Bone Fragility: The Neglected Role Of Cortical Porosity
Funder
National Health and Medical Research Council
Funding Amount
$620,381.00
Summary
Cortical (outer shell) or compact bone constitutes 80% of the skeleton. It is not solid as implied by its name but made of inter-connected canals resembling a network of roads. We recently discovered that most of the bone loss with age occurs from these canals, not from t rabecular bone as currently believed. This suggests to know why and how bone breaks requires the study of the morphology of these canals and how they change with age. This is what we propose to do. It has never been done.
Fragility Fractures: The Neglected Role Of Cortical Porosity
Funder
National Health and Medical Research Council
Funding Amount
$865,474.00
Summary
We just discovered that bone lost with age occurs mostly from pores within the cortex (outer shell) of the bone; These pores become larger (porosity) making bones fragile. This process is poorly detected by bone density (currently used tool) so that most people with weak bones are missed. To address this issue, we have for the first time, develop a technology to accurately quantify porosity in living peoples. With teams around the world, we aim here to fill this gap in the diagnosis.
Genetic Regulation Of Hip Geometry, Structure And Fracture
Funder
National Health and Medical Research Council
Funding Amount
$403,625.00
Summary
Osteoporotic hip fracture is common in the elderly and a major cause of hospitalization. Hip fracture may lead to surgery, chronic reduced mobility, loss of function, institutionalization or death. The term osteoporosis covers a heterogeneous syndrome including juvenile, secondary (e.g. corticosteroid induced) and postmenopausal osteoporosis. This later broad grouping shows evidence of a strong familial association. Previous work has shown that a family history of fracture increases the risk of ....Osteoporotic hip fracture is common in the elderly and a major cause of hospitalization. Hip fracture may lead to surgery, chronic reduced mobility, loss of function, institutionalization or death. The term osteoporosis covers a heterogeneous syndrome including juvenile, secondary (e.g. corticosteroid induced) and postmenopausal osteoporosis. This later broad grouping shows evidence of a strong familial association. Previous work has shown that a family history of fracture increases the risk of fracture by more than four fold. Furthermore, studies in twins have persistently shown that phenotypes such as bone mineral density (BMD), broadband ultrasound attenuation of bone and hip structural indices are strongly inherited. This confirms a genetic basis for the disease in some individuals. Community health in general has improved substantially in Australia in the past four decades and this has resulted in increased longevity. In contrast, the incidence of hip fracture and the resulting drain on public health funding continues to increase rapidly. Presently the cost of osteoporosis in Australia is $7.5 billion per annum. Hip fracture accounts for the majority of these costs. Instituting effective prevention strategies is essential. This project aims to contribute to one of Australia's National Research Pritoities by improving understanding about the way in which inherited aspects of hip geometry and structure contribute to the hip fracture susceptibility. We have successfully completed genome screen projects studying genetic linkage in the families to localize genes regulating BMD in the past. However, BMD is only one of a number of relevant phenotypes. In relation to hip fracture, geometry and structure are thought to be particularly important. In this project we will make use of existing resources to advance studies of both genetic linkage and association to examine fundamental issues related to hip facture.Read moreRead less
Is Hip Fracture Rehabilitation Cost Effective In Residential Care? A Randomised Controlled Trial Of Rehabilitation
Funder
National Health and Medical Research Council
Funding Amount
$137,970.00
Summary
Some of the frailest members of our community live in nursing homes and a hip fracture can be devastating to a person with dementia as it can leave them permanently unable to walk. We don't know how best to promote recovery when they break their hips. At present there is an assumption that rehabilitation at this stage of life is not worthwhile but this study will test whether the benefits outweigh the costs. We will test whether an assessment by a geriatrician and rehabilitation improves walking ....Some of the frailest members of our community live in nursing homes and a hip fracture can be devastating to a person with dementia as it can leave them permanently unable to walk. We don't know how best to promote recovery when they break their hips. At present there is an assumption that rehabilitation at this stage of life is not worthwhile but this study will test whether the benefits outweigh the costs. We will test whether an assessment by a geriatrician and rehabilitation improves walking, independence and quality of life.Read moreRead less
