Premature Mortality Post Fracture:A NSW Linked Data Study
Funder
National Health and Medical Research Council
Funding Amount
$391,012.00
Summary
Osteoporotic fractures are associated with increased morbidity and mortality. Anti-osteoporosis medications reduce re-fracture and possibly morality, yet osteoporosis is poorly treated. This study will link information from >260,000 people (45&Up study) with hospital admissions, medications and deaths to create the largest, detailed dataset of its kind. We will be able to determine cause of any fracture-associated mortality and the effect of medication to improve osteoporosis management.
Improving Outcomes In Osteoporosis And Bone Health
Funder
National Health and Medical Research Council
Funding Amount
$348,494.00
Summary
Osteoporotic fractures are a common and increasing problem as the population ages. They are associated with increased risk of re-fracture and early death yet most patients remain untreated. This proposal will identify which fracture patients are at highest risk of re-fracture and premature death (b) identify whether osteoporosis treatment decreases this risk and (c) increase osteoporosis awareness and treatment uptake by general practitioners with an integrated fracture risk prediction tool.
Fracture Associated Premature Mortality; An International Consortium
Funder
National Health and Medical Research Council
Funding Amount
$579,807.00
Summary
Following an osteoporotic fracture there is an increased premature mortality compared with someone who has not fractured. There is also evidence that anti-osteoporosis medication reduces this premature mortality. This study will determine the size of the fracture-mortality relationship and the effect of treatment on this mortality for different fracture types and in different populations by integrating data from multiple international epidemiology studies of osteoporosis.
Osteoporosis is a major and increasing public health problem. Fracture, the ultimate consequence of osteoporosis is associated with significant morbidity, mortality and economic costs. The Dubbo Osteoporosis Epidemiology Study, starting in 1989, with over 2000 women and men, is one of the longest running epidemiological studies in osteoporosis worldwide. It has been at the forefront of epidemiological advances in osteoporosis. It has identified osteoporotic fracture risks including low bone dens ....Osteoporosis is a major and increasing public health problem. Fracture, the ultimate consequence of osteoporosis is associated with significant morbidity, mortality and economic costs. The Dubbo Osteoporosis Epidemiology Study, starting in 1989, with over 2000 women and men, is one of the longest running epidemiological studies in osteoporosis worldwide. It has been at the forefront of epidemiological advances in osteoporosis. It has identified osteoporotic fracture risks including low bone density and bone loss, muscle weakness and postural instability, as well as the extent of the problem in men, and the significant costs, ill-heath and mortality associated with fracture. Despite the clarification of risk factors over the past decade, there are significant gaps in knowledge about osteoporosis, particularly in the accurate prediction of fracture risk and in identification of factors related to fracture-associated mortality and survival post fracture. Although bone density is one of the best predictors of fracture risk, it incompletely discriminates between those who will fracture from those who will not. Although a number of clinical risk factors, and other measures of bone strength, such as quantitative ultrasound and geometry, have been shown to be independent predictors of fracture risk, it is not clear that these measures can be integrated with BMD to improve fracture prediction. The aim of the current study, is to develop and validate models using bone density, other measures of bone strength and clinical parameters that will more accurately predict fracture risk and mortality following fracture in older men and women. The more precise identification of those at high risk of fracture and at risk for poor outcomes following fracture will provide a rational basis for the development of more cost effective interventions for prevention of fracture and its associated morbidity and mortality.Read moreRead less
Whole Body Vibration For Osteoporosis: Shaking Up Our Treatment Options
Funder
National Health and Medical Research Council
Funding Amount
$961,017.00
Summary
Our aim is to examine the ability of vibration alone and in combination with osteoporosis drugs to reduce hip fracture in postmenopausal women. In Australia, 1 in 2 women >60yrs, will sustain an osteoporotic fracture. Only drugs notably decrease fracture; however none are entirely effective and some patients don’t respond. Whole body vibration has emerged as a potentially effective therapy. A combination of vibration and drugs may enhance the effects of both and revolutionise treatment.
GENETIC PREDICTION OF FRACTURE IN A RISK-STRATIFIED POPULATION
Funder
National Health and Medical Research Council
Funding Amount
$363,000.00
Summary
Osteoporosis is a condition characterised by excessive bone loss and impaired bone quality, which ultimately results in fracture with minimal trauma. Osteoporosis affects 27% of women and 11% of men aged 60 years or above in the community, and costs Australia around $7 billion each year. Individuals with low bone mineral density (BMD) have a significantly higher risk of fracture than those with normal BMD. In the long-term (14-year) Dubbo Osteoporosis Epidemiology Study, more than half of indivi ....Osteoporosis is a condition characterised by excessive bone loss and impaired bone quality, which ultimately results in fracture with minimal trauma. Osteoporosis affects 27% of women and 11% of men aged 60 years or above in the community, and costs Australia around $7 billion each year. Individuals with low bone mineral density (BMD) have a significantly higher risk of fracture than those with normal BMD. In the long-term (14-year) Dubbo Osteoporosis Epidemiology Study, more than half of individuals with osteoporosis (e.g., low BMD) did not sustain a fracture, while approximately 60% of fracture cases had BMD above the high risk levels. Thus, BMD alone is not a good discriminant of fracture versus non-fracture cases. It is widely known that the liability to fracture is determined in part by genes. Previous studies, including from our group, have suggested a number of candidate genes that are associated with fracture risk. The fundamental issue that this study is concerned is that how and whether genetic markers could be used to facilitate case finding. It is proposed that common variations of certain genes are associated with fracture risk independent of BMD. That is, they can identify individuals at relatively high and low fracture risk after stratification for BMD. Hence, some markers may identify those individuals likely (and unlikely) to fracture even with low (osteoporotic) BMD. Similarly, some, possibly the same, markers may identify individuals at high risk of fracture despite relatively good (ie non-osteoporotic) BMD. It is further proposed that no single gene will achieve this outcome, but rather a small set of such gene polymorphisms will provide clinically useful risk information. This effect is entirely analogous to the use of clinical risk indicators (eg, age, weight, sex, family history, etc) to assess the risk of future fracture.Read moreRead less
The overall aim is to improve treatments and outcomes for people with osteoporosis. This will be achieved by better predicting those who are likely to fracture and subsequently those who do well post fracture from those who do poorly. Following an osteoporotic fracture there is an increased risk of re- fracture and of premature death. This research will define those risk factors for fracture, re-fracture and early death in a large group of men and women followed for over 20 years.
Vitamin D, Bone Loss, Fracture And Mortality Outcome
Funder
National Health and Medical Research Council
Funding Amount
$408,736.00
Summary
Vitamin D most commonly from sunlight exposure is considered an important determinant of health, including the liability to falls and fractures; not only in the elderly but in adulthood in general. This study aims to distinguish if low vitamin D levels cause adverse health outcomes or relate to ill health, limited sunlight exposure and nutritional change. Only if low vitamin D level is causative of ill health does replacement make good public health sense.