M. Lorentzon

Inferior physical performance tests in 10,998 men in the MrOS study is associated with recurrent falls

BACKGROUNDnrecurrent fallers are at especially high risk for injuries.nnnOBJECTIVEnto study whether tests of physical performance are associated with recurrent falls.nnnSUBJECTSna total of 10,998 men aged 65 years or above.nnnMETHODSnquestionnaires evaluated falls sustained 12 months preceding testing of grip strength, timed stand, 6-m walk and 20-cm narrow walk test. Means with 95% confidence interval (95% CI) are reported. Pxa0<xa00.01 is a statistically significant difference.nnnRESULTSnin comparison to both occasional fallers and non-fallers, recurrent fallers performed more poorly on all the physical ability tests (all Pxa0<xa00.001). A score below -2 standard deviations (SDs) in the right-hand grip strength test was associated with an odds ratio of 2.4 (95% CI 1.7, 3.4) for having had recurrent falls compared with having had no fall and of 2.0 (95% CI 1.3, 3.4) for having had recurrent falls compared with having had an occasional fall.nnnCONCLUSIONnlow performance in physical ability tests are in elderly men associated with recurrent falls.

The number and characteristics of prevalent vertebral fractures in elderly men are associated with low bone mass and osteoporosis

We sought to determine whether specific characteristics of vertebral fractures in elderly men are associated with low bone mineral density (BMD) and osteoporosis. Mister Osteoporosis Sweden is a population based cohort study involving 3014 men aged 69 to 81 years. Of these, 1427 had readable lateral radiographs of the thoracic and lumbar spine. Total body (TB) BMD (g/cm²) and total right hip (TH) BMD were measured by dual energy x-ray absorptiometry. The proportion of men with osteoporosis was calculated from TH BMD. There were 215 men (15.1%) with a vertebral fracture. Those with a fracture had lower TB BMD than those without (p < 0.001). Among men with a fracture, TB BMD was lower in those with more than three fractures (p = 0.02), those with biconcave fractures (p = 0.02) and those with vertebral body compression of > 42% (worst quartile) (p = 0.03). The mean odds ratio (OR) for having osteoporosis when having any type of vertebral fracture was 6.1 (95% confidence interval (CI) 3.9 to 9.5) compared with those without a fracture. A combination of more than three fractures and compression in the worst quartile had a mean OR of 114.2 (95% CI 6.7 to 1938.3) of having osteoporosis compared with those without a fracture. We recommend BMD studies to be undertaken in these subcohorts of elderly men with a vertebral fracture.

EPIDEMIOLOGY OF FALLS AMONG 11009 ELDERLY MEN - THE MR OS STUDY

of benefit and 24.5% (170/693) required an 80% or greater risk reduction with a mean absolute risk reduction of 11.9% (CI:11.412.5) before indicating they would initiate treatment. Conclusions: Individualized estimates of 10-year absolute fracture risk affect fracture prevention attitudes. Many women require fracture risk reductions that exceed the benefits of most currently available treatments.

Risk factors for low back pain and sciatica in elderly men—the MrOS Sweden study

IntroductionnThe aim of this study was to identify whether factors beyond anatomical abnormalities are associated with low back pain (LBP) and LBP with sciatica (SCI) in older men.nnnMaterial and MethodsnMister Osteoporosis Sweden includes 3,014 men aged 69–81 years. They answered questionnaires on lifestyle and whether they had experienced LBP and SCI during the preceding 12 months. About 3,007 men answered the back pain (BP) questions, 258 reported BP without specified region. We identified 1,388 with no BP, 1,361 with any LBP (regardless of SCI), 1,074 of those with LBP also indicated if they had experienced LBP (n = 615), LBP+SCI (n = 459).nnnResultsnAbout 49% of those with LBP and 54% of those with LBP+SCI rated their health as poor/very poor (P < 0.001). Men with any LBP to a greater extent than those without BP had poor self-estimated health, depressive symptoms, dizziness, fall tendency, serious comorbidity (diabetes, stroke, coronary heart disease, pulmonary disease and/or cancer) (all P < 0.001), foreign background, were smokers (all P < 0.01), had low physical activity and used walking aids (all P < 0.05). Men with LBP+SCI to a greater extent than those with LBP had lower education, lower self-estimated health, comorbidity, dizziness and used walking aids (all P < 0.001).nnnConclusionsnIn older men with LBP and SCI, anatomical abnormalities such as vertebral fractures, metastases, central or lateral spinal stenosis or degenerative conditions may only in part explain prevalent symptoms and disability. Social and lifestyle factors must also be evaluated since they are associated not only with unspecific LBP but also with LBP with SCI.

THE PATTERN OF MORTALITY ASSOCIATED WITH BONE MINERAL DENSITY IN ELDERLY MEN - MROS SWEDEN

statistical differences were observed, however these differences over the first 52 weeks of treatment were small and not deemed by the investigators as having major clinical importance. Both the 5 mg IR daily and the 35 mg OaW DR regimens were well tolerated, and the overall frequency of adverse events was similar. Conclusions: Risedronate 35 mg OaW DR, whether taken before or after breakfast, provided similar efficacy and tolerability to risedronate 5 mg IR taken daily per the label.

FALL IN ELDERLY MEN CAN BE PREDICTED BY PHYSICAL ABILITY TESTS - THE MR OS INTERNATIONAL STUDY

statistical differences were observed, however these differences over the first 52 weeks of treatment were small and not deemed by the investigators as having major clinical importance. Both the 5 mg IR daily and the 35 mg OaW DR regimens were well tolerated, and the overall frequency of adverse events was similar. Conclusions: Risedronate 35 mg OaW DR, whether taken before or after breakfast, provided similar efficacy and tolerability to risedronate 5 mg IR taken daily per the label.

INCREASED BONE MINERAL DENSITY IN ELDERLY SWEDISH MEN WITH DIABETES TYPE 2: POSSIBLE MECHANISM

statistical differences were observed, however these differences over the first 52 weeks of treatment were small and not deemed by the investigators as having major clinical importance. Both the 5 mg IR daily and the 35 mg OaW DR regimens were well tolerated, and the overall frequency of adverse events was similar. Conclusions: Risedronate 35 mg OaW DR, whether taken before or after breakfast, provided similar efficacy and tolerability to risedronate 5 mg IR taken daily per the label.