Performance of FRAX in a cohort of community-dwelling, ambulatory older men: the Osteoporotic Fractures in Men (MrOS) study

Abstract Introduction With steadily growing numbers of patients with a depressive disorder, the effect of antidepressants on sleep architecture is of increasing concern. One major oral antidepressant medication is trazadone, which has also been prescribed in low doses for sleep insomnia treatment. Here, we investigate the effect of trazadone on NREM sleep instability also known as cyclic alternating pattern (CAP) in community-dwelling older men. Methods CAP was scored in overnight EEG recordings from 41 older men on trazadone (TRZ) and 50 age-matched men who did not use trazadone (NTRZ), participating in the Osteoporotic Fractures in Men Sleep Study. A high performance automated detection system determined the ratio between CAP time and NREM sleep time (CAP rate), the number of A1-phases per hour of NREM sleep (A1 index), and the number of A2+A3-phases per hour of NREM sleep (A2+A3 index). The effect of TRZ on CAP parameters was determined using the Mann-Whitney U test. Results CAP rate was significantly decreased in men using trazadone (NTRZ: 58.2±19.7%, TRZ: 47.9±15.9%) as compared to non-trazadone user (p < 0.01). Subtype indices did not show any significant difference between both groups but to some extent less frequent A2-A3 phases for TRZ user (A1-phases: NTRZ 13.0±18.7 no./h vs. TRZ 10.8±20.4 no./h, p = 0.35; A2+A3-phases: NTRZ 51.5±33.7 no./h vs. TRZ 44.7±23.3 no./h, p = 0.068). Conclusion CAP rate was significantly decreased in older men on trazadone as compared to older men who did not use trazadone, suggesting that trazadone usage has a stabilising effect on sleep micro-structure. Support The National Heart, Lung, and Blood Institute (NHLBI) provides funding for the MrOS Sleep ancillary study “Outcomes of Sleep Disorders in Older Men” under the following grant numbers: R01 HL071194, R01 HL070848, R01 HL070847, R01 HL070842, R01 HL070841, R01 HL070837, R01 HL070838, and R01 HL070839.

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Mean nocturnal respiratory rate predicts cardiovascular and all-cause mortality in community-dwelling older men and women

European Respiratory Journal ◽

10.1183/13993003.02175-2018 ◽

2019 ◽

Vol 54 (1) ◽

pp. 1802175 ◽

Cited By ~ 3

Author(s):

Mathias Baumert ◽

Dominik Linz ◽

Katie Stone ◽

R. Doug McEvoy ◽

Steve Cummings ◽

...

Keyword(s):

Osteoporotic Fractures ◽

Older Men ◽

Community Dwelling ◽

Sleep Study ◽

Men And Women ◽

All Cause Mortality ◽

The Relationship ◽

Older Men And Women

Respiratory frequency (fR) predicts in-hospital and short-term mortality in patients with a variety of pathophysiological conditions, but its predictive value for long-term cardiovascular and all-cause mortality in the general population is unknown. Here, we investigated the relationship between mean nocturnal fR and mortality in community-dwelling older men and women.We measured mean nocturnal fR during sleep from overnight polysomnography in 2686 men participating in the Osteoporotic Fractures in Men Study (MrOS) Sleep study and 406 women participating in the Study of Osteoporotic Fractures (SOF) to investigate the relationship between mean nocturnal fR and long-term cardiovascular and all-cause mortality.166 (6.1%) men in the MrOS cohort (8.9±2.6 years’ follow-up) and 46 (11.2%) women in the SOF cohort (6.4±1.6 years’ follow-up) died from cardiovascular disease. All-cause mortality was 51.2% and 26.1% during 13.7±3.7 and 6.4±1.6 years’ follow-up in the MrOS Sleep study and the SOF cohorts, respectively. Multivariable Cox regression analysis adjusted for significant covariates demonstrated that fR dichotomised at 16 breaths·min−1 was independently associated with cardiovascular mortality (MrOS: hazard ratio (HR) 1.57, 95% CI 1.14–2.15; p=0.005; SOF: HR 2.58, 95% CI 1.41–4.76; p=0.002) and all-cause mortality (MrOS: HR 1.18, 95% CI 1.04–1.32; p=0.007; SOF: HR 1.50, 95% CI 1.02–2.20; p=0.04).In community-dwelling older men and women, polysomnography-derived mean nocturnal fR ≥16 breaths·min−1 is an independent predictor of long-term cardiovascular and all-cause mortality. Whether nocturnal mean fR can be used as a risk marker warrants further prospective studies.

