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Biomedical subjects

Joseph M Zmuda

Publications and source records attributed to Joseph M Zmuda.

At least 19 recordsLinked to original sources

Genetic determination of adiponectin and its relationship with body fat topography in multigenerational families of African heritage.

Adiponectin, an adipose-specific protein, is negatively associated with adiposity, insulin sensitivity, and diabetes. Very few studies have examined the role of heredity in the regulation of adiponectin and its association with body fat among individuals of African heritage. Thus, we measured fasting serum adiponectin levels by radioimmunoassay and body composition by dual-energy x-ray absorptiometry (DEXA) in 402 individuals aged 18 to 103 years belonging to 7 multigenerational families of African heritage in the relatively homogeneous island population of Tobago. Heritability of adiponectin was 33.2% (P < .01), and age, sex, and body mass index explained 23.4% of the variance in adiponectin. Sex-specific heritability was significant in men (heritability, 34%; P < .05), but not in women. The inverse associations between body mass index and percentage of body fat and adiponectin, independent of age and height, were much stronger in women (all P values <.001) than in men. However, percentage of trunk fat was consistently strongly associated with adiponectin in both men (r = -0.40, P < .001) and women (r = -0.44, P < .001), independent of age and height. This study suggests that genetic factors are a significant source of interindividual differences in circulating adiponectin among Afro-Caribbeans. Adiponectin may serve as a promising quantitative intermediate trait in studies designed to map the genes underlying diabetes and obesity in this population.

Absorptiometry, Photon↗

Genetic and environmental determinants of volumetric and areal BMD in multi-generational families of African ancestry: the Tobago Family Health Study.

UNLABELLED: BMD is higher and fracture risk is lower among individuals of African versus European descent, but little is known about the genetic architecture of BMD in the former group. Heritabilities of areal and volumetric BMD were moderate in our large families of African descent but differed for trabecular and cortical BMD. INTRODUCTION: Populations of African ancestry have lower osteoporotic fracture risk and higher BMD than other ethnic groups. However, there is a paucity of information regarding the genetic and environmental influences on bone health among populations of African heritage. MATERIALS AND METHODS: We dissected the genetic architecture of areal BMD measured by DXA at the proximal femur, lumbar spine, and whole body and volumetric BMD measured by pQCT at the distal and proximal radius and tibia in 283 women and 188 men > or =18 years of age (mean, 43 years) from eight multigenerational Afro-Caribbean families (mean family size > 50). Using quantitative genetic methods, we estimated the residual heritability and the effects of anthropometric, demographic, lifestyle, and medical variables on areal and volumetric BMD. RESULTS: Compared with U.S. non-Hispanic blacks and whites, areal BMD at the femoral neck was highest in the Afro-Caribbean men and women at all ages. Trabecular volumetric BMD decreased linearly with increasing age, whereas cortical volumetric BMD did not decrease until age 40-49, especially in women. Anthropometric, lifestyle, and medical factors accounted for 12-32% of the variation in areal and volumetric BMD, and residual heritabilities (range, 0.23-0.52) were similar to those reported in other ethnic groups. Heritability of cortical BMD was substantially lower than that of areal or trabecular volumetric BMD, although the measured covariates accounted for a similar proportion of the total phenotypic variation. CONCLUSIONS: Our study is the first comprehensive genetic epidemiologic analysis of volumetric BMD measured by QCT and the first analysis of these traits in extended families of African descent. Genes account for as much or more of the total variation in areal and volumetric BMD than do environmental factors, but these effects seem to differ for trabecular and cortical bone.

Adolescent↗

Patterns and correlates of muscle strength loss in older women.

