Hip fracture secondary to falling in the elderly represents a large and rising health care problem in Australia. At least 12,000 such hip fractures occur in the elderly in Australia each year and this number is expected to increase substantially over the next several decades. Long term disability, nursing home placement, reduced quality of life, and excess mortality are known sequelae of hip fracture despite successful surgical repair. Factors have been previous identified in epidemiological res ....Hip fracture secondary to falling in the elderly represents a large and rising health care problem in Australia. At least 12,000 such hip fractures occur in the elderly in Australia each year and this number is expected to increase substantially over the next several decades. Long term disability, nursing home placement, reduced quality of life, and excess mortality are known sequelae of hip fracture despite successful surgical repair. Factors have been previous identified in epidemiological research which predict poor recovery of function and the most prominent of these are advanced age, pre-exiting mental or functional impairment, malnutrition, depression, poor social support networks, and poor gait, balance and muscle function. Current treatment paradigms for hip fracture do not uniformly screen for or appropriately address potentially reversible factors such as poor nutrition, neuromuscular dysfunction, depression, strength of social supports, or risk factors for recurrent injurious falls. It is unlikely that a unidimensional treatment will ever optimize long term functional independence in such a multifactorial syndrome. Therefore, we propose to apply a multifaceted targeted experimental treatment package (HIPFIT) to elderly patients admitted to hospital for repair of a fractured hip secondary to a fall. HIPFIT would begin in hospital and continue throughout the 12 months of follow up, using individualized treatment strategies based on periodic reassessments in these vital domains over time. The goal of the study is to reduce the number of patients requiring nursing home care at the end of 12 months, as well as to improve independence in a range of activities of daily living among experimental subjects. This would have significance not only in terms of large economic savings for the health care system but reduced personal suffering and dependency on the part of the affected individuals.Read moreRead less
This proposal is designed to test the protein leverage hypothesis (PLH) in humans: the idea that the level of food consumption in humans, like other animals, is adjusted to maintain a target protein intake. As the prevalence of overweight and obesity increases, with its attendant health problems, the need to identify which dietary components limit rather than exacerbate energy intake is imperative. According to the PLH, the consumption of a diet low in % protein and high in % fat and carbohydrat ....This proposal is designed to test the protein leverage hypothesis (PLH) in humans: the idea that the level of food consumption in humans, like other animals, is adjusted to maintain a target protein intake. As the prevalence of overweight and obesity increases, with its attendant health problems, the need to identify which dietary components limit rather than exacerbate energy intake is imperative. According to the PLH, the consumption of a diet low in % protein and high in % fat and carbohydrate, typical of many Western countries, inevitably requires the ingestion of additional energy to maintain protein intake constant, thus driving weight gain. Conversely, the consumption of a diet that is relatively high in % protein requires the ingestion of lower levels of energy, creating the potential for weight loss. Preliminary experimental and population-level nutritional survey data support the PLH, as does the finding that protein is more satiating than other macronutrients. If, as predicted, small changes in the proportion of protein in diets described in the current study are found to impact on total energy intake there will be significant implications for weight control strategies. Thus, if the PLH is confirmed, public health dietary recommendations and government policy settings for the food industry will need to change. Large-scale intervention studies aimed at demonstrating the longer term impact on body weight will also be required.Read moreRead less
Factors That Affect Knee Structure In Healthy Women
Funder
National Health and Medical Research Council
Funding Amount
$199,176.00
Summary
Osteoarthritis (OA) has the largest impact of any chronic disease on burden of disease borne in later life, affecting women more often than men. The importance of OA has been acknowledged by its listing within musculoskeletal disease, the 7th health priority in Australia. It is 4 times as common in women as in men.Treatments which slow or prevent OA progressing are limited, so prevention must play a key role. With increasing disease severity, joint cartilage is lost. We have recently developed a ....Osteoarthritis (OA) has the largest impact of any chronic disease on burden of disease borne in later life, affecting women more often than men. The importance of OA has been acknowledged by its listing within musculoskeletal disease, the 7th health priority in Australia. It is 4 times as common in women as in men.Treatments which slow or prevent OA progressing are limited, so prevention must play a key role. With increasing disease severity, joint cartilage is lost. We have recently developed a method to measure joint cartilage from magnetic resonance imaging (MRI) scans which is able to assess the severity of structural changes in the knee. Using this method will allow us to assess 2 issues: 1) Obesity is the only identified modifiable risk factor for knee OA. However, the mechanism is poorly understood. Weight loss programs may be more effective at reducing the risk of OA if they are combined with programs aimed at maintaining muscle mass. 2) Bone is important in development of Knee OA, but its role is poorly understood. Understanding how bone metabolism relates to risk of knee OA may allow us to prevent disease. Bone is more likely to respond to pharmacological manipulation than cartilage. Thus it may prove a more effective target for intervention than cartilage. The Geelong Osteoporosis Study was begun in 1994 to study bone health in Australian women (urban and rural). Much information relevant to the risk of OA has been collected over the past decade. By performing MRI of the knee now and in 2 years time, we will determine the effect of different measures of obesity and bone metabolism on structural change at the knee which predisposes to OA. Since both of these factors (obesity and bone metabolism) are potentially modifiable, this study may offer new avenues of prevention and therapy in knee OA. This has the potential to promote a better quality of life as people age and to reduce the economic burden of knee OA in the community.Read moreRead less