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Ahire JJ, Kumar V, Rohilla A. Understanding Osteoporosis: Human Bone Density, Genetic Mechanisms, Gut Microbiota, and Future Prospects. Probiotics Antimicrob Proteins 2024; 16:875-883. [PMID: 37874496 DOI: 10.1007/s12602-023-10185-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 10/25/2023]
Abstract
Osteoporosis is a systemic condition of the skeleton that leads to diminished bone mass, a breakdown in the bone tissue's microscopic architecture, and an elevated risk of breaking a bone. The elderly and women particularly after menopause are disproportionately affected, and the condition generally stays undiagnosed until a broken bone causes severe pain and immobility. Causes of osteoporosis include low bone mass, more than normal bone loss, changes in hormone levels (decreased estrogen or testosterone), certain diseases and therapies, and lifestyle factors like smoking and inactivity. The spine, hip, and forearm are particularly vulnerable to osteoporosis-related fractures. The purpose of this article is to present a thorough understanding of osteoporosis, including the disease's connection to bone density in humans, and the major part played by genetic pathways and gut flora. The causes of osteoporosis, the effects of aging on bone density, and why some groups experience a higher incidence of the disease than others are investigated. The paper also includes animal and human experiments investigating the link between gut flora and osteoporosis. Finally, it looks to the future and speculates on possible developments in osteoporosis prevention and therapy.
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Affiliation(s)
- Jayesh J Ahire
- Dr. Reddy's Laboratories Limited, Hyderabad, 500016, India.
| | - Vikram Kumar
- Department of Basic and Applied Sciences, National Institute of Food Technology Entrepreneurship and Management, Sonipat, 131028, India
| | - Alka Rohilla
- Institute of Biology Sciences, Faculty of Science, University of Malaya, 5060, Kuala Lumpur, Malaysia
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Gül S, Büyükbayram Z. "A natural consequence of aging in women?": a mixed-method exploration on osteoporosis self-efficacy in Turkey. Arch Osteoporos 2023; 18:47. [PMID: 37022623 DOI: 10.1007/s11657-023-01239-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/28/2023] [Indexed: 04/07/2023]
Abstract
The perception of osteoporosis self-efficacy is an important factor in coping with osteoporosis. Being older, not exercising regularly, inadequate consumption of milk and dairy products, inadequate exposure to sunlight, knowledge gaps, negative disease perceptions, and barriers to osteoporosis treatment adherence negatively affect osteoporosis self-efficacy levels of women (p < 0.001). PURPOSE The purpose of this study to determine the osteoporosis-related self-efficacy levels of women with osteoporosis and investigate the relationship between the characteristics of these women and their osteoporosis self-efficacy. METHODS The study was conducted in Siirt province in the Southeastern Anatolia Region of Turkey. A mixed-method approach was selected. Data were collected with 280 surveys and 30 participants' interviews. RESULTS The mean total OSES score of the participants was 649.82 ± 221.09. Aging, not exercising regularly, inadequate consumption of milk and dairy products, and inadequate exposure to sunlight were significant predictors of low osteoporosis self-efficacy (p < 0.001), explaining 23.4% of the total variance. Knowledge gaps, disease perceptions, facilitators of treatment adherence, and barriers to treatment adherence affected the osteoporosis self-efficacy of the participants. CONCLUSION The osteoporosis-related self-efficacy levels of the participants of this study were low. The results suggest that a strategy to organize routine health education programs should be established in order to create a higher perception of osteoporosis self-efficacy in women with osteoporosis and to reduce knowledge gaps and barriers.
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Affiliation(s)
- Sidar Gül
- Faculty of Health Sciences, Siirt University, Siirt, Turkey.
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Aghvinian M, Morris EP, Savin MJ, Summers AC, Crook CL, Stiver J, Gonzalez J, Byrd D, Rivera Mindt M. Health Locus of Control and Neurocognitive Function in Latinx and Non-Latinx White People Living With HIV: A Cross-sectional Study. J Assoc Nurses AIDS Care 2022; 33:248-258. [PMID: 34265825 PMCID: PMC8741820 DOI: 10.1097/jnc.0000000000000286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
ABSTRACT Research suggests that health locus of control (HLOC) is related to important health and neurocognitive outcomes in people living with HIV. However, the role of ethnicity in these relationships remains poorly understood. This study explored the role of HLOC on neurocognition in a diverse sample of 134 people living with HIV (Latinx: n = 96; non-Latinx White: n = 38) who completed comprehensive neurocognitive evaluations and the Multidimensional HLOC Scale-Form C. Results indicate no ethnocultural differences in HLOC beliefs (ps > .05). External HLOC (i.e., chance and powerful others) related to worse neurocognition in the Latinx group and contributed to significant variance in global neurocognition and learning, memory, and verbal fluency, underscoring the role of external HLOC beliefs on neurocognition, particularly for Latinx individuals. Additional research is needed to better characterize the mechanistic relationship between HLOC beliefs and neurocognitive function and to further explore this relationship among other underrepresented populations also disproportionately affected by HIV.
