| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
- Ismail, AA, et al.
(författare)
-
Incidence of limb fracture across Europe: Results from the European Prospective Osteoporosis Study (EPOS)
- 2002
-
Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 13:7, s. 565-571
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this population-based prospective study was to determine the incidence of limb fracture by site and gender in different regions of Europe. Men and women aged 50-79 years were recruited from population registers in 31 European centers. Subjects were invited to attend for an interviewer-administered questionnaire and lateral spinal radiographs. Subjects were subsequently followed up using an annual postal questionnaire which included questions concerning the occurrence of new fractures. Self-reported fractures were confirmed where possible by radiograph, attending physician or subject interview. There were 6451 men and 6936 women followed for a median of 3.0 years. During this time there were 140 incident limb fractures in men and 391 in women. The age-adjusted incidence of any limb fracture was 7,3/1000 person-years [pyrs] in men and 19 per 1000 pyrs in women, equivalent to a 2,5 times excess in women. Among women, the incidence of hip, humerus and distal forearm fracture, though not 'other' limb fracture, increased with age, while in men only the incidence of hip and humerus fracture increased with age. Among women, there was evidence of significant variation in the occurrence of hip, distal forearm and humerus fractures across Europe, with incidence rates higher in Scandinavia than in other European regions. though for distal forearm fracture the incidence in east Europe was similar to that observed in Scandinavia. Among men, there was no evidence of significant geographic variation in the occurrence of these fractures. This is the first large population-based study to characterize the incidence of limb fracture in men and women over 50 years of age across Europe. There are substantial differences in the descriptive epidemiology of limb fracture by region and gender.
|
|
| 5. |
|
|
| 6. |
- Johnell, K, et al.
(författare)
-
Neighbourhood social participation and women's use of anxiolytic-hypnotic drugs: a multilevel analysis.
- 2004
-
Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 1470-2738 .- 0143-005X. ; 58:1, s. 59-64
-
Tidskriftsartikel (refereegranskat)abstract
- Study objectives: To identify and quantify a hypothesised collective effect of the neighbourhood on individual use of anxiolytic-hypnotic drugs (AHD). To analyse the general impact of neighbourhood social participation on use of AHD, adjusting for individual characteristics. Design: Cross sectional analysis performed by multilevel logistic regression with women at the first level and neighbourhoods at the second level. Setting: Malmö (250 000 inhabitants), Sweden. Participants:15 456 women aged 45 to 73, residing in 95 neighbourhoods in Malmö, who took part in the Malmö diet and cancer study (1991–1996). Main results: The prevalence of AHD use was 5.5% in the study sample. Overall, 1.7% of the total individual differences in the propensity for using AHD were explained by the neighbourhood level. This percentage, however, differed between different individuals. Low level of social participation in the neighbourhood was associated with higher probability of AHD use (OR = 3.10 (95% CI 1.51 to 6.41)), independently of individual age, low social participation, low educational level, and living alone. This association was reduced (OR = 2.01 (95% CI 0.97 to 4.14)) after the additional accounting for individual disability pension, low self rated health, stress, and medication for somatic disorders. Conclusions: The neighbourhood level of social participation seems to affect individual use of AHD, possibly through individual characteristics. However, neighbourhood boundaries play a minor part in understanding individual AHD use in the city of Malmö.
|
|
| 7. |
- Karlsson, M K, et al.
(författare)
-
Age, gender, and fragility fractures are associated with differences in quantitative ultrasound independent of bone mineral density
- 2001
-
Ingår i: Bone. - 1873-2763. ; 28:1, s. 118-122
-
Tidskriftsartikel (refereegranskat)abstract
- Bone strength is determined by bone mineral density (BMD) and bone structure. Dual-energy X-ray absorptiometry (DXA) measures BMD. Whether quantitative ultrasound (qUS) measures a property of bone distinct from BMD is uncertain. To evaluate this, DXA and qUS were measured in 58 fracture patients and 428 controls. To study the independent effects of age and gender on qUS measurements and control for BMD by study design rather than statistical methods, subgroups from the normative database were created and intentionally matched by the same femoral neck (FN) BMD. Speed of sound (SOS; m/sec), broadband ultrasound attenuation (BUA; dB/MHz), and stiffness index (SI) were then compared in individuals matched by FN BMD but differing in age, gender, and presence or absence of fractures. The results are presented as percentage difference (mean +/- SD). Elderly women with the same FN BMD as young women had 1 +/- 2% lower SOS (p < 0.05), 8 +/- 15% lower SI (p < 0.05), and 4 +/- 9% lower BUA (p = 0.07). Elderly women with the same FN BMD as elderly men had 5 +/- 9% lower BUA (p < 0.05). Elderly men with the same FN BMD as young men had 1 +/- 2% lower SOS (p = 0.1), 5 +/- 14% lower SI (p = 0.2), and 1 +/- 9% lower BUA (n.s.). Young women with the same FN BMD as young men had 2 +/- 7% lower BUA (n.s.). Women with fragility fractures had 8 +/- 11% lower BUA (p < 0.001) and 13 +/- 22% lower SI (p < 0.01) than controls with no fractures matched by FN BMD, age, and gender. Men with fragility fractures had 13 +/- 12% lower BUA (p < 0.01) and 16 +/- 19% lower SI (p < 0.05) than controls with no fractures matched by FN BMD, age, and gender. Despite comparable femoral neck BMD, qUS measurements differed according to age, gender, and fracture status, suggesting that qUS may provide additional information independent of femoral neck BMD, such as differences in connectivity or other properties yet to be identified.
|
|
| 8. |
- Karlsson, M K, et al.
