks associated with subclinical hypothyroidism in older adults are unclear. Our objective was to compare the functional mobility of people aged 70 to 79 years by thyroid function categorized by thyrotropin (TSH) level as euthyroid (>or=0.4 to <4.

Inverse association between serum 25(OH) vitamin D levels and non-melanoma skin cancer in elderly men.

To determine the relationship between 25(OH) vitamin D levels and non-melanoma skin cancer (NMSC), we performed a nested case-control study in ambulatory, elderly men enrolled in the Osteoporotic Fractures in Men (MrOS) Study. Health habit and medical history, including self-reported history of NMSC were recorded and 25(OH)D levels were measured on serum collected at baseline from a random sample of Caucasian MrOS subjects. Mean age (73 +/- 5), BMI, daily vitamin D and calcium intake were similar in the men with (n = 178) and without NMSC (n = 930), but higher levels of 25(OH)D were associated with a decreased risk of having a history of NMSC (P(trend) = 0.

Assessing fracture risk and effects of osteoporosis drugs: bone mineral density and beyond.

Although there have been numerous advances in the assessment of bone strength and fracture risk, the majority of these techniques can only be performed in research laboratories, making them largely unavailable to practicing clinicians. Prospective epidemiologic studies have identified risk factors that can be assessed within the clinic and combined with bone mineral density to allow clinicians to better identify untreated individuals at heightened risk for fracture and to make informed treatment decisions based on 10-year absolute fracture risk. This article discusses the assessment of fracture risk in clinical practice, reviews currently and soon-available bone measurement tools, and details the impacts of osteoporosis therapies on fracture risk.

Serum 25-hydroxyvitamin D and the risk of hip and nonspine fractures in older men.

The association between vitamin D levels and incident fractures in older men is uncertain. To test the hypothesis that low serum 25-hydroxyvitamin D [(25(OH)D] levels are associated with an increased risk of fracture, we performed a case-cohort study of 436 men with incident nonspine fractures, including 81 hip fractures, and a random subcohort of 1608 men; average follow-up time 5.3 years.

Activity energy expenditure and change in body composition in late life.

Background: Change in body composition, specifically loss of fat-free mass and gain in fat mass, in older adults is a major pathway leading to the onset of functional decline and physical disability.

Objective: The objective was to determine the association of activity-related energy expenditure with change in body mass and composition among older men and women.

Design: Total energy expenditure (TEE) was assessed over 2 wk by using the doubly labeled water method in 302 community-dwelling older adults aged 70-82 y.

Glycemic status and incident heart failure in elderly without history of diabetes mellitus: the health, aging, and body composition study.

Background: It is unclear whether measures of glycemic status beyond fasting glucose (FG) levels improve incident heart failure (HF) prediction in patients without history of diabetes mellitus (DM).

Methods And Results: The association of measures of glycemic status at baseline (including FG, oral glucose tolerance testing [OGTT], fasting insulin, hemoglobin A(1c) [HbA(1c)] levels, and homeostasis model assessment of insulin resistance [HOMA-IR] and insulin secretion [HOMA-B]) with incident HF, defined as hospitalization for new-onset HF, was evaluated in 2386 elderly participants without history of DM enrolled in the Health, Aging, and Body Composition Study (median age, 73 years; 47.6% men; 62.

Central nervous system medication use and incident mobility limitation in community elders: the Health, Aging, and Body Composition study.

Purpose: To evaluate whether CNS medication use in older adults was associated with a higher risk of future incident mobility limitation.

Methods: This 5-year longitudinal cohort study included 3055 participants from the health, aging and body composition (Health ABC) study who were well-functioning at baseline. CNS medication use (benzodiazepine and opioid receptor agonists, antipsychotics, and antidepressants) was determined yearly (except year 4) during in-home or in-clinic interviews.

Value of routine monitoring of bone mineral density after starting bisphosphonate treatment: secondary analysis of trial data.

Objective: To assess the value of monitoring response to bisphosphonate treatment by means of measuring bone mineral density.

Design: Secondary analysis of trial data using mixed models. Data source The Fracture Intervention Trial, a randomised controlled trial that compared the effects of alendronate and placebo in 6459 postmenopausal women with low bone mineral density recruited between May 1992 and May 1993.

Biochemical markers of bone turnover, hip bone loss, and fracture in older men: the MrOS study.