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Affiliation(s)
- Maral Aghvinian
- Maral Aghvinian, MA, is a Doctoral Student, Clinical Psychology Program, Fordham University, Bronx, New York, USA. Emily P. Morris, MS, is a Doctoral Student, Clinical Science Program, University of Michigan, Detroit, Michigan, USA. Micah J. Savin, MA, Angela C. Summers, MA, Cara L. Crook, MA, and Jordan Stiver, MA, are Doctoral Students, Clinical Psychology Program, Fordham University, Bronx, New York, USA. Jairo Gonzalez, PsyD, is a Clinical Psychologist, Icahn School of Medicine at Mount Sinai, New York City, New York, USA. Desiree Byrd, PhD, ABPP, is a Board-Certified Clinical Neuropsychologist, Icahn School of Medicine at Mount Sinai, New York City, New York, USA, and is an Associate Professor, Queens College, Queens, New York, USA. Monica Rivera Mindt, PhD, ABPP, is a Board-Certified Clinical Neuropsychologist, Icahn School of Medicine at Mount Sinai, New York City, New York, USA, and is a Professor of Psychology, Fordham University, Bronx, New York, USA
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Abstract
Osteoporosis is a skeletal disease characterized by low bone density and poor bone quality that weakens bones and increases the risk of fractures. Serious consequences of fractures include disability, loss of independence, and death. Despite the availability of clinical tools to evaluate fracture risk and medications to reduce fracture risk, many or most patients at risk, even those with a recent fracture, are not being treated. This represents a large osteoporosis treatment gap that has reached a crisis level. Importantly, the treatment gap is not evenly distributed among populations of different race/ethnicity. Black women are less likely to have bone density testing when indicated, are less likely to be treated, and have worse outcomes after a fracture than White women. This is a review and update of race-based disparities and inequalities, with suggestions for interventions to optimize patient care.
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Affiliation(s)
- E Michael Lewiecki
- E. Michael Lewiecki, MD, New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM
- Sarah F. Erb, FNP-C, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Sarah F Erb
- E. Michael Lewiecki, MD, New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM
- Sarah F. Erb, FNP-C, University of New Mexico Health Sciences Center, Albuquerque, NM
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Noel SE, Santos MP, Wright NC. Racial and Ethnic Disparities in Bone Health and Outcomes in the United States. J Bone Miner Res 2021; 36:1881-1905. [PMID: 34338355 PMCID: PMC8607440 DOI: 10.1002/jbmr.4417] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/12/2021] [Accepted: 07/21/2021] [Indexed: 11/10/2022]
Abstract
Osteoporosis is a bone disease classified by deterioration of bone microarchitecture and decreased bone strength, thereby increasing subsequent risk of fracture. In the United States, approximately 54 million adults aged 50 years and older have osteoporosis or are at risk due to low bone mass. Osteoporosis has long been viewed as a chronic health condition affecting primarily non-Hispanic white (NHW) women; however, emerging evidence indicates racial and ethnic disparities in bone outcomes and osteoporosis management. The primary objective of this review is to describe disparities in bone mineral density (BMD), prevalence of osteoporosis and fracture, as well as in screening and treatment of osteoporosis among non-Hispanic black (NHB), Hispanic, and Asian adults compared with NHW adults living on the US mainland. The following areas were reviewed: BMD, osteoporosis prevalence, fracture prevalence and incidence, postfracture outcomes, DXA screening, and osteoporosis treatments. Although there are limited studies on bone and fracture outcomes within Asian and Hispanic populations, findings suggest that there are differences in bone outcomes across NHW, NHB, Asian, and Hispanic populations. Further, NHB, Asian, and Hispanic populations may experience suboptimal osteoporosis management and postfracture care, although additional population-based studies are needed. There is also evidence that variation in BMD and osteoporosis exists within major racial and ethnic groups, highlighting the need for research in individual groups by origin or background. Although there is a clear need to prioritize future quantitative and qualitative research in these populations, initial strategies for addressing bone health disparities are discussed. © 2021 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Sabrina E Noel
