Osteoporosis piece of multi-morbidity puzzle in geriatric care

The relationship of severe health disorders with bone loss, grip strength, and mobility in postmenopausal women - a 15-year follow-up study

PURPOSE

To investigate the relationships of severe health disorders (SHD) with bone loss, grip strength (GS) and mobility in postmenopausal women.

METHOD

The study sample consisted of 2227 Finnish women (mean age 53.2) from the Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) cohort. Postal inquiries and clinical measurements were completed during the 15-year follow-up at 5-year intervals between 1989 and 2004. Femoral neck bone mineral density (BMD) and GS were measured. Life-style factors and mobility were obtained via postal inquiries. Work disability pension according to the ICD-9 was an indicator of a SHD.

RESULTS

At the baseline 242 women had SHD, 506 got late SHD during 1989-1995, whereas 1479 women had none until 1996. The women with baseline SHD had higher annual bone loss (0.44%) than those without SHD (0.34%) (p < 0.05), those with late SHD (0.39%) no difference was seen. Bone loss was highest with respiratory diseases, but BMD was lowest throughout the follow-up in nervous and sense organ diseases. Lower GS and mobility was also associated with SHD.

CONCLUSION

Effects of SHDs on BMD, GS, and mobility are disease-specific. Thus, rehabilitation should be encouraged in postmenopausal women with SHD, especially in case of diseases of respiratory and nervous system. Implications for Rehabilitation Osteoporosis, muscle strength and co-morbidity Women with severe health disorders (SHD) leading to work disability have impaired musculoskeletal health. Active monitoring of the musculoskeletal health is advised for those with SHD. Women with SHD may benefit from rehabilitative treatment in order to avoid complications of musculoskeletal impairments.

Abdominal aortic calcification in young adult survivors of childhood acute lymphoblastic leukemia: results from the St. Jude Lifetime Cohort study

Abdominal aortic calcification (AAC), metabolic syndrome, and low bone mineral density (BMD) are risk factors for atherosclerotic disease and cardiovascular morbidity. We evaluated AAC in 662 adult survivors of childhood ALL (median age 31 years). AAC was present in 10% of subjects, metabolic syndrome in 36%, and low BMD in 29%. The adjusted odds ratio (OR) for AAC among women with metabolic syndrome was 2.3 (95% CL = 1.0, 4.3). The adjusted OR for AAC in men with low BMD was 3.1 (95% CL = 1.3, 7.3). A substantial proportion of adult survivors of childhood ALL have AAC and/or metabolic syndrome, suggestive of early atherosclerotic disease.