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0392 The Effect of Benzodiazepine Use on Non-REM Sleep Instability in Community-Dwelling Older Men

SLEEP ◽

10.1093/sleep/zsaa056.389 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A150-A150

Author(s):

S Hartmann ◽

M Baumert

Keyword(s):

Detection System ◽

Osteoporotic Fractures ◽

Nrem Sleep ◽

Older Men ◽

Community Dwelling ◽

Control Group ◽

Sleep Study ◽

Short Acting ◽

Cap Rate ◽

Long Acting

Abstract Introduction Previous studies on the implications of benzodiazepine (BZD), a widely prescribed pharmacotherapeutic treatment method for sleep insomnia, on sleep architecture demonstrated significantly reduced EEG activity in low-frequency bands. In this study, we explore the effect of BZD on NREM sleep instability also known as cyclic alternating pattern (CAP) in community-dwelling older men. Methods CAP was scored in overnight EEG recordings from 30 older men on long-acting BZD (LBZD), 35 older men on short-acting BZD (SBZD), and 50 age-matched men who did not use BZD (NBZD), participating in the Osteoporotic Fractures in Men Sleep Study (MrOS sleep). A high performance automated detection system determined the ratio between CAP time and NREM sleep time (CAP rate), the number of A1-phases per hour of NREM sleep (A1 index), and the number of A2+A3-phases per hour of NREM sleep (A2+A3 index). The relationship between CAP parameters and BZD use was determined using the Kruskal-Wallis test by ranks with Bonferroni correction for post-hoc analysis. Results CAP rate was significantly decreased in older men using long-acting BZD (NBZD: 59.6±18.0%, LBZD: 46.9±13.1%, SBZD: 53.0±20.1%) as compared to non-BZD user (p < 0.01). All BZD users demonstrated significantly lower frequencies of A1-phases (NBZD: 19.9±23.0 no./h, LBZD: 6.9±13.3 no./h, SBZD: 4.5±9.9 no./h) as compared to non-BZD users (LBZD: p < 0.01, SBZD: p < 0.001). The A2+A3 index did not show any variations between the three groups. Conclusion Older men using long-acting BZD demonstrate a significantly reduced CAP rate during sleep, particularly less frequent A1-phases, compared to the control group. Moreover, short-acting BZD user show significantly less frequent A1-phases but no difference in CAP rate and A2+A3-phases than older men using no BZD. Hence, BZD usage has a major adverse effect on the occurrence of EEG slow waves. Support The National Heart, Lung, and Blood Institute (NHLBI) provides funding for the MrOS Sleep ancillary study “Outcomes of Sleep Disorders in Older Men” under the following grant numbers: R01 HL071194, R01 HL070848, R01 HL070847, R01 HL070842, R01 HL070841, R01 HL070837, R01 HL070838, and R01 HL070839.

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Clinical Definitions of Sarcopenia and Risk of Hospitalization in Community-Dwelling Older Men: The Osteoporotic Fractures in Men Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glw327 ◽

2017 ◽

Vol 72 (10) ◽

pp. 1383-1389 ◽

Cited By ~ 20

Author(s):

Peggy M Cawthon ◽

Li-Yung Lui ◽

Brent C Taylor ◽

Charles E McCulloch ◽

Jane A Cauley ◽

...

Keyword(s):

Osteoporotic Fractures ◽

Older Men ◽

Community Dwelling

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Association of Intact Parathyroid Hormone Levels with Subsequent Hip BMD Loss: The Osteoporotic Fractures in Men (MrOS) Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2011-2431 ◽

2012 ◽

Vol 97 (6) ◽

pp. 1937-1944 ◽

Cited By ~ 22

Author(s):

Jeffrey R. Curtis ◽

Susan K. Ewing ◽

Douglas C. Bauer ◽

Jane A. Cauley ◽

Peggy M. Cawthon ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Femoral Neck ◽

Glomerular Filtration ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Osteoporotic Fractures ◽

