Publications by authors named "Fink H"

The coronavirus disease 2019 pandemic substantially impacted the delivery of cancer services and programs. Here we reviewed and synthesized the global scale and impact of pandemic-related delays and disruptions on cancer services, including diagnosis, diagnostic procedures, screening, treatment and supportive and palliative care. Based on data from 245 articles in 46 countries, we observed declines in the number of cancer screening participation (39.

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Background: To assess proportions of metastatic recurrence in women initially diagnosed with non-metastatic breast cancer by stage at diagnosis, breast cancer subtype, calendar period and age.

Methods: A systematic search of MEDLINE and Web of Science databases (January 2010-12 May 2022) was conducted. Studies reporting the proportion of distant metastatic recurrence in women with non-metastatic breast cancer were identified and outcomes and characteristics were extracted.

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  • The study investigates the association between frailty, measured using the Study of Osteoporotic Fractures (SOF) phenotype, and increased healthcare costs among older adults with Medicare.
  • It analyzes data from over 8,000 community-dwelling seniors, comparing costs related to frailty as defined by the SOF and the more complex Cardiovascular Health Study (CHS) phenotype.
  • Results show that SOF phenotypic frailty is linked to significant incremental healthcare costs, comparable to those identified by the CHS phenotype, indicating the importance of recognizing frailty in clinical settings for cost management.
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Background: Life-space mobility captures the daily, enacted mobility of older adults. We determined cross-sectional associations between life-space mobility and cognitive impairment (CI) among community-dwelling women in the 9th and 10th decades of life.

Methods: A total of 1375 (mean age 88 years; 88% White) community-dwelling women enrolled in a prospective cohort of older women.

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Type 2 diabetes mellitus and lower weight are both associated with osteoporotic fractures, but the roles of variability and trajectory are less clear. The associations of these factors among older adults with dysglycemia, who are at highest risk of fracture, with fracture risk and BMD remain uncertain. We followed 775 men and 1080 women from the Cardiovascular Health Study (mean age 77.

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Although low back pain (LBP) may persist or recur over time, few studies have evaluated the individual course of LBP over a long-term period, particularly among older adults. Based on data from the longitudinal Osteoporotic Fractures in Men (MrOS) Study, we aimed to identify and describe different LBP trajectories in older men and characterize members in each trajectory group. A total of 5 976 community-dwelling men (mean age = 74.

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Importance: While adults aged 80 years and older account for 70% of hip fractures in the US, performance of fracture risk assessment tools in this population is uncertain.

Objective: To compare performance of the Fracture Risk Assessment Tool (FRAX), Garvan Fracture Risk Calculator, and femoral neck bone mineral density (FNBMD) alone in 5-year hip fracture prediction.

Design, Setting And Participants: Prognostic analysis of 3 prospective cohort studies including participants attending an index examination (1997 to 2016) at age 80 years or older.

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Unlabelled: This study examined if the amino acids phenylalanine or tyrosine contribute to risk of hip fracture or frailty in older adults. We determined that neither phenylalanine nor tyrosine are important predictors of hip fracture or frailty. We suggest advice on protein intake for skeletal health consider specific amino acid composition.

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Objective: The aim of this study was to examine associations between empirically derived dietary pattern scores and cognition, as well as risk of cognitive decline, over an average of 4.6 (± 0.3) years in older men.

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During the COVID-19 pandemic, countries adopted mitigation strategies to reduce disruptions to cancer services. We reviewed their implementation across health system functions and their impact on cancer diagnosis and care during the pandemic. A systematic search was performed using terms related to cancer and COVID-19.

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Article Synopsis
  • Researchers developed a protein-based risk score for predicting hip fractures using an aptamer-based proteomic platform that showed promise in initial studies.
  • The risk score demonstrated strong predictive capabilities and improved fracture discrimination when validated in additional health study cohorts and in a UK Biobank cohort.
  • While the proteomic risk score outperformed existing tools, including the FRAX assessment, its clinical usefulness beyond current methods and the modest improvement in prediction need further evaluation.
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Objective: We evaluated whether more severe back pain phenotypes-persistent, frequent, or disabling back pain-are associated with higher mortality rate among older men.

Methods: In this secondary analysis of a prospective cohort, the Osteoporotic Fractures in Men (MrOS) study, we evaluated mortality rates by back pain phenotype among 5215 older community-dwelling men (mean age, 73 years, SD = 5.6) from 6 sites in the United States.

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Hip fractures are associated with significant disability, high cost, and mortality. However, the exact biological mechanisms underlying susceptibility to hip fractures remain incompletely understood. In an exploratory search of the underlying biology as reflected through the circulating proteome, we performed a comprehensive Circulating Proteome Association Study (CPAS) meta-analysis for incident hip fractures.

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Background: Most fractures occur in women aged ≥80 years but competing mortality unrelated to fracture may limit the benefit of osteoporosis drug therapy for some women in late life. Our primary aim was to develop separate prediction models for non-spine fracture (NSF) and mortality before fracture to identify subsets of women with varying fracture versus mortality risks.

