Mid-calf skeletal muscle density and its associations with physical activity, bone health and incident 12-month falls in older adults: The Healthy Ageing Initiative

Accepted manuscript version, licensed CC BY-NC-ND 4.0. Background - Lower skeletal muscle density, indicating greater infiltration of adipose tissue into muscles, is associated with higher fracture risk in older adults. We aimed to determine whether mid-calf muscle density is associated with falls risk and bone health in community-dwelling older adults. Methods - 2214 community-dwelling men and women who participated in the Healthy Ageing Initiative (Sweden) study at age 70 were included in this analysis. Mid-calf muscle density (mg/cm3) at the proximal tibia, and volumetric bone mineral density (vBMD) and architecture at the distal and proximal tibia and radius, were assessed by peripheral quantitative computed tomography. Whole-body lean and fat mass, lumbar spine and total hip areal bone mineral density (aBMD) were assessed by dual-energy X-ray absorptiometry. Participants completed seven-day accelerometer measurements of physical activity intensity, and self-reported falls data were collected 6 and 12 months later. Results - 302 (13.5%) participants reported a fall at the 6- or 12-month interview, and 29 (1.3%) reported a fall at both interviews. After adjustment for confounders, each standard deviation decrease in mid-calf muscle density was associated with a trend towards greater likelihood of experiencing a fall (OR 1.13; 95% CI 1.00, 1.29 per SD lower) and significantly greater likelihood of multiple falls (1.61; 1.16, 2.23). Higher muscle density was not associated with total hip aBMD, and was associated with lower lumbar spine aBMD (B = -0.003; 95% CI -0.005, -0.001 per mg/cm3) and higher proximal cortical vBMD (0.74; 0.20, 1.28) at the radius. At the tibia, muscle density was positively associated with distal total and trabecular vBMD, and proximal total and cortical vBMD, cortical thickness, cortical area and stress-strain index (all P  Conclusions - Lower mid-calf muscle density is independently associated with higher likelihood for multiple incident falls and appears to have localised negative effects on bone structure in older adults

Associations of health-related quality of life, fear of falling and objective measures of physical function with bone health in postmenopausal women with low bone mass

Health-related quality of life (HRQoL) and physical function deteriorate with age and may adversely impact bone health in older adults. We determined associations of objective measures of physical function and HRQoL with bone health in postmenopausal women with low areal bone mineral density (aBMD). Fifty postmenopausal women (64.4 ± 7.7 years old, mean ± standard deviation) with low spine, hip or femoral neck aBMD (T- or Z-score < −1.0) on dual-energy X-ray absorptiometry (DXA) participated. Femoral surface BMD, trabecular, integral and cortical volumetric BMD (vBMD) measurements were obtained using 3D-SHAPER software on DXA. Distal tibial vBMD and microarchitecture were assessed using high-resolution peripheral quantitative computed tomography (HRpQCT). Participants completed self-administered EuroQol-5D (EQ-5D) and modified falls efficacy scale (MFES) questionnaires, and physical function assessments. Stair climb power was positively associated with bone parameters at the hip, femoral neck, and distal tibia (all p < 0.05) in multivariable linear regression. EQ-5D demonstrated no significant associations with bone parameters and MFES was positively associated only with distal tibial cortical vBMD and cortical von Mises stress (both p < 0.05). Objective measures of physical function, particularly muscle power, are more consistently associated with bone parameters compared with self-administered HRQoL questionnaires

Accumulation in coastal West Antarctic ice core records and the role of cyclone activity

Cyclones are an important component of Antarctic climate variability, yet quantifying their impact on the polar environment is challenging. We assess how cyclones which pass through the Bellingshausen Sea affect accumulation over Ellsworth Land, West Antarctica, where we have two ice core records. We use self-organizing maps (SOMs), an unsupervised machine learning technique, to group cyclones into nine SOM nodes differing by their trajectories (1980–2015). The annual frequency of cyclones associated with the first SOM node (SOM1, which generally originate from lower latitudes over the South Pacific Ocean) is significantly (p < 0.001) correlated with annual accumulation, with the highest seasonal correlations (p < 0.001) found during autumn. While significant (p < 0.01) increases in vertically integrated water vapor over the South Pacific Ocean coincide with this same group of cyclones, we find no indication that this has led to an increase in moisture advection into, nor accumulation over, Ellsworth Land over this short time period

Honours Thesis 2015

Thesis produced as a part of Bachelor of Biomedical Science - Honours at Victoria University in 2015<div><br></div><div>Supervised by Assoc Prof Alan Hayes & Dr David Scott</div