BACKGROUND: The aging process is associated with progressive declines in muscle strength, resulting in functional disability and reduced quality of life. OBJECTIVE: The purpose of this epidemiological study was to examine the age-related loss of grip strength both cross-sectionally and longitudinally and the risk factors associated with the decline in muscle strength in a large population of community-living older women (aged 65-91 years). METHODS: Clinical visits, including physical examinations and lifestyle assessment, were conducted at baseline and biennially afterwards for a total of 10 years of follow-up. The upper-body muscle strength was measured by grip strength using a hand-held dynamometer. RESULTS: The muscle strength decreased cross-sectionally (n = 9,372) as well as longitudinally (n = 5,214), as age increased, and the decline in muscle strength measured during follow-up was greater than that measured cross-sectionally at baseline. The average loss of grip strength during 10 years of follow-up was 5.1 kg, equivalent to a rate of 2.4% decline per year, with the greatest loss seen in the oldest age group (80 years or older). Cross-sectional analysis revealed that the correlates of lower muscle strength included older age, greater weight, greater height loss since age 25 years, lower protein intake, difficulties in functional tasks, and lower physical activity. In longitudinal analysis, older age, baseline strength, weight and height loss during follow-up, difficulties in functional tasks, and lower physical activity were found to be significantly and independently associated with greater loss in grip strength during follow-up. CONCLUSIONS: Cross-sectional and longitudinal analyses of age-related loss of muscle strength yielded different rates of decline. In addition to older age and difficulties in functional tasks, a number of modifiable factors, including weight and physical activity, are associated with increased decline in muscle strength among older women.

Age Factors↗

Determinants of serum total and free testosterone levels in women over the age of 65 years.

CONTEXT: Little is known about testosterone (T) levels and their determinants in women of late postmenopausal age. OBJECTIVE: We describe levels of total and free T and selected factors that influence these levels in a random sample of older women. DESIGN: Levels of serum total T and free T by microdialysis were measured using ultrasensitive assays in 347 community-dwelling women aged 65-98 yr enrolled in the Cardiovascular Health Study. Cross-sectional analyses were performed to define factors associated with total and free T levels. RESULTS: In adjusted models: 1) total T levels declined with age until 80, whereas free T levels did not vary by age; 2) women with bilateral oophorectomy had 23% lower total T and 16% lower free T levels than those with at least one intact ovary; 3) oral estrogen users had total and free T levels that were 47% lower than never users; 4) obese women had 47% higher total T and 20% higher free T levels, and overweight women had 24% higher total T and 14% higher free T levels, than normal weight women; and 5) free T levels were 51% higher in black women. Corticosteroid users had 75% lower total T and 43% lower free T levels than nonusers. CONCLUSIONS: Bilateral oophorectomy, estrogen use, corticosteroid use, and low body mass index are independent risk factors for lower T levels in women aged 65 yr and over. Although highly prevalent in women of this age, the physiological significance of low T levels in late postmenopausal women requires further investigation.

Age Distribution↗

Peroxisome proliferator-activated receptor-gamma polymorphism, body mass and prostate cancer risk: evidence for gene-environment interaction.

BACKGROUND: Peroxisome proliferator-activated receptor (PPAR)-gamma has been implicated in prostate cancer. In the present case-control study, we tested if a common Pro12Ala polymorphism in PPAR-gamma is associated with the risk of prostate cancer. METHODS: Ninety-one adult Caucasians with prostate cancer were recruited between 1994 and 1998. Blood samples were also obtained from 237 community-based Caucasian men without prostate cancer. RESULTS: Twenty-six percent of cases and 19% of controls carried at least one Ala allele (p = 0.16). There was a significant interaction between the PPAR-gamma polymorphism and body mass index (BMI) in age-adjusted analyses (p < 0.05). Among the subgroup of men with BMI above 27.2 kg/m2 (median in controls), carriers of the Ala allele had over 2-fold greater risk of prostate cancer compared to those with the Pro12Pro genotype (odds ratio, OR: 2.77; 95% confidence interval, CI: 1.25-6.16). No association was observed between the PPAR-gamma genotype and prostate cancer among men with BMI below the median (OR: 0.68; 95% CI: 0.23-1.97). CONCLUSIONS: Our results suggest a novel gene-environment interaction between the PPAR-gamma Pro12Ala polymorphism and body mass in prostate cancer. Further research, particularly prospective studies, is needed to confirm these findings and to clarify the underlying mechanisms involved.

Adult↗

Simple tandem repeat (TTTA)n polymorphism in CYP19 (aromatase) gene and breast cancer risk in Nigerian women.