Older Men ◽

Community Dwelling ◽

Mineral Density ◽

Total Hip

Introduction: There is little information on the association between intact PTH (iPTH) and longitudinal changes in bone mineral density (BMD) in older men. This association was evaluated in relation to conditions related to higher iPTH [e.g. decreased renal function, low serum 25-hydroxyvitamin D (25[OH]D)]. Methods: Eligible men were part of a random sample of 1593 community-dwelling individuals aged 65 yr or older participating in the Osteoporotic Fractures in Men study with baseline iPTH data. Of these, 1227 had at least two BMD measurements at the total hip and femoral neck over a mean follow-up of 4.5 yr. Annualized BMD change across iPTH quartiles was estimated using mixed-effects regression models, adjusting for age, serum calcium, serum 25(OH)D, estimated glomerular filtration rate, and other factors. Splines were used to identify more optimal iPTH thresholds associated with less BMD loss. Results: Among the cohort of 1138 eligible men, men in the highest quartile of iPTH (≥38 pg/ml) lost 0.46% per year at the total hip compared with men in the lowest iPTH quartile who lost 0.22% per year (P = 0.0004). Results were similar at the femoral neck. The association between iPTH and BMD loss was not modified by baseline estimated glomerular filtration rate or 25(OH)D status. Spline results suggested that iPTH levels below 30 pg/ml were more physiologically optimal than higher iPTH values in reducing BMD loss, although an exact threshold for optimal iPTH was not identified. Conclusion: Older men with higher iPTH levels had approximately a 2-fold greater rate of BMD loss compared with men with lower iPTH levels, irrespective of estimated glomerular filtration rate and 25(OH)D.

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Faculty Opinions recommendation of Lower urinary tract symptoms and incident falls in community dwelling older men: the concord health and ageing in men project.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726468861.793532446 ◽

2017 ◽

Author(s):

Tomas Griebling

Keyword(s):

Urinary Tract ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Older Men ◽

Community Dwelling ◽

Urinary Tract Symptoms ◽

Lower Urinary

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Exploring the ‘active mechanisms’ for engaging rural-dwelling older men with dementia in a community technological initiative

Ageing and Society ◽

10.1017/s0144686x19000357 ◽

2019 ◽

Vol 40 (9) ◽

pp. 1906-1938 ◽

Cited By ~ 1

Author(s):

Ben Hicks ◽

Anthea Innes ◽

Samuel R. Nyman

Keyword(s):

Computer Game ◽

Older Men ◽

Community Dwelling ◽

Microsoft Kinect ◽

Participatory Action ◽

Nintendo Wii ◽

Traditional Health ◽

People With Dementia ◽

Health And Social Care ◽

Field Notes

AbstractResearch has suggested ecopsychosocial initiatives can promote a sense of wellbeing and inclusion in people with dementia. However, few studies have elucidated the ‘active mechanisms’ whereby such initiatives can achieve these outcomes, so hindering their generalisability. This is particularly pertinent when seeking to support community-dwelling older men with dementia who are reluctant to engage with traditional health and social care initiatives. This paper reports on a study that drew from the principles of Participatory Action Research to explore the ‘active mechanisms’ of a technological initiative for older men (65+ years) with dementia in rural England. An individually tailored, male-only initiative, using off-the-shelf computer game technology (e.g. iPad, Nintendo Wii and Microsoft Kinect) was delivered over a nine-week period. Multiple qualitative methods were employed, including: focus groups, open interviews and extensive reflective field notes, to gather data from the perspective of 22 men, 15 care partners and five community volunteers. The data were analysed thematically and interpreted using a masculinity lens. Three mechanisms contributed to the initiative's success: the use of the technology, the male-only environment and the empowering approach adopted. The paper argues that initiatives aimed at community-dwelling older men with dementia would be advised to consider these gendered experiences and ensure participants can maximise their masculine capital when participating in them, by providing enabling activities, non-threatening environments and empowering approaches of delivery.

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Low Levels of Estradiol Are Associated with Vertebral Fractures in Older Men, But Not Women: The Rancho Bernardo Study1

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.85.1.6327 ◽

2000 ◽

Vol 85 (1) ◽

pp. 219-223 ◽

Cited By ~ 1

Author(s):

Elizabeth Barrett-Connor ◽

Judith E. Mueller ◽

Denise G. von Mühlen ◽

Gail A. Laughlin ◽

Diane L. Schneider ◽

...