Maintenance Of Bone Strength In Aged Rats: The Vitamin D Requirement
Funder
National Health and Medical Research Council
Funding Amount
$543,301.00
Summary
Hip fracture remains the most devastating of the osteoporotic fractures particularly in women in whom the incidence increases to about 3% per annum by the ninth decade. This incidence is bound to increase as the population ages with increasing longevity. Supplementation of diets of elderly female nursing home residents with vitamin D and calcium has been shown to reduce the risk of hip fracture by 30% in two years. However we do not know how much vitamin D is necessary to maintain optimal bone s ....Hip fracture remains the most devastating of the osteoporotic fractures particularly in women in whom the incidence increases to about 3% per annum by the ninth decade. This incidence is bound to increase as the population ages with increasing longevity. Supplementation of diets of elderly female nursing home residents with vitamin D and calcium has been shown to reduce the risk of hip fracture by 30% in two years. However we do not know how much vitamin D is necessary to maintain optimal bone strength. This project will determine the level of vitamin D required to maintain optimal bone strength in aged rats using a simple blood test which could then be used to screen the elderly and identify those at risk of hip fracture from low vitamin D levels. The project will also investigate the effects of vitamin D on the bone cells that maintain optimal skeletal architecture. This information is essential for comparison with the current knowledge of other biochemical bone markets in blood and vitamin D status in the elderly, in order to develop nutritional recommendations to reduce the incidence of hip fracture.Read moreRead less
Hip fracture remains the most devastating of the osteoporotic fractures particularly in women, in whom the incidence increases to about 3% per annum by the ninth decade. This incidence is bound to increase as the population ages with increasing longevity. Supplementation of diets of elderly female nursing home residents with vitamin D and calcium has been shown to reduce the risk of hip fracture by 30% in two years. However we do not know how much vitamin D is necessary to maintain optimal bone ....Hip fracture remains the most devastating of the osteoporotic fractures particularly in women, in whom the incidence increases to about 3% per annum by the ninth decade. This incidence is bound to increase as the population ages with increasing longevity. Supplementation of diets of elderly female nursing home residents with vitamin D and calcium has been shown to reduce the risk of hip fracture by 30% in two years. However we do not know how much vitamin D is necessary to maintain optimal bone strength. This project will determine the level of vitamin Drequired to maintain optimal bone strength in adult and senescent rats using a simple blood test which could then be used to screen the elderly and identify those at risk a hip fracture from low vitamin D levels. The project will also investigate the effects of vitamin D on bone cells which is necessary to maintain optimal skeletal architecture. This information is essential for comparison with the current knowledge of other biochemical bone markers in blood and vitamin D status in the elderly, in order to develop nutritional recommendations to reduce the incidence of hip fracture.Read moreRead less
Improving Adherence With The Use Of Hip Protectors, In Community, Residential Aged Care And Hospital Settings
Funder
National Health and Medical Research Council
Funding Amount
$405,250.00
Summary
Hip protectors are plastic shields or foam pads worn over the hip in specially adapted underwear. A number of studies in older people have shown that hip protectors are very effective if worn when a fall occurs and these have been available for the last few years in Australia. Unfortunately it has been difficult for older people to wear the hip protectors reliably and because of limited compliance with their use they have not been fully effective. This study will compare provision of a brochure, ....Hip protectors are plastic shields or foam pads worn over the hip in specially adapted underwear. A number of studies in older people have shown that hip protectors are very effective if worn when a fall occurs and these have been available for the last few years in Australia. Unfortunately it has been difficult for older people to wear the hip protectors reliably and because of limited compliance with their use they have not been fully effective. This study will compare provision of a brochure, with supply of the older person's choice of hip protectors , with or without cost, and with or without contact with a nurse who will assist with use of the hip protector. After six months the level of use of the hip protectors will be checked. The new strategies tested in this study may increase compliance with hip protectors to a level where they will be effective if used at home in the community, in residential aged care facilities, and in hospitals.Read moreRead less