Prevalence of osteoporosis and incidence of hip fracture in women - secular trends over 30 years

<p>Abstract</p> <p>Background</p> <p>The number of hip fractures during recent decades has been reported to be increasing, partly because of an increasing proportion of elderly women in the society. However, whether changes in hip fracture annual incidence in women are attributable to secular changes in the prevalence of osteoporosis is unclear.</p> <p>Methods</p> <p>Bone mineral density was evaluated by single-photon absorptiometry at the distal radius in 456 women aged 50 years or above and living in the same city. The measurements were obtained by the same densitometer during three separate time periods: 1970-74 (n = 106), 1987-93 (n = 175) and 1998-1999 (n = 178), and the age-adjusted prevalence of osteoporosis in these three cohorts was calculated. Additionally, all hip fractures sustained in the target population of women aged 50 years or above between 1967 and 2001 were registered, whereupon the crude and the age-adjusted annual incidence of hip fractures were calculated.</p> <p>Results</p> <p>There was no significant difference in the age-adjusted prevalence of osteoporosis when the three cohorts were compared (P = 1.00). The crude annual incidence (per 10,000 women) of hip fracture in the target population increased by 110% from 40 in 1967 to 84 in 2001. The overall trend in the crude incidence between 1967 and 2001 was increasing (1.58 per 10,000 women per year; 95 percent confidence interval, 1.17 to 1.99), whereas the age-adjusted incidence was stable over the same period (0.22 per 10,000 women per year; 95 percent confidence interval, -0.16 to 0.60).</p> <p>Conclusions</p> <p>The increased number of hip fracture in elderly women is more likely to be attributable to demographic changes in the population than to secular increase in the prevalence of osteoporosis.</p

Morning warming-up exercise-effects on musculoskeletal fitness in construction workers.

The aim of the present study was to evaluate the effects on muscle stretchability, joint flexibility, muscle strength and endurance in construction workers of a 3-month period of a 10-min morning warming-up exercise (MWU), performed at the building site every working day. Thirty construction workers participated in the program. Seventeen construction workers at other building sites served as controls. Muscle stretchability, joint flexibility, muscle strength and endurance were measured before and after the program. Significant increase of thoracic and lower back mobility, increase of hamstring and thigh muscle stretchability were seen in the MWU group. A significant difference in back muscle endurance was found due to decreased endurance in the controls. Muscular strength was not influenced by the MWU. The results indicate that a short dose of morning warming-up exercise could be beneficial for increasing or maintaining joint and muscle flexibility and muscle endurance for workers exposed to manual material handling and strenous working positions

Bone mass following physical activity in young years: a mean 39-year prospective controlled study in men.

This is a study on exercise-associated bone mineral density (BMD) which in men is maintained three decades after cessation of sports. In this prospective controlled cohort study active athletes had a BMD Z-score of 1.0 and after 39 years 0.5 to 1.2 depending on the measured region), using the same single-photon absorptiometry device, dual X-ray absorptiometry (DXA), and peripheral computed tomography (pQCT). INTRODUCTION: The aims of this study were to prospectively evaluate BMD changes in male athletes from activity into long-term retirement and to simultaneously evaluate other bone traits. METHODS: Bone mineral density (grams per square centimeter) was measured in 46 male athletes with a mean age of 22 years (range, 15-40) by using the same single-photon absorptiometry device, both at active career and a mean of 39 years (range, 38-40) later when they had long-term retired. At follow-up, BMD was also evaluated by DXA and pQCT. Twenty-four non-athletic males of similar age served as controls. Between-group differences are presented as means with 95 % confidence intervals. RESULTS: The active athletes (baseline) had a BMD Z-score of 1.0 (0.7, 1.4) in the femoral condyles. The retired athletes (follow-up) had a BMD Z-score of 0.5 to 1.2 depending on the measuring technique and the measured region. The tibial cortical area Z-score at follow-up was 0.8 (0.5, 1.2) and the tibial strength index Z-score 0.7 (0.4, 1.0). There were no changes in BMD Z-scores from activity to retirement, neither when estimated by the same device in different regions [∆ Z-score -0.3 (-0.8, 0.2)] nor in the same region with different devices [∆ Z-score 0.0 (-0.4, 0.4)]. The benefits remained after adjustments for anthropometrics and lifestyle. No correlation was seen with years since retirement. CONCLUSIONS: Exercise-associated high BMD in young years seems, in men, to be maintained three decades after cessation of high-level physical activity

An Increase in Forearm Cortical Bone Size After Menopause May Influence the Estimated Bone Mineral Loss-A 28-Year Prospective Observational Study.