Methods: Separate prediction models were developed for NSF and mortality before NSF for 4895 women aged ≥80 years enrolled in the Study of Osteoporotic Fractures (SOF) or the Health Aging and Body Composition (HABC) study.

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Article Synopsis
  • The objective is to update recommendations for preventing and treating glucocorticoid-induced osteoporosis (GIOP) in patients on glucocorticoids for more than three months at doses of 2.5 mg daily or higher.
  • A systematic review was conducted to address various treatment approaches, assessing the quality of evidence and reaching a consensus on recommendations for fracture risk assessment and appropriate therapies.
  • The guidelines emphasize early assessment of fracture risk, strongly advise pharmacologic treatment for high-risk individuals, and provide tailored recommendations for specific populations, while ensuring these guidelines do not restrict access to necessary therapies.
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  • The text aims to update guidelines for preventing and treating glucocorticoid-induced osteoporosis (GIOP) in patients using glucocorticoids for over three months at daily doses of 2.5 mg or more.
  • A systematic review of literature was conducted, and recommendations were developed with consensus from a panel, focusing on both medication and non-medication strategies for managing GIOP.
  • Strong recommendations include early fracture risk assessments for patients starting glucocorticoids and pharmacologic treatment for those at medium to very high fracture risk, along with specific guidance for certain populations.*
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Amino acids are the building blocks of proteins, and sufficient protein intake is important for skeletal health. We utilized stored serum from the Cardiovascular Health Study in 1992-1993 to examine the relationship between levels of the essential amino acid tryptophan (trp) and its oxidized and nonoxidized metabolites to risk for incident hip fractures and mortality over 12 years of follow-up. We included 131 persons who sustained a hip fracture during this time period and 131 without a hip fracture over these same 12 years of follow-up; 58% female and 95% White.

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Background: Reference intervals of thyroid-stimulating hormone (TSH) and free thyroxine (FT) are statistically defined by the 2·5-97·5th percentiles, without accounting for potential risk of clinical outcomes. We aimed to define the optimal healthy ranges of TSH and FT based on the risk of cardiovascular disease and mortality.

Methods: This systematic review and individual participant data (IPD) meta-analysis identified eligible prospective cohorts through the Thyroid Studies Collaboration, supplemented with a systematic search via Embase, MEDLINE (Ovid), Web of science, the Cochrane Central Register of Controlled Trials, and Google Scholar from Jan 1, 2011, to Feb 12, 2017 with an updated search to Oct 13, 2022 (cohorts found in the second search were not included in the IPD).

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  • * They measured 25 immune cell types in nearly 2,000 participants and found specific associations: in women, more natural killer (NK) cells seemed to lower the risk of hip fractures, while higher levels of Th17 cells increased the risk; for men, more γδ T cells were linked to a lower risk.
  • * However, when combining data from both sexes, no clear associations between immune cell types and hip fracture risk were found, highlighting potential differences in men and women regarding immune responses and fracture risk.
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Background: Stressful life events, such as loss of a partner, loss of a pet or financial problems, are more common with increasing age and may impact the experience of pain. The aim of the current study is to determine the cross-sectional and prospective association between stressful life events and low back pain reporting in the Osteoporotic Fracture in Men Study, a cohort of older men aged ≥65 years.

Methods: At a study visit (March 2005-May 2006), 5149 men reported whether they had experienced a stressful life event or low back pain in the prior 12 months.

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Targeted fracture prevention strategies among late-life adults should balance fracture risk versus competing mortality risk. Models have previously been constructed using Fine-Gray subdistribution methods. We used a machine learning method adapted for competing risk survival time to evaluate candidate risk factors and create models for hip fractures and competing mortality among men and women aged 80 years and older using data from three prospective cohorts (Study of Osteoporotic Fractures [SOF], Osteoporotic Fracture in Men study [MrOS], Health Aging and Body Composition study [HABC]).

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The American Society of Bone and Mineral Research (ASBMR) Professional Practice Committee charged an ASBMR Task Force on Clinical Algorithms for Fracture Risk to review the evidence on whether current approaches for differentiating fracture risk based on race and ethnicity are necessary and valid. To help address these charges, we performed a systematic literature review investigating performance of calculators for predicting incident fractures within and across race and ethnicity groups in middle-aged and older US adults. We included English-language, controlled or prospective cohort studies that enrolled US adults aged >40 years and reported tool performance predicting incident fractures within individual race and ethnicity groups for up to 10 years.

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Objective: Branched chain amino acids (BCAA) are building blocks for protein, an essential component of bone. However, the association of plasma levels of BCAA with fractures in populations outside of Hong Kong or with hip fractures in particular is not known. The purpose of these analyses was to determine the relationship of BCAA including valine, leucine, and isoleucine and total BCAA (SD of the sum of Z-scores for each BCAA) with incident hip fractures and bone mineral density (BMD) of the hip and lumbar spine in older African American and Caucasian men and women in the Cardiovascular Health Study.

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