(författare)
-
Exercise during growth and bone mineral density and fractures in old age
- 2000
-
Ingår i: The Lancet. - 1474-547X. ; 355:9202, s. 469-470
-
Tidskriftsartikel (refereegranskat)abstract
- If exercise is to be recommended during growth, benefits in bone mineral density (BMD) must be maintained in old age and shown to prevent fractures. Our cross-sectional study of soccer players suggests that a high BMD is no longer recorded after retirement and fracture frequency is no less than predicted in old age.
|
|
| 9. |
- Magnusson, H I, et al.
(författare)
-
Bone mass changes in weight-loaded and unloaded skeletal regions following a fracture of the hip
- 2001
-
Ingår i: Calcified Tissue International. - : Springer Science and Business Media LLC. - 1432-0827 .- 0171-967X. ; 69:2, s. 78-83
-
Tidskriftsartikel (refereegranskat)abstract
- Higher bone mineral density (BMD) has been reported in weight-loaded skeletal regions and lower BMD in unloaded regions in active athletes compared with controls. These discrepancies remain the first decades after cessation of active careers in former athletes with no remaining discrepancies found after age 65 years compared with age- and gender-matched controls. Physical activity is reduced after a hip fracture and BMD decreases in weight-loaded skeletal regions following the injury. If BMD increases in unloaded regions following a fracture of the hip it is not known. A BMD increase in an unloaded region would support the hypothesis of discrepancies in BMD response to physical activity in loaded and unloaded skeletal regions. BMD (g/cm2) was measured longitudinally using dual X-ray absorptiometry (DXA) in 32 women, mean age 77 years (range 57-90) and 12 men, mean age 74 years (range 53-89) with a hip fracture, the upper part of the skull representing an unloaded skeletal region, the arms a partly loaded region, and the femoral neck a weight-loaded region. Measurements (mean) were done in 11 days, 5 months, and 13 months after the hip fracture. Data are presented as mean +/- SEM. BMD increased in the upper part of the skull by 1.9%+/-0.8% the first 5 months and 3.7%+/-0.9% the first 13 months after the fracture (P < 0.05 and P < 0.001, respectively). BMD did not change in the arms but decreased in the nonfractured femoral neck by 4.7%+/-1.8% the first 5 months and 4.5%+/-1.7% the first 13 months after the fracture (both P < 0.01, respectively). In summary, in this longitudinal study, BMD increased in an unloaded skeletal region and decreased in a weight-loaded region following a hip fracture with reduced activity level, suggesting that loaded and unloaded skeletal regions confer different BMD response after changed activity level.
|
|
| 10. |
- Sundberg, Martin, et al.
(författare)
-
Peripubertal moderate exercise increases bone mass in boys but not in girls: a population-based intervention study
- 2001
-
Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 12:3, s. 230-238
-
Tidskriftsartikel (refereegranskat)abstract
- On the basis of cross-sectional studies in elite athletes and longitudinal studies, physical activity in growing children has been suggested to enhance bone mineral acquisition and prevent osteoporosis later in life. The level of exercise in most of these studies is not applicable in a population on a day-to-day basis. The aim of this study was to determine whether moderate increased exercise within the school curriculum from age 12 to 16 years would have anabolic bone effects. In a population-based setting of 40 boys and 40 girls the school curriculum was enhanced to physical education 4 times per week for 3-4 years. Controls were 82 boys and 66 girls who had had physical education twice a week over a corresponding period. Both cases and controls were measured at age 16 years. Bone mineral content (BMC), areal bone mineral density (aBMD), bone size (femoral neck width) and volumetric BMD (vBMD) were measured in total body, spine and femoral neck (FN) by dual-energy X-ray absorptiometry. Data are presented as mean +/- SD. BMC (8 +/- 15%, p = 0.04), aBMD (9 +/- 13%, p = 0.002) and vBMD (9 +/- 15%, p = 0.001) were all higher in FN in the male intervention group compared with controls. FN bone size was no higher in the intervention group than in the controls. In girls, no differences were found when comparing the intervention group with controls. The results remained after adjusting for confounding factors such as weight, height, milk intake and activity after school. In summary, we report that increased bone mass can be achieved in a population-based cohort of boys (but not in girls) by moderate increased physical activity within the school curriculum from age 12 to 16 years. We speculate that the same results can be seen in girls if intervention starts at an earlier age. We conclude that increasing the physical education content of the Swedish school curriculum may improve bone mass in at least peripubertal boys.
|
|
