Does An Annual High Dose Vitamin D Supplement Decrease Healthcare Utilisation In Older Women?
Funder
National Health and Medical Research Council
Funding Amount
$104,995.00
Summary
The shorter bleaker days of winter can cause a vitamin D deficiency in Australian women, increasing their risk of osteoporosis and broken bones including hip fracture. New research suggests that the low winter levels of the vitamin may not be good for us in many ways and the NHMRC is funding a Geelong-based study to determine if Austrlia's elderly can improve their overall health by taking a once-a-year dose of vitamin D tablets.
Primary Care Prevention Of Falls And Fractures In The Elderly By Annual Vitamin D Supplementation
Funder
National Health and Medical Research Council
Funding Amount
$305,750.00
Summary
While Australia has one of the highest rates of skin cancer, many of us are not receiving enough sun exposure to adequately maintain necessary blood levels of vitamin D. For years it was assumed that vitamin D deficiency was rarely seen in Australia where sunlight abounds for most of the year. Although few foods are high in vitamin D, it was thought that only certain cultural groups where women are always veiled in public, very dark-skinned people and the housebound elderly, were at risk of vita ....While Australia has one of the highest rates of skin cancer, many of us are not receiving enough sun exposure to adequately maintain necessary blood levels of vitamin D. For years it was assumed that vitamin D deficiency was rarely seen in Australia where sunlight abounds for most of the year. Although few foods are high in vitamin D, it was thought that only certain cultural groups where women are always veiled in public, very dark-skinned people and the housebound elderly, were at risk of vitamin D deficiency. Lower vitamin D levels following wintertime have now been reported in many populations including those living near the Mediterranean and in Geelong, Victoria. Vitamin D insufficiency is associated with an increased risk of falling through increased body sway and muscle weakness. Low levels of the vitamin also encourage the removal of calcium from bones and will predispose to bone fracture for two reasons - increased likelihood of falling and increased bone fragility and osteoporosis. Osteoporotic fractures are amongst the most important causes of ill-health among elderly people, causing an estimated 65,000 fractures in 2000-01. If nothing is done, fracture rates are estimated to increase from one every 8.1 minutes in 2001, to one every 3.7 minutes in 2021. Falls among the elderly are also a major health with about a third of people over 70years falling at least once every year. Almost 90% of all hip fractures result from the impact of a fall. This project will trial an annual dose of vitamin D to the elderly at high risk of vitamin D deficiency, falls and fractures. Fifteen hundred women will be supplemented with either vitamin D or a placebo dummy pill at the beginning of winter for five years. The supplementation will take place through their local doctor and researchers will expect to see fewer falls and bone fractures occurring in those receiving vitamin D than in the group receiving the placebo.Read moreRead less
Inhibition Of Bone Resorption Increases Skeletal Mechanical Strength By Thickening Trabecular Structures
Funder
National Health and Medical Research Council
Funding Amount
$175,648.00
Summary
This project will identify the basis by which a number of therapies for osteoporosis decrease the risk of bone fractures. Currently at least four classes of these compounds in current use for the treatment of osteoporosis. Some of them have been found to have a very marked beneficial effect by halving the risk of fracture. This study will determine if each of these classes of compounds have the ability to increase the mechanical strength of bone to the same level and if each of these compounds h ....This project will identify the basis by which a number of therapies for osteoporosis decrease the risk of bone fractures. Currently at least four classes of these compounds in current use for the treatment of osteoporosis. Some of them have been found to have a very marked beneficial effect by halving the risk of fracture. This study will determine if each of these classes of compounds have the ability to increase the mechanical strength of bone to the same level and if each of these compounds has the same effects on bone structure. Further the effects of stimulating bone formation by subjecting the skeletal to mechanical stress, on the efficacy of each of the therapies will be established. Conversely the effect of aging, which imposes a limitation on bone formation, will be studied.Read moreRead less
Risk Factors For Serious Farm-work Related Injury Among Adult Males
Funder
National Health and Medical Research Council
Funding Amount
$665,930.00
Summary
This study addresses occupational injury among male adult farm workers. The health and safety performance of agricultural industries is among the worst in Australia. A recently published study of work-related fatalities from 1989 to 1992 found that rural industries ranked third, with a fatality rate 3-4 times that for all industries. The rural industries accounted for 80 deaths annually. Best estimates place the cost of farm injury between $0.5 and $1.29 billion per year. This study is designed ....This study addresses occupational injury among male adult farm workers. The health and safety performance of agricultural industries is among the worst in Australia. A recently published study of work-related fatalities from 1989 to 1992 found that rural industries ranked third, with a fatality rate 3-4 times that for all industries. The rural industries accounted for 80 deaths annually. Best estimates place the cost of farm injury between $0.5 and $1.29 billion per year. This study is designed to contribute to farm injury prevention by: (1) identifying factors associated with a higher risk of serious injury among adult farm workers and (2) determining the proportions of the farm workforce who are exposed to various injury risks. The study will recruit 300 seriously injured or killed farm workers from regional Victoria and collect information about themselves, their working life and the property on which they work. This information will be compared with 600 randomly selected farm workers who are not seriously injured to determine which personal, work and environmental factors place farm workers at higher risk of injury. The study will lead to the development of new or more refined prevention strategies and programs. A study of this kind has not been conducted before in Australia and would contribute to a continuing scientific basis for selection of interventions for farm injury and targeting of prevention programs, at a time of increasing momentum in agricultural health and safety.Read moreRead less
Epidemiology Of Osteoporotic Fractures In The Very Frail Elderly: Risk Factors, Quality Of Life And Mortality
Funder
National Health and Medical Research Council
Funding Amount
$340,550.00
Summary
Osteoporosis, a disease characterised by skeletal fragility, is a major public health problem. The direct costs alone of treating osteoporotic fractures have been estimated at more than $800 million in Australia. Hip fractures are the most costly to treat and are due to a fall or injury in over 90% of cases. The frail elderly are at particular risk of osteoporotic fractures but little is known about risk fractures in this 'at risk' group or the effect of fracture on quality of life. This study i ....Osteoporosis, a disease characterised by skeletal fragility, is a major public health problem. The direct costs alone of treating osteoporotic fractures have been estimated at more than $800 million in Australia. Hip fractures are the most costly to treat and are due to a fall or injury in over 90% of cases. The frail elderly are at particular risk of osteoporotic fractures but little is known about risk fractures in this 'at risk' group or the effect of fracture on quality of life. This study is examining risk factors for fractures in the frail and institutionalised older person by asessment of quantitative bone ultrasound, falls risk, vitamin D status and other biochemical markers of bone in an attempt to identify predictors that can be modified to reduce fractures, improve quality of life and reduce mortality due to osteoporotic fractures.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
Geelong Osteoporosis Study: Fracture Risk Prediction Based On Twenty Years Of Prospective Data.