The top 100 most cited articles in Australian orthopaedic surgery

Background: This study sought to identify and evaluate the one hundred most cited articles relating to orthopaedic surgery from Australian authors, so to describe characteristics of and gain insight into the most seminal Australian orthopaedic publications. Methods: The Web of Science was utilised to identify the one hundred most cited publications from within the Science Citation Index Expanded subject category of “ORTHOPEDICS”. Articles were identified from 127 journals within the collection and filtered for those originating from Australian authors. Each article was individually reviewed as related to orthopaedic surgery. The title, authors, journal, city, and publication focusses were identified and evaluated. Results: The top 100 publications from Australian authors were published between 1975 and 2017. The most cited article received 465 citations within the Web of Science Core collection, and the fewest receiving 140. The most common decade of publication began in the year 2000. The American Journal of Sports Medicine was the most prolific with 25 publications. The city with the most publications was Melbourne (38) followed by Sydney (28) and Adelaide (10). Conclusions: This study has identified the top 100 cited publications related to orthopaedics produced by Australian authors. This list comprises a vast number of seminal papers and may hold utility as a reading list for current and aspiring surgical trainees

Prescribing physical activity for the prevention and treatment of osteoporosis in older adults

Osteoporosis is an age-related disease, characterised by low bone mineral density (BMD) and compromised bone geometry and microarchitecture, leading to reduced bone strength. Physical activity (PA) has potential as a therapy for osteoporosis, yet different modalities of PA have varying influences on bone health. This review explores current evidence for the benefits of PA, and targeted exercise regimes for the prevention and treatment of osteoporosis in older adults. In particular, the outcomes of interventions involving resistance training, low- and high-impact weight bearing activities, and whole-body vibration therapy are discussed. Finally, we present recommendations for future research that may maximise the potential of exercise in primary and secondary prevention of osteoporosis in the ageing population

Associations of Sarcopenia and Its Components with Bone Structure and Incident Falls in Swedish Older Adults

The aim of this study was to compare bone structure parameters and likelihood of falls across European Working Group on Sarcopenia in Older People (EWGSOP2) sarcopenia categories. 3334 Swedish 70-year olds had appendicular lean mass (normalized to height; ALMHt), lumbar spine and total hip areal BMD (aBMD) estimated by dual-energy X-ray absorptiometry. Volumetric BMD (vBMD) and structure at the distal and proximal tibia and radius were estimated by peripheral quantitative computed tomography. Hand grip strength and timed up-and-go were assessed, and sarcopenia was defined according to EWGSOP2 criteria. Incident falls were self-reported 6 and 12 months after baseline. Only 0.8% and 1.0% of participants had probable and confirmed sarcopenia, respectively. Almost one-third of participants with confirmed sarcopenia reported incident falls, compared with 20% for probable sarcopenia and 14% without sarcopenia (P = 0.025). Participants with confirmed sarcopenia had poorer bone parameters (all P 2) and periosteal and endosteal circumferences at the proximal tibia (− 3.3; − 6.4, − 0.3 and − 3.8; − 7.5, − 0.1 mm2, respectively), compared with those without sarcopenia. Compared with probable sarcopenia, confirmed sarcopenic participants had significantly lower lumbar spine and total hip aBMD, distal radius and tibia total vBMD, and proximal radius and tibia cortical vBMD, area and thickness (all P < 0.05). Swedish 70-year olds with confirmed sarcopenia demonstrate poorer BMD and bone architecture than those with probable and no sarcopenia, and have increased likelihood of incident falls

Metabolic Syndrome and Its Associations with Components of Sarcopenia in Overweight and Obese Older Adults

Ageing, obesity and the metabolic syndrome (MetS) may all contribute to poor muscle health (sarcopenia). This study aimed to determine the cross-sectional associations between MetS (International Diabetes Federation classification) and sarcopenia (revised European Working Group on Sarcopenia in Older People definition) in 84 overweight and obese older adults. Components of sarcopenia included muscle strength (hand grip and leg extension), physical performance (stair climb test and short physical performance battery (SPPB), including gait speed and repeated chair stands time), muscle mass (appendicular lean mass (ALM), dual-energy X-ray absorptiometry), muscle size (peripheral quantitative computed tomography-determined calf and forearm cross-sectional area (CSA)) and muscle quality (muscle density and strength normalised to lean mass). Waist circumference was associated with greater muscle size, but poorer leg extension strength, chair stands and stair climb time, gait speed, SPPB scores and muscle quality measures (all p &lt; 0.05). MetS was positively associated with ALM and forearm muscle CSA, and negatively associated with muscle quality measures and chair stands time (all p &lt; 0.05). MetS is associated with larger muscle size, yet poorer muscle quality in overweight and obese older adults. Assessments of muscle function and quality should be considered for obese older adults and those with MetS