We used data from the Osteoporotic Fractures in Men (MrOS) study to test the hypothesis that men with higher levels of bone turnover would have accelerated bone loss and an elevated risk of fracture. MrOS enrolled 5995 subjects >65 yr; hip BMD was measured at baseline and after a mean follow-up of 4.6 yr.

Bone: Does TSH concentration influence skeletal health?

Controversy surrounds the skeletal consequences of altered thyroid function. According to the latest report from the Tromsø population survey, however, variations of serum TSH concentration that remain within the normal range do not greatly influence BMD.

Effect of adherence on lifetime fractures in osteoporotic women treated with daily and weekly bisphosphonates.

Patients miss doses of their osteoporosis medications, or stop taking them altogether, for a variety of reasons. Whereas the reasons have been well-studied, their consequences, at the population level, have not. The goal of this study was to estimate the number of fractures that could be prevented with optimal adherence compared with usual adherence to daily and weekly bisphosphonates in the United States (US).

Activity energy expenditure and mobility limitation in older adults: differential associations by sex.

In this study, the authors aimed to determine whether higher activity energy expenditure, assessed by using doubly labeled water, was associated with a reduced decline in mobility limitation among 248 older community-dwelling US adults aged 70-82 years enrolled in 1998-1999. Activity energy expenditure was calculated as total energy expenditure (assessed over 2 weeks by using doubly labeled water) minus resting metabolic rate (measured with indirect calorimetry), with adjustment for the thermic effect of food. Across sex-specific tertiles of activity energy expenditure, men in the lowest activity group experienced twice the rate of mobility limitation as men in the highest activity group (41% (n = 18) vs.

Pentosidine and increased fracture risk in older adults with type 2 diabetes.

Context: Type 2 diabetes is associated with higher fracture risk at a given bone mineral density. Advanced glycation endproducts (AGEs) accumulate in bone collagen with age and diabetes and may weaken bone.

Objective: The aim was to determine whether urine pentosidine, an AGE, was associated with fractures in older adults with and without diabetes.

Epidemiology of incident heart failure in a contemporary elderly cohort: the health, aging, and body composition study.

Background: The race- and sex-specific epidemiology of incident heart failure (HF) among a contemporary elderly cohort are not well described.

Methods: We studied 2934 participants without HF enrolled in the Health, Aging, and Body Composition Study (mean [SD] age, 73.6 [2.

Self-reported sleep and nap habits and risk of mortality in a large cohort of older women.

Objectives: To determine the association between self-reported sleep and nap habits and mortality in a large cohort of older women.

Design: Study of Osteoporotic Fractures prospective cohort study.

Setting: Four communities within the United States.

Effect of central nervous system medication use on decline in cognition in community-dwelling older adults: findings from the Health, Aging And Body Composition Study.

Objectives: To evaluate whether combined use of multiple central nervous system (CNS) medications over time is associated with cognitive change.

Design: Longitudinal cohort study.

Setting: Pittsburgh, Pennsylvania, and Memphis, Tennessee.

Number and dosage of central nervous system medications on recurrent falls in community elders: the Health, Aging and Body Composition study.

Background: Few studies have examined the risk of multiple or high doses of combined central nervous system (CNS) medication use for recurrent falls in the elderly. The study objective was to evaluate whether multiple- or high-dose CNS medication use in older adults was associated with a higher risk of recurrent (>or=2) falls.

Methods: This longitudinal cohort study included 3,055 participants from the Health, Aging and Body Composition study who were well functioning at baseline.

Homocysteine levels and risk of hip fracture in postmenopausal women.

Background: Recent studies suggest that high homocysteine levels are associated with an increased risk of fractures. Homocysteine levels are known to be influenced by vitamin B and folate supply or status, and poor renal function can result in higher levels independent of nutritional adequacy.

Objective: The aim of the study was to determine the associations between fasting homocysteine levels and incident hip fractures, and the effects of other factors on hip fracture risk.

The association of bone mineral density with prostate cancer risk in the Osteoporotic Fractures in Men (MrOS) Study.

We investigated the association of bone mineral density (BMD) measures with prostate cancer (PCa) risk in older men enrolled in the Osteoporotic Fractures in Men Study. We hypothesized that men with higher BMD, a marker of exposure to endogenous sex hormones, would have an increased incidence of PCa. The cohort included 4,597 men (89% White, 65 years or older) with no prior history of PCa.