scholarly journals 08 Evidence Base for Treatment of Osteoporosis in Older People

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv3-iv3
Author(s):  
Tahir Masud
Keyword(s):  
Oldest Old ◽  
Age Groups ◽  
Osteoporotic Fractures ◽  
Osteoporosis Treatment ◽  
Fracture Reduction ◽  
Older Population ◽  
Term Care ◽  
Treatment Of Osteoporosis ◽  
Post Hoc Analysis ◽  
Post Hoc

Abstract After the age of fifty years the prevalence of osteoporosis and incidence of osteoporotic fractures rise substantially with age. It is ironic however that the pivotal trials for the common drugs used to treat osteoporosis mainly recruited participants under the age of 80 years leading some to question the use of these drugs in the older population. This talk explores the evidence accumulated for the treatment of osteoporosis in the frailer older population. The FOSIT trial showed a 47% reduction in non-vertebral fractures with alendronate in people up to 84 years, and a study in long term care in those up to 91 years showed a significant improvement in bone density at the spine and hip. A post hoc analysis of the risedronate HIP trial in people aged 70-100 years with established osteoporosis showed a 47% reduction in hip fractures. In the zoledronic acid Horizon studies fractures were significantly reduced in a population up to the age of 89 years and mortality was reduced by 28%, with half of the participants being older than 75 years. Interestingly a post hoc analysis showed that those participants who ended up having only a single infusion had a reduction of all clinical fractures at 3 years. The Freedom trial of denosumab was performed in a population aged up to 90 years with significant fracture reduction across all age groups. Studies with the anabolic agent teriparatide showed that vertebral and non-vertebral fracture reduction occurred in both the under and over 75 age groups. Trials with the recently developed agents abaloparatide and romosozumab have shown significant fracture reductions in populations up to ages of 86 and 90 years respectively. There is now enough evidence to suggest that the oldest old should be considered for osteoporosis treatment as well having a focus on falls reduction.

scholarly journals Resilience and Mental Health Among Male Older Adults in Extreme Poverty in Long-term Care Facilities in Rural China

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 855-855
Author(s):  
Ying Ma ◽  
Patrick Leung
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Long Term Care ◽  
Oldest Old ◽  
Age Groups ◽  
Term Care ◽  
Extreme Poverty ◽  
Significant Difference ◽  
Care Facilities

Abstract Older adults in extreme poverty refer to “three-noes people”: no working ability, no income source, and no children or legal supporters. They are eligible for a government-funded welfare system called “Five Guarantee system”. The majority of residents in rural welfare institutes are male older adults in extreme poverty. Research demonstrates that resilience is a critical factor in shaping health. This study aims to examine the association between resilience and mental health for male older adults in extreme poverty, and its differences in young-old (60-69 years), old-old (70-79 years), and oldest-old groups (≥80 years). A cross-sectional study was conducted with 1,427 eligible subjects in rural long-term care facilities from Anhui province in China during 2019, with a response rate of 77.4%. Resilience was measured by the Chinese version of Connor-Davidson Resilience Scale, including three subscales of optimism, strength and tenacity. Mental health was assessed using General Health Questionnaire-12. A MANOVA test revealed a significant difference among age groups on three subscales of resilience [Pillai’s Trace=.023, F (6,1486) =2.709, p=.013, ηp2=.012]. Tukey Post hoc indicated the oldest reported significantly lower levels of strength, optimism, and tenacity compared to the other two groups. A multiple logistic regression identified a significant negative association between resilience and mental disorder for the old-old (OR=0.95, 95%CI:0.93-0.97) and oldest-old (OR=0.93, 95%CI: 0.88-0.99) groups. Our findings identified th differences in the link between resilience and mental health within the three different age groups. Resilience-training programs to improve mental health would require targeting specific subscales of resilience for each group.

Personalisierte Osteoporose-Therapie

2019 ◽  
Vol 144 (16) ◽  
pp. 1111-1119
Author(s):  
Karoline Schulz ◽  
Hannes Kalscheuer ◽  
Hendrik Lehnert
Keyword(s):  
Fracture Risk ◽  
Osteoporotic Fractures ◽  
Osteoporosis Treatment ◽  
High Fracture ◽  
Osteoporosis Therapy ◽  
Treatment Of Osteoporosis ◽  
First Line Therapy ◽  
Severity Of The Disease ◽  
The Individual ◽  
Care Costs

AbstractIn Germany, over six million people suffer from osteoporosis. Nearly half of the women over 70 years and nearly 20 % of men at the same age are affected. The clinical and socioeconomical relevance of the disease lies in osteoporotic fractures leading to extensive bone-associated morbidity, increased mortality and health care costs. Fracture risk algorithms and guidelines for the diagnosis and treatment of osteoporosis help to assess the individual fracture risk. By calculating the individual fracture risk, the indication for specific osteoporosis treatment can objectively be determined. A consequent specific osteoporosis therapy is required for patients with a high fracture risk and is essential to prevent osteoporotic fractures and their consequences. As first-line therapy a drug with a proven fracture-reducing effect should be taken. However, for successful osteoporosis therapy, many individual factors have to be considered. A personalized treatment approach should be established according to the severity of the disease, the patient’s sex and comorbidities as well as the possible additive and side effects of the drug.

scholarly journals Efficacy and serious adverse events profile of the adjuvanted recombinant zoster vaccine in adults with pre-existing potential immune-mediated diseases: a pooled post hoc analysis on two parallel randomized trials

Rheumatology ◽  
2020 ◽  
Author(s):  
Alemnew F Dagnew ◽  
Debora Rausch ◽  
Caroline Hervé ◽  
Toufik Zahaf ◽  
Myron J Levin ◽  
...  
Keyword(s):  
Adverse Events ◽  
Age Groups ◽  
Zoster Vaccine ◽  
Post Dose ◽  
Serious Adverse Events ◽  
Post Hoc Analysis ◽  
Immune Mediated ◽  
Recombinant Zoster Vaccine ◽  
Post Hoc ◽  
Placebo Recipients