BACKGROUND: Breast cancer is the most common cancer and the leading cause of cancer related deaths in women worldwide. The incidence of the disease is increasing globally and this increase is occurring at a faster rate in population groups that hirtherto enjoyed low incidence. This study was designed to evaluate the role of a simple tandem repeat polymorphism (STRP) in the aromatase (CYP19) gene in breast cancer susceptibility in Nigerian women, a population of indigenous sub-Saharan African ancestry. METHODS: A case-control study recruiting 250 women with breast cancer and 250 women without the disease from four University Teaching Hospitals in Southern Nigeria was carried out between September 2002 and April 2004. Participants were recruited from the surgical outpatient clinics and surgical wards of the Nigerian institutions. A polymerase chain reaction (PCR)-based assay was employed for genotyping and product sizes were detected with an ABI 3730 DNA Analyzer. RESULTS: Conditional logistic regression analysis revealed that harboring the putative high risk genotypes conferred a 29% increased risk of breast cancer when all women in the study were considered (Odds ratio [OR] = 1.29, 95% confidence interval [CI] 0.83-2.00), although this association was not statistically significant. Subgroup analysis based on menopausal status showed similar results among premenopausal women (OR = 1.35, 95% CI 0.76-2.41 and postmenopausal women (OR = 1.27, 95% CI 0.64-2.49). The data also demonstrated marked differences in the distribution of (TTTA)n repeats in Nigerian women compared with other populations. CONCLUSION: This study has shown that harboring 10 or more repeats of the microsatellite (TTTA)n repeats of the CYY19 gene is associated with a modest increased risk of breast cancer in Nigerian women.

Journal Article↗

Association of endothelial nitric oxide synthase genotypes with bone mineral density, bone loss, hip structure, and risk of fracture in older women: the SOF study.

Nitric oxide (NO) is an important bone-signaling molecule. We examined the associations between the Glu298Asp polymorphism of NOS3, indices of bone strength, and the incidence of fracture among 6691 women aged 65 years and older enrolled in the Study of Osteoporotic Fractures. Calcaneal BMD was measured at an initial exam and after an average of 5.9 years of follow-up. Hip BMD was measured at an initial exam and after 3.7 years of follow-up. Baseline spine BMD and hip structural parameters were measured. Incident hip fractures were confirmed by review of radiographic reports; follow-up was greater than 98% complete. Incident vertebral fractures were defined by morphometry using lateral spine radiography at baseline and an average of 3.7 years later. The frequencies of the NOS3 Glu298Asp genotypes were Glu/Glu=46.2%, Glu/Asp=42.7%, and Asp/Asp=11.1%. There were no significant associations between NOS3 genotypes and initial calcaneal BMD, hip BMD, or rate of change in hip or calcaneal BMD. None of the hip structural parameters differed substantially by genotype. NOS3 genotype was not significantly associated with either incident or prevalent radiographic vertebral fractures. Women with the heterozygous Glu/Asp genotype had a borderline statistically significantly lower rate of hip fracture than either the Glu/Glu genotype (HR=0.87, 95% CI: 0.74, 1.01) or the Asp/Asp genotype (HR=0.78, 95% CI: 0.62, 0.98). In conclusion, the Glu298Asp polymorphism does not contribute substantially or consistently to indices of bone strength in this sample of older white women, although our findings suggest allelic variation at the NOS3 locus maybe associated with hip fracture risk. Confirmation of these findings is needed in other populations and with additional markers within and flanking the NOS3 gene region.

Age Factors↗

High bone density is associated with prostate cancer in older Afro-Caribbean men: Tobago prostate survey.

OBJECTIVE: To test the hypothesis that bone mineral density (BMD), a possible surrogate of lifetime exposure to hormone/growth factor/vitamin D/calcium exposure, is higher in prostate cancer cases than controls. METHODS: Hip BMD was measured by dual X-ray absorptiometry in 222 Afro-Caribbean screening-detected prostate cancer cases and 1,503 screened non-cases, aged 45-79, in the population-based Tobago Prostate Survey. Because possible skeletal metastases may modulate BMD, men with prostate specific antigen >20 ng/ml or highly undifferentiated tumors (Gleason score > or = 8) were excluded. Mean BMD, adjusted for age and body mass index, was compared in cases and non-cases by analysis of variance. Risk across age group-specific BMD quartiles was compared using logistic regression. RESULTS: Overall, adjusted mean hip BMD was higher in cases (1.157 g/cm2) than non-cases (1.134 g/cm2) (p = 0.02). In men aged 60-79, prostate cancer risk was two-fold higher (OR, 2.12; 95% CI: 1.21-3.71) in the highest BMD quartile compared to the lowest. There was no association in younger men (interaction, p = 0.055). CONCLUSIONS: High bone density is associated with prostate cancer among older men, consistent with an etiological role for lifetime exposure to factors which modulate bone density. However, other etiologies may dominate prostate cancer risk among younger men.