Funder
National Health and Medical Research Council
Funding Amount
$1,107,758.00
Summary
In this population-based study we will generate evidence, both environmental and genetic, for defining fracture risk in Australian men and women. This will help identify individuals likely to sustain fragility fractures so that suitable therapies can be recommended. The data will be useful for developing prognostic models in both a clinical setting and for genetic screening programmes.
Effects Of Vitamin D And Calcium On Bone Strength, Balance And Falls In Elderly Women
Funder
National Health and Medical Research Council
Funding Amount
$230,900.00
Summary
Many osteoporotic fractures occur as a result of bone fragility and falls. Both falls and fractures are huge public health problems in Australia. Falls are the leading cause of injury-related hospitalization and death in person older than 65 years of age. During 1996 almost 36,000 people attended a hospital after a fall and 5% of these resulted in fracturing a bone. The incidence of fall-related hospital admission increases exponentially with age, reaching 4% per annum for men and 7% per annum f ....Many osteoporotic fractures occur as a result of bone fragility and falls. Both falls and fractures are huge public health problems in Australia. Falls are the leading cause of injury-related hospitalization and death in person older than 65 years of age. During 1996 almost 36,000 people attended a hospital after a fall and 5% of these resulted in fracturing a bone. The incidence of fall-related hospital admission increases exponentially with age, reaching 4% per annum for men and 7% per annum for women aged 85 years and older. In the community approximately one third of older people fall each year. Compared to men, women are three times more likely to be hospitalized or one and half times more likely to die from a fall-related injury. Importantly women have an increased risk of fracture and over 40% of women over the age of 50 will break a bone. Previous European and American studies suggest that calcium replacement may improve bone strength while vitamin D may reduce falls. However, the separation of these two effects has never been studied. We have previously studied elderly falling women who attended the Emergency Department of large teaching hospitals in Perth and have shown that many are calcium and vitamin D deficient. We are undertaking a short term randomized controlled trial of calcium alone or calcium with vitamin D, to study the effects on bone strength as measured non-invasively, balance and falls in this high risk group of subjects. We have already recruited 100 subjects and six subjects have completed their 6 months assessment. We plan to recruit the remaining 200 subjects during the following 12 months and give all subjects one year of treatment. At the end of this study we should be able to offer clear treatment guidelines for this high risk group of patients.Read moreRead less
Fractures, in particular femoral neck (FN) fractures, are a huge public health problem resulting in disabilities, mortality and financial cost to the community. The prevention of these fractures is based on estimation of bone strength. The decision whether someone needs treatment, or the effectiveness of a treatment can only be judged by estimating bone strength. The bottom line is that currently we cannot correctly estimate bone strength. Present methods such as bone mineral density (BMD) perfo ....Fractures, in particular femoral neck (FN) fractures, are a huge public health problem resulting in disabilities, mortality and financial cost to the community. The prevention of these fractures is based on estimation of bone strength. The decision whether someone needs treatment, or the effectiveness of a treatment can only be judged by estimating bone strength. The bottom line is that currently we cannot correctly estimate bone strength. Present methods such as bone mineral density (BMD) perform poorly. Most people who fracture are not detected by BMD because their BMD is either normal or high, and many people with low BMD never fracture. The main aim of this grant application is to develop new tools to allow doctors and scientists worldwide to better estimate FN strength. To develop new methods to replace BMD, scientists need to make use of the 3D aspects of the bone such as size, shape and internal architecture. Presently, these 3D aspects (structure) have not been adequately studied and scientists incorrectly approximate them. As a result new methods are not any better. A good quantification of structure is needed. Another reason for the failure to accurately estimate the strength of bones is that estimates are based on a single parameter whereas the bone, like any architectural structure (e.g. building), comprises many components acting together to maintain its strength. To determine the strength based on density alone is incorrect; the size, the shape and things inside the structure need to be considered as a whole. After quantifying correctly the structure and components of bone strength, we will determine how they can be used individually and together to better estimate the strength of the FN in men and women. Tools generated will be used to better determine people likely to fracture and needing treatment; to better tailor and monitor treatments. A better understanding of the causes and epidemiology of fractures will ensue.Read moreRead less