Areal bone mineral density (aBMD) is the most common estimate of bone mass, incorporated in the World Health Organization definition of osteoporosis. However, aBMD depends on not only the amount of mineral but also the bone size. The estimated postmenopausal decline in aBMD could because of this be influenced by changes in bone size.We measured bone mineral content (BMC; mg), aBMD (mg/cm(2)), and bone width (mm) by single-photon absorptiometry at the cortical site of the forearm in a population-based sample of 105 Caucasian women. We conducted 12 measurements during a 28-yr period from mean 5 yr (range: 2-9) before menopause to mean 24 yr (range: 18-28) after menopause. We calculated individual slopes for changes in the periods before menopause, 0-<8, 8-<16, and 16-28 yr after menopause. Data are presented as means with 95% confidence intervals. The annual BMC changes in the 4 periods were -1.4% (-0.1, -2.6), -1.1% (-0.9, -1.4), -1.2% (-0.9, -1.6), and -1.1% (-0.8, -1.4) and the annual increase in bone width 0.4% (-1.2, 1.9), 0.7% (0.5, 0.9), 0.1% (-0.2, 0.4), and 0.1% (-0.2, 0.4). BMC loss was similar in all periods, whereas the increase in bone width was higher in the first postmenopausal period than in the second (p = 0.003) and the third (p = 0.01) postmenopausal periods. Menopause is followed by a transient increase in forearm bone size that will influence the by aBMD estimated cortical loss in bone minerals

Secular Trends in Swedish Hip Fractures 1987-2002: Birth Cohort and Period Effects.

BACKGROUND: Recently, a leveling off in hip-fracture incidence has been reported in several settings, but the annual number is nonetheless predicted to increase due to the growing elderly population. METHODS: Using Swedish national data for 1987-2002 for all inpatients 50 years or older, we examined the annual number and incidence of hip fractures and explored age, period, and cohort effects. Age adjustment was done by direct standardization, time-trend analysis by linear regression, changes in linear trends by joinpoint regression, and age-period-cohort effects by log-likelihood estimates in Poisson regression models. RESULTS: Before 1996, the age-standardized hip fracture incidence was stable (0.1% per year [95% confidence interval = -0.2% to 0.5%]), and the annual number of hip fractures increased (2.1% per year [1.8% to 2.4%]). After 1996, both the age-standardized hip fracture incidence (-2.2% per year [-2.8% to -1.6%]) and the number of hip fractures (-0.9% per year [-1.5% to -0.4%]) decreased. The period + cohort effects were more marked among women than men, with a major reduction in hip fracture incidence in subsequent birth cohorts (estimated incidence rate ratio = 2.2 comparing women born 1889-1896 with 1945-1952) or periods (estimated incidence rate ratio = 1.1 comparing women living 1987-1990 with 1999-2002). CONCLUSION: The age-standardized hip fracture incidence has decreased since 1996, more than counteracting the effects of the aging population and resulting in a decline in the annual number of hip fractures through 2002. The magnitude of the combined period and cohort effects in women seems to be of biologic importance. If this persists into older age, the annual number of hip fractures will be lower than has been projected

Time Trends in Trajectories of Forearm Mineral Content and Bone Size during Childhood—Results from Cross‐Sectional Measurements with the Same Apparatus Four Decades Apart

ABSTRACT Evidence suggests that single photon absorptiometry (SPA)‐measured forearm bone mineral density (BMD) is lower in contemporary children in Malmö than it was four decades ago, but the fracture incidence in the at‐risk population (all Malmö children) has been stable during the same period. The aim of this study was to evaluate if improvements in skeletal structure over time may explain this observation. In 2017–2018 we measured distal forearm bone mineral content (BMC; mg/cm) and periosteal diameter (mm) in 238 boys and 204 girls aged 7–15 using SPA. Based on the SPA measurements, we calculated forearm BMD (mg/cm2), bone mineral apparent density (BMAD, mg/cm3), section modulus, and strength index (BMAD × section modulus). The results were compared with those derived from measurements of 55 boys and 61 girls of the same ages using the same scanner in 1979–1981. We used log‐linear regression with age, sex, and cohort as predictors to investigate differences in trait trajectories (trait versus age slopes [mean percent difference in beta values (95% confidence interval)]). SPA‐measured forearm BMC was lower at each age in 2017–2018 compared to 1979–1981 (a mean age and sex adjusted relative difference of 9.1%), the forearm BMC trajectory was similar in 2017–2018 to that in 1979–1981 (reference) [0.0%/year (−1.0%, 1.0%)], while the 2017–2018 forearm periosteal diameter trajectory was steeper [1.1%/year (0.3%, 2.0%)]. Since bone size influences both BMD (BMC divided by scanned area) and mechanical characteristics, the forearm BMD trajectory was flatter in 2017–2018 [−1.1%/year (−2.0%, −0.2%)] and the forearm section modulus trajectory steeper [3.9%/year (1.4%, 6.4%)]. Forearm strength index trajectory was similar [1.8%/year (−0.5%, 4.1%)]. The lower SPA‐measured forearm BMD trajectory in contemporary children compared to four decades ago may be offset by changes in forearm bone structure, resulting in similar overall bone strength. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research