Adult↗

Plasminogen activator inhibitor type 1 gene polymorphisms and haplotypes are associated with plasma plasminogen activator inhibitor type 1 levels but not with myocardial infarction or stroke.

BACKGROUND: The 4G allele in the promoter region of the plasminogen activator inhibitor type 1 (PAI-1) gene is associated with higher plasma PAI-1 levels and activity, but its association with cardiovascular diseases is unclear. We investigated the association of polymorphisms and common haplotypes of the PAI-1 gene with plasma PAI-1 levels, as well as the risk of myocardial infarction and stroke. METHODS AND RESULTS: This study is a prospective analysis of 2995 community-based participants (41% blacks and 51% women) aged 70 to 79 years old in the Health, Aging, and Body Composition Study. From 1997/1998 to 2001, 177 myocardial infarction events and 101 stroke events were identified. In addition to the 4G/5G polymorphism, 2 potential functional variants and other 4 haplotype-tagging variants were genotyped. In general linear models, the 4G allele was associated with higher PAI-1 levels after adjusting for age, sex, race, and site (26, 29, and 32 ng/mL for 5G/5G, 4G/5G, and 4G/4G, respectively; P for trend < .0001), but none of the other 6 polymorphisms was associated with PAI-1 levels. Haplotype analysis produced similar results. However, in Cox proportional hazard models, neither the polymorphisms nor the common haplotypes of the PAI-1 gene was associated with the risk of either myocardial infarction or stroke. CONCLUSIONS: The 4G allele is associated with higher PAI-1 levels, but this study does not support an association of the PAI gene polymorphisms with the risk of either myocardial infarction or stroke.

Aged↗

Prevalence, severity, and health correlates of lower urinary tract symptoms among older men: the MrOS study.

OBJECTIVES: To describe the prevalence, severity, and health correlates of lower urinary tract symptoms (LUTS) in older community-dwelling U.S. men. METHODS: We performed a cross-sectional analysis from a cohort study recruited from six U.S. clinical centers. This analysis included 5284 men without a history of prostate cancer who were at least 65 years of age. Participants completed questionnaires regarding the presence and severity of LUTS, including the American Urological Association Symptom and Bother indexes. Health status measures included the Medical Outcomes Survey SF-12 and self-rated health and instrumental activities of daily living. RESULTS: LUTS were absent in 2.3%, mild in 51.6%, moderate in 39.6%, and severe in 6.6%. Dissatisfaction with the urinary symptoms increased with LUTS severity (P <0.001); 19.8% of moderate and 58.1% of men with severe LUTS reported feeling mostly unsatisfied to terrible with their present urinary symptoms. The prevalence, severity, and dissatisfaction with LUTS increased with age. Men reporting moderate or severe LUTS were 1.41-fold (95% confidence interval 1.23 to 1.61) and 1.51-fold (95% confidence interval 1.23 to 1.85) more likely to rate their overall health quality as fair to very poor for their age instead of good to excellent, even after controlling for age and comorbid conditions. Increased LUTS also was independently associated with increased impairment in instrumental activities of daily living and poorer SF-12 scores. CONCLUSIONS: Moderate-to-severe LUTS is common in community-dwelling elderly U.S. men. In this study, LUTS severity was associated with poorer health quality and a greater prevalence of an inability to perform activities of daily living. The association of LUTS severity with poor health warrants increased clinical attention.

Activities of Daily Living↗

Correlates of decline in lower extremity performance in older women: A 10-year follow-up study.