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA.,Center for Population Health, University of Massachusetts Lowell, Lowell, MA, USA
| | - Michelly P Santos
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA.,Center for Population Health, University of Massachusetts Lowell, Lowell, MA, USA
| | - Nicole C Wright
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
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Adami G, Saag KG, Mudano AS, Rahn EJ, Wright NC, Outman RC, Greenspan SL, LaCroix AZ, Nieves JW, Silverman SL, Siris ES, Watts NB, Miller MJ, Ladores S, Curtis JR, Danila MI. Factors associated with the contemplative stage of readiness to initiate osteoporosis treatment. Osteoporos Int 2020; 31:1283-1290. [PMID: 32020264 PMCID: PMC7365553 DOI: 10.1007/s00198-020-05312-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 01/22/2020] [Indexed: 02/02/2023]
Abstract
UNLABELLED We investigated the factors associated with readiness for initiating osteoporosis treatment in women at high risk of fracture. We found that women in the contemplative stage were more likely to report previously being told having osteoporosis or osteopenia, acknowledge concern about osteoporosis, and disclose prior osteoporosis treatment. INTRODUCTION Understanding factors associated with reaching the contemplative stage of readiness to initiate osteoporosis treatment may inform the design of behavioral interventions to improve osteoporosis treatment uptake in women at high risk for fracture. METHODS We measured readiness to initiate osteoporosis treatment using a modified form of the Weinstein Precaution Adoption Process Model (PAPM) among 2684 women at high risk of fracture from the Activating Patients at Risk for OsteoPOroSis (APROPOS) clinical trial. Pre-contemplative participants were those who self-classified in the unaware and unengaged stages of PAPM (stages 1 and 2). Contemplative participants were those in the undecided, decided not to act, or decided to act stages of PAPM (stages 3, 4, and 5). Using multivariable logistic regression, we evaluated participant characteristics associated with levels of readiness to initiate osteoporosis treatment. RESULTS Overall, 24% (N = 412) self-classified in the contemplative stage of readiness to initiate osteoporosis treatment. After adjusting for age, race, education, health literacy, and major osteoporotic fracture in the past 12 months, contemplative women were more likely to report previously being told they had osteoporosis or osteopenia (adjusted odds ratio [aOR] (95% CI) 11.8 (7.8-17.9) and 3.8 (2.5-5.6), respectively), acknowledge concern about osteoporosis (aOR 3.5 (2.5-4.9)), and disclose prior osteoporosis treatment (aOR 4.5 (3.3-6.3)) than women who self-classified as pre-contemplative. CONCLUSIONS For women at high risk for future fractures, ensuring women's recognition of their diagnosis of osteoporosis/osteopenia and addressing their concerns about osteoporosis are critical components to consider when attempting to influence stage of behavior transitions in osteoporosis treatment.
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Affiliation(s)
- G Adami
- University of Alabama at Birmingham, Birmingham, AL, 35233, USA
- Rheumatology Unit, University of Verona, Verona, Italy
| | - K G Saag
- University of Alabama at Birmingham, Birmingham, AL, 35233, USA
| | - A S Mudano
- University of Alabama at Birmingham, Birmingham, AL, 35233, USA
| | - E J Rahn
- University of Alabama at Birmingham, Birmingham, AL, 35233, USA
| | - N C Wright
- University of Alabama at Birmingham, Birmingham, AL, 35233, USA
| | - R C Outman
- University of Alabama at Birmingham, Birmingham, AL, 35233, USA
| | - S L Greenspan
- University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - A Z LaCroix
- Group Health Cooperative, Seattle, WA, 98112, USA
- University of California San Diego, La Jolla, CA, 92093, USA
| | - J W Nieves
- Helen Hayes Hospital, West Haverstraw, NY, 10993, USA
| | - S L Silverman
- Cedars-Sinai Medical Center, Los Angeles, CA, 30211, USA
| | - E S Siris
- Columbia University Medical Center, New York, NY, 10032, USA
| | - N B Watts
- Mercy Health Osteoporosis and Bone Health Services, Cincinnati, OH, 45236, USA
| | - M J Miller
- Texas A&M University, College Station, TX, 77843, USA
- Kaiser Permanente, Rockville, MD, 20852, USA
| | - S Ladores
- University of Alabama at Birmingham, Birmingham, AL, 35233, USA
| | - J R Curtis
- University of Alabama at Birmingham, Birmingham, AL, 35233, USA
| | - M I Danila
- University of Alabama at Birmingham, Birmingham, AL, 35233, USA.