Keyword(s):

Vertebral Fractures ◽

Critical Role ◽

Dehydroepiandrosterone Sulfate ◽

Older Men ◽

Community Dwelling ◽

Total Testosterone ◽

Skeletal Health ◽

Lateral Spine ◽

Assay Sensitivity ◽

Endogenous Estrogen

This longitudinal study included 288 postmenopausal women without estrogen use (median age, 72 yr) and 352 men (median age, 66 yr). All were community-dwelling, ambulatory, and Caucasian. Blood for hormone assays (total and bioavailable estradiol and testosterone, estrone, androstenedione, dihydrotestosterone, dehydroepiandrosterone, and dehydroepiandrosterone sulfate) was obtained in 1984–1987, and vertebral fractures were diagnosed from lateral spine radiographs obtained in 1992–1996. At least one vertebral fracture was found in 21% of women and 8% of men. Among men, age-adjusted hormone levels differed by fracture status only for total (64.1 vs. 75.4 pmol/L, P = 0.012) and bioavailable (43.0 vs. 51.4 pmol/L, P = 0.008) estradiol. There was a graded association between higher concentrations of total and bioavailable estradiol and lower fracture prevalence (trend P < 0.01 for both hormones). Men with total testosterone levels compatible with hypogonadism (<7 nmol/L) were not more likely to have vertebral fractures. In women, none of the measured sex hormones was associated with vertebral fractures. There was also no increased prevalence of fractures in women with estradiol levels below the assay sensitivity (<11 pmol/L). These data suggest that estrogen plays a critical role in the skeletal health of older men and confirm other studies showing no association of postmenopausal endogenous estrogen levels with vertebral fractures in older women.

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P-174: Type 2 diabetes and cognitive decline in a large sample of community-dwelling older men and women

Alzheimer s & Dementia ◽

10.1016/j.jalz.2007.04.137 ◽

2007 ◽

Vol 3 (3S_Part_2) ◽

pp. S154-S154

Author(s):

Olivia I. Okereke ◽

Jae H. Kang ◽

Nancy R. Cook ◽

J. Michael Gaziano ◽

JoAnn E. Manson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cognitive Decline ◽

Older Men ◽

Community Dwelling ◽

Men And Women ◽

Large Sample ◽

Older Men And Women

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Risk Factors for the Development of Osteoporosis and Osteoporotic Fractures Among Older Men

The Journal of Rheumatology ◽

10.3899/jrheum.080527 ◽

2009 ◽

Vol 36 (9) ◽

pp. 1947-1952 ◽

Cited By ~ 19

Author(s):

MARIA THOMAS-JOHN ◽

MARY B. CODD ◽

SIALAJA MANNE ◽

NELSON B. WATTS ◽

ANNE-BARBARA MONGEY

Keyword(s):

Risk Factors ◽

African American ◽

Dairy Products ◽

African American Men ◽

Osteoporotic Fractures ◽

Fragility Fractures ◽

Older Men ◽

Current Treatment ◽

Androgen Deprivation ◽

Mineral Density

Objective.Osteoporotic fractures are associated with significant morbidity and mortality particularly among older men. However, there is little information regarding risk factors among this population. The aims of our study were to determine risk factors for osteoporosis and fragility fractures and the predictive value of bone mineral density (BMD) measurements for development of fragility fractures in a cohort of elderly Caucasian and African American men.Methods.We evaluated 257 men aged 70 years or older for risk factors for osteoporosis and fragility fractures using a detailed questionnaire and BMD assessment. Exclusion criteria included conditions known to cause osteoporosis such as hypogonadism and chronic steroid use, current treatment with bisphosphonates, bilateral hip arthroplasties, and inability to ambulate independently.Results.Age, weight, weight loss, androgen deprivation treatment, duration of use of dairy products, exercise, and fracture within 10 years prior to study entry were associated with osteoporosis (p ≤ 0.05). Fragility fractures were associated with duration of use of dairy products, androgen deprivation treatment, osteoporosis, and history of fracture within 10 years prior to BMD assessment (p ≤ 0.05). There were some differences in risk factors between the Caucasian and African American populations, suggesting that risk factors may vary between ethnic groups.Conclusion.Although men with osteoporosis had a higher rate of fractures, the majority of fractures occurred in men with T-scores > −2.5 standard deviations below the mean, suggesting that factors other than BMD are also important in determining risk.

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