BACKGROUND: Decline in lower extremity performance increases the risk of functional disability. This study examined the correlates of decline in lower extremity performance in older women. METHODS: A total of 5178 women aged 65-91 years were recruited from population-based listings from four centers in the United States. Clinical examinations were performed and lifestyle information was obtained at baseline and 10 years later. Lower extremity performance was measured by walking speed (meters/second) and time (seconds) to complete five chair-stands. Changes were calculated by subtracting baseline values from follow-up values. RESULTS: During the 10-year follow-up period, walking speed declined 17% and time to complete five chair-stands increased 22% (p < .0001). The decline in performance during the follow-up increased with baseline age: women aged 65-69 years experienced an 11% decline in walking speed and a 16% increase in the time to complete five chair-stands, while women aged 80 years or older experienced a 37% decline in walking speed and a 38% increase in chair-stand time. After adjusting for age, baseline physical performance, greater weight, greater height loss, smoking, history of arthritis and diabetes, and use of thyroid and estrogen medications were independently related to greater declines in lower extremity performance. CONCLUSIONS: Lower extremity performance decreased dramatically with advancing age in older women. Effective management of common diseases, such as arthritis and diabetes, and a healthy lifestyle, including avoidance of smoking and weight control, could help older women maintain their lower extremity physical functions.

Aged↗

Dimensions and volumetric BMD of the proximal femur and their relation to age among older U.S. men.

UNLABELLED: We measured femoral neck and shaft dimensions and volumetric BMD with QCT. Relations of these measures to age were quantified in a cross-sectional study among 3358 men 65-100 years old. Relations of femoral neck dimensions and vBMD to age differed from those in the shaft, indicating that patterns of bone modeling and remodeling in the neck and shaft are distinct. INTRODUCTION: Little is known about population variation in dimensions and volumetric BMD of the proximal femur or the relation of these measures to age among older men. MATERIALS AND METHODS: In a cross-sectional study, dimensions and volumetric BMD (vBMD) in the femoral neck and shaft were obtained from QCT scans among 3358 men 65-100 years of age in the Osteoporotic Fractures in Men cohort. Total bone size and size of the cortical and medullary compartments were measured with volumes in the femoral neck and with areas in the shaft. We quantified distributions of these measures and examined their relations to age with multivariable linear regression. RESULTS: Population variation in femoral neck and shaft dimensions and vBMD was substantial. In the femoral neck, total volume was minimally related to age, whereas cortical volume was 5% smaller and medullary volume was 10% larger (both p < 0.0001) in the oldest (85+ years) compared with the youngest (65-69 years) men. Across these ages, the percent of cortical bone declined from 46% to 42% (p < 0.0001). Integral and trabecular vBMD were 9% and 22% lower, whereas DXA femoral neck BMD was 4% lower, in the older men. Neck cortical vBMD was unrelated to age. In the shaft, cross-sectional area and medullary area were 9% and 22% larger, respectively, in the oldest men (both p < 0.0001), but cortical area was unchanged with age. The percent of cortical bone declined from 69% to 65% across these ages (p < 0.0001). Shaft cortical BMD was 4% lower in the older men (p < 0.0001). CONCLUSIONS: There is substantial diversity of femoral morphology and vBMD among older U.S. men. Patterns indicative of modeling and remodeling in the femoral neck were distinct from those in the shaft. Notably, changes in periosteal and endosteal dimensions that underlie cortical thinning appear to differ in the neck and shaft.

Absorptiometry, Photon↗

Reduced peripheral nerve function is related to lower hip BMD and calcaneal QUS in older white and black adults: the Health, Aging, and Body Composition Study.