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Barcenilla-Wong AL, Cross M, Fry M, March L. Ambiguity hindering self-management and prevention of osteoporosis in post-menopausal women. Arch Osteoporos 2020; 15:73. [PMID: 32417979 DOI: 10.1007/s11657-020-0683-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 02/03/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED As osteoporosis relies largely on self-managed prevention and adherence to long-term treatment regimens, it is imperative that those at risk understand the disease that they are attempting to prevent. Ambiguity regarding osteoporosis and reluctance to take anti-osteoporosis medication (AOM) as well as calcium was noted in Australian post-menopausal women. This may lead to underestimating women's own risk of osteoporosis and fracture. INTRODUCTION Fragility fractures caused by osteoporosis have been known to inflict significant personal and financial burden on individuals and society. As treatment of osteoporosis relies largely on self-managed prevention and adherence to long-term AOM regimens, it is imperative that women have a sound understanding of the disease that they are attempting to prevent. Much can also be gained from qualitatively exploring the level of osteoporosis knowledge particularly in post-menopausal women who are at greater risk of osteoporosis and fractures. This study thus aims to determine what post-menopausal Australian women know about osteoporosis and osteoporosis prevention. METHOD Six focus group sessions, using purposive sampling, were conducted with 23 female participants (mean age 68 years (range 62-83)). Women responded to a series of open-ended questions regarding their knowledge about osteoporosis. The audiotaped focus groups were transcribed verbatim and analysed using a thematic analysis framework. RESULTS Three key themes were identified: ambiguity about the nature of osteoporosis, ambiguity about osteoporosis prevention and reluctance to take AOM and calcium. CONCLUSION Ambiguity associated with risk and prevention may provide women with a false sense of security that they are adequately acting to prevent the disease. Underestimation of their risk of osteoporosis and fracture as well as reluctance associated with AOM may be barriers to osteoporotic fracture prevention.
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Affiliation(s)
- A L Barcenilla-Wong
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia.
| | - M Cross
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia
| | - M Fry
- Nursing Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - L March
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia.,Florance and Cope Professorial Rheumatology Department, University of Sydney Royal North Shore Hospital, St Leonards, Sydney, Australia
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des Bordes J, Prasad S, Pratt G, Suarez-Almazor ME, Lopez-Olivo MA. Knowledge, beliefs, and concerns about bone health from a systematic review and metasynthesis of qualitative studies. PLoS One 2020; 15:e0227765. [PMID: 31940409 PMCID: PMC6961946 DOI: 10.1371/journal.pone.0227765] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 12/27/2019] [Indexed: 12/14/2022] Open
Abstract
Background Patients with low bone density or osteoporosis need information for effective prevention or disease management, respectively. However, patients may not be getting enough information from their primary care providers or other sources. Inadequate disease information leaves patients ill-informed and creates misconceptions and unnecessary concerns about the disease. Objective We systematically reviewed and synthesized the available literature to determine patient knowledge, beliefs, and concerns about osteoporosis and identify potential gaps in knowledge. Methods A systematic search was conducted for full-text qualitative studies addressing understanding, literacy, and/or perceptions about osteoporosis and its management, using Medline, EMBASE, Web of Science, Cochrane Library, CINAHL, ERIC, PsychINFO, Psyc Behav Sci Collec, and PubMed, from inception through September 2016. Studies were selected by two reviewers, assessed for quality, and themes extracted using the Joanna Briggs Institute data extraction tool. Thematic analysis was used to identify themes and subthemes. Results Twenty-five studies with a total of 757 participants (including 105 men) were selected for analysis out of 1031 unique citations. Selected studies were from Australia, Canada, Denmark, Norway, the United Kingdom, and the United States. Four main themes emerged: inadequate knowledge, beliefs and misconceptions, concerns about osteoporosis, and lack of information from health care providers. Participants had inadequate knowledge about osteoporosis and were particularly uninformed about risk factors, causes, treatment, and prevention. Areas of concern for participants included diagnosis, medication side effects, and inadequate information from primary care providers. Conclusion Although there was general awareness of osteoporosis, many misconceptions and concerns were evident. Education on bone health needs to reinforce areas of knowledge and address deficits, misconceptions, and concerns.
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Affiliation(s)
- Jude des Bordes
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Seema Prasad
- Department of Gastroenterology Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Greg Pratt
- Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Maria E. Suarez-Almazor
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Maria A. Lopez-Olivo
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
- * E-mail:
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