UNLABELLED: Bone tissue is innervated, and peripheral nerve function may impact BMD. Older black and white men and women (N = 2200) in the Health, Aging, and Body Composition Study with worse sensory and motor peripheral nerve function had lower hip BMD and calcaneal BUA independent of lean mass, strength, physical ability, and diabetes. Poor peripheral nerve function may directly affect bone. INTRODUCTION: Bone tissue is innervated, yet little is known about the impact of nerve function on BMD. Poor peripheral nerve function may contribute to lower BMD and higher fracture risk, particularly in those with diabetic neuropathy. MATERIALS AND METHODS: The Health, Aging, and Body Composition (Health ABC) Study included annual exams in white and black men and women 70-79 years of age recruited from Pittsburgh and Memphis. Nerve function in legs/feet was assessed by 1.4- and 10-g monofilament detection, vibration threshold, and peroneal motor nerve conduction velocity (NCV) and amplitude (CMAP). Total hip BMD, heel broadband ultrasound attenuation (BUA), and total fat and lean mass were measured 1 year later (QDR 4500A, Sahara QUS; Hologic). RESULTS: Participants (N = 2200) were 48% men and 37% black. Poor nerve function (lower monofilament detection, higher vibration threshold, lower CMAP, lower NCV) was associated with 1.4-5.7% lower BUA and significant for all but NCV, adjusted for demographics, diabetes, body composition, and physical ability. Results were similar for adjusted hip BMD, with 1.0-2.9% lower BMD, significant for monofilament and CMAP testing. When considering the components of BMD, total hip area was 1.8-4.9% higher in those with the worst nerve function, although BMC showed little difference. Lower monofilament detection and CMAP were independently associated with lower heel BUA (p < 0.01), and monofilament detection was associated with lower hip BMD (p < 0.05) in regression additionally adjusted for lifestyle factors, bone-active medications, and diabetes-related complications. CONCLUSIONS: Poor peripheral nerve function may directly related to lower BMD, likely through an increase in bone area in older adults, independent of lean mass, strength, physical ability, and diabetes. Whether those with impaired nerve function are at higher risk for fracture independent of falls needs to be studied.

Aged↗

Nuclear receptor coactivator-3 alleles are associated with serum bioavailable testosterone, insulin-like growth factor-1, and vertebral bone mass in men.

CONTEXT: Nuclear receptor coactivator-3 (NCOA3) is a member of the steroid receptor coactivator family that interacts with nuclear hormone receptors to enhance their transcriptional activation function and may play a role in somatic growth. OBJECTIVE: The aim of this study was to examine the relationships between the CAG/CAA (glutamine) length variation at the NCOA3 locus, sex steroid hormone, and IGF-I levels and bone mineral density (BMD) in a cohort of older Caucasian men. DESIGN AND METHODS: We analyzed the association between potentially functional alleles at this locus, serum sex steroid hormone, and IGF-I levels and lumbar spine and proximal femur BMD (Hologic QDR) in 263 community-dwelling Caucasian men (age 66 +/- 7 yr, mean +/- sd; range 51-84 yr). Men were genotyped for a CAG/CAA repeat polymorphism in NCOA3, which encodes a polyglutamine tract of variable length in the C-terminal transcriptional activation domain of the protein. RESULTS: We found a significant monotonic decrease in lumbar spine, but not hip, BMD with increasing copies of the most common allele (29 repeats, 53%). For example, men with the 29/29 genotype had 6% or nearly 0.5 sd lower spine BMD than men without this genotype, and NCOA3 genotype explained 3.2% of the phenotypic variation in this trait. Serum levels of bioavailable testosterone and IGF-I paralleled genotype-related differences in lumbar spine BMD. CONCLUSION: Allelic variation at the NCOA3 locus may contribute to the genetic control of androgenic hormone and IGF levels and vertebral bone mass among older men.

Acetyltransferases↗

Association of estrogen receptor alpha polymorphisms with breast cancer risk in older Caucasian women.

Estrogens exert their effect on the breast through the estrogen receptor. We prospectively investigated breast cancer risk associated with 2 polymorphic sites in the estrogen receptor alpha gene (ESR1). A total of 4,248 Caucasian women from the Study of Osteoporotic Fractures were genotyped for the -401 T/C and -354 A/G polymorphisms in ESR1. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the associations between genotypes and breast cancer. During a mean follow-up of 12.4 years, 252 (5.9%) women developed breast cancer. The HR (95% CI) for breast cancer were 0.928 (0.708, 1.22) and 0.834 (0.538, 1.29) for the -354 A/G and A/A genotypes, respectively. Interactions with -354 variant were observed for smoking (HR = 1.52 and 1.56 for A/G and A/A smokers, respectively; HR = 0.74 and 0.60 for A/G and A/A non-smokers, respectively; interaction p = 0.03) and walking (HR = 0.75 and 1.15 for A/G and A/A walkers, respectively; HR = 0.18 and 0.49 for A/G and A/A non-walkers, respectively; interaction p = 0.01). There were no differences in the HR for the -401 T/C genotypes. An interaction between parity and carriage of the T allele was found (HR = 0.60 vs. 1.12 for nulliparous vs. parous women; interaction p = 0.03). ESR1 polymorphisms in combination with lifestyle factors may be associated with breast cancer risk in older Caucasian women.

Aged↗

Reciprocal influence of concurrent walking and cognitive testing on performance in older adults.

This study investigated how cognitive and walking performance are influenced when performed concurrently in older adults and what factors are associated with poorer dual-task responses. Using a dual-task study design, 217 subjects aged 74-85 years completed three information processing test conditions--(1) no test; (2) push-button simple reaction-time; and (3) visual-spatial decision reaction-time; and three walking test conditions--(1) seated; (2) walking over a 20m straight course; and (3) walking over 20m with a turn. Push-button and visual-spatial reaction-times increased approximately 21% and 6%, respectively, while walking compared to sitting (p<0.008). Reaction-time tests had a relatively weak impact on walking-time. Poorer dual-task walking-time responses correlated with slower walking velocity and weaker muscle strength (p< or =.062). Findings suggest that walking requires significant cognitive resources among older adults and slower-walking adults and weaker adults may require higher cognitive loading while walking.

Age Factors↗

Physical activity and decreased risk of clinical gallstone disease among post-menopausal women.

BACKGROUND: Physical activity may play a role in preventing gallstone disease. METHODS: The activity/gallstone relationship was examined in post-menopausal women from the Study of Osteoporotic Fractures (SOF; 1986-1988), a prospective study of fracture risk factors in 8010 women (mean age = 71.1 years, SD = 4.9). RESULTS: Multivariate logistic regression indicated women in the lowest two quartiles of physical activity, according to questionnaire, had a 59% {OR = 1.59 (1.11-2.29), P = 0.02} and a 57% higher risk {OR = 1.57 (1.11-2.23), P = 0.01} of developing gallstone disease compared to women in the highest quartile of activity (PTrend = <0.0001). Additionally, this relationship was examined in a cohort of 182 post-menopausal women (mean age 74.2 years, SD = 4.1) who participated in a randomized controlled trial of a walking intervention. Women in the randomized clinical trial in the lowest tertile of physical activity determined by a physical activity monitor had a higher risk of developing gallstone disease than women in the highest tertile of physical activity, 13% {OR-1.13 (1.01-1.28), P = 0.05, PTrend = <0.04}. CONCLUSION: Physical activity appears to be inversely related to the development of gallstone disease in post-menopausal women independent of body mass index.

Aged↗

Factors associated with the lumbar spine and proximal femur bone mineral density in older men.

Bone mass is a major determinant of fracture, but there have been few comprehensive studies of the correlates of bone mineral density (BMD) in older men. The objective of the current cross-sectional analysis was to determine the factors associated with BMD of the lumbar spine and proximal femur in a large population-based sample of older men enrolled in The Osteoporotic Fractures in Men Study, "Mr.OS." We enrolled 5,995 men 65 years of age or older, 89% Caucasian, in Mr.OS at six US clinical centers. Demographic, medical and family history and lifestyle information was obtained by interview and physical function and anthropometric data by examination. Spine and hip BMD was measured using dual-energy X-ray absorptimetry. The multivariable linear regression models predicted 19 and 10% of the overall variance in BMD of the femoral neck and spine, respectively. African-American men had 6 to 11% higher BMD than Caucasian men independent of multiple factors. Hip BMD declined with advancing age, while spine BMD increased. Body weight (per 10 kg) and self report of diabetes were each associated with 2 to 4% higher BMD, while history of a non-trauma fracture and current use of selective serotonin reuptake inhibitors, but not other antidepressants, were associated with at least 4% lower BMD. Both maternal and paternal histories of fracture were associated with 1.4-1.7% lower BMD. Osteoarthritis, physical activity, grip strength, alcohol intake, and dietary calcium were positively related to BMD, while a history of chronic lung disease, prostate cancer, and kidney stones was associated with lower BMD. Smoking, caffeine intake, and thiazide diuretics were not related to BMD in older men. A number of lifestyle and behavioral characteristics and medical conditions were associated with BMD in older men. Identification of these correlates could improve methods to identify men at risk for fracture and improve our understanding of fracture etiology.

Aged↗