Abstract Objective In the ZOE-50 (NCT01165177) and ZOE-70 (NCT01165229) phase 3 clinical trials, the adjuvanted recombinant zoster vaccine (RZV) demonstrated ≥90% efficacy in preventing herpes zoster (HZ) in all age groups ≥50 years. Given the increased HZ risk associated with certain underlying autoimmune diseases or their treatment regimes, we conducted a post hoc analysis of RZV’s efficacy against HZ and safety profile [specifically, the occurrence of serious adverse events (SAEs)] in ZOE-50/70 participants who reported pre-existing potential immune-mediated diseases (pIMDs) at enrolment and were not on immunosuppressive therapies. Methods Adults aged ≥50 (ZOE-50) and ≥70 (ZOE-70) years were randomized to receive two doses of RZV or placebo 2 months apart. In this subgroup analysis of participants with at least one pIMD at enrolment, the efficacy was calculated for two-dose recipients who did not develop confirmed HZ before 30 days post-dose 2. SAE occurrence was evaluated for all participants who received at least one dose. Results Of the 14 645 RZV and 14 660 placebo recipients from the ZOE-50/70 studies, 983 and 960, respectively, reported at least one pre-existing pIMD at enrolment and were included in these analyses. The most frequent pre-existing conditions were psoriasis, spondyloarthropathy and RA. Efficacy against HZ was 90.5% (95% CI: 73.5, 97.5%) overall with the lowest being 84.4% (95% CI: 30.8, 98.3%) in the 70–79-year-old age group. SAEs and fatal SAEs were similar between RZV and placebo recipients. Conclusion In ZOE-50/70 participants with pre-existing pIMDs, RZV was highly efficacious against HZ and SAE incidence was similar between RZV and placebo recipients. Trial registration ClinicalTrials.gov, https://clinicaltrials.gov, NCT01165177 (ZOE-50), NCT01165229 (ZOE-70).

scholarly journals Use of Long-Term Care Decreased Over Time Among the Oldest-Old With and Without Dementia - A Register-Based Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 995-996
Author(s):  
Mari Aaltonen ◽  
Leena Forma ◽  
Jutta Pulkki ◽  
Jani Raitanen ◽  
Marja Jylhä
Keyword(s):  
Home Care ◽  
Long Term Care ◽  
Negative Binomial ◽  
Oldest Old ◽  
Age Groups ◽  
Term Care ◽  
Total Study Population ◽  
Health And Social Care ◽  
Over Time

Abstract Care policies for older adults emphasize aging-in-place and home care over residential long-term care (LTC). We explore how the use of residential LTC in the last five years of life among people with and without dementia changed between those who died in 2001, 2007, 2013, and 2017 in Finland. Retrospective data drawn from the national health and social care registers include all those who died aged 70+ in 2007, 2013, and 2017, plus a 40% random sample from 2001 (N=128 050). Negative binomial regression analysis was used to estimate the association of dementia with LTC use during the last five years of life (1825 days). The independent variables included dementia, age, marital status, annual income, education, and chronic conditions. In the total study population, the proportion of LTC users and the mean number of days in LTC increased until 2013, after which it decreased. Changes in LTC use differed between different age groups and by dementia status. Over time, the decrease in round-the-clock LTC use was steep in those aged 90≤ with dementia and in people aged 80≤ without dementia. The individual factors related to morbidity and sociodemographic factors did not explain these results. The changes in LTC care policy may have contributed to the decrease in LTC use among the oldest. However, according to national statistics, the availability of formal home care has not increased. This development may suggest that the oldest-old and those with dementia – a highly vulnerable group – are left without proper care.

scholarly journals Is it possible to prevent dementia?

2002 ◽  
Vol 24 (suppl 1) ◽  
pp. 22-27 ◽  
Author(s):  
Nicola T Lautenschlager
Keyword(s):  
Functional Disability ◽  
Long Term Care ◽  
Oldest Old ◽  
Age Groups ◽  
Later Life ◽  
Present Knowledge ◽  
Term Care ◽  
Factors Associated ◽  
Prevention Trials

It is a robust trend that the World's population is growing older. The proportion of elderly compared to other age groups and especially the number of oldest old, above age 85 years, is steadily increasing. One of the most common disorders in later life is dementia, the major cause of functional disability and the need for long-term care. This has prompted intensive research towards identifying risk factors associated with dementia. For current therapeutic intervention of incipient dementia and future prevention trials it is important to identify subjects at high risk of developing dementia. This article reviews clinical and biological findings of the quest to identify pre-dementia in subjects with mild cognitive impairment. It gives an overview of the present knowledge in this area and discusses strategies that may be useful in delaying the onset of dementia.

Effectiveness of Indapamide/amlodipine Single-pill Combination in Patients With Isolated Systolic Hypertension: Post-hoc Analysis of the ARBALET Study

2021 ◽  
Author(s):  
Zh Kobalava ◽  
Eteri Kolesnik ◽  
E Shavarova ◽  
L Goreva ◽  
L Karapetyan
Keyword(s):  
Clinical Practice ◽  
Systolic Hypertension ◽  
Age Groups ◽  
Real Life ◽  
Isolated Systolic Hypertension ◽  
Open Label ◽  
Post Hoc Analysis ◽  
Single Pill ◽  
Treatment Naïve ◽  
Post Hoc

Abstract Background: Isolated systolic hypertension (ISH) is a major cause of morbidity and mortality. This study evaluated the effectiveness of treatment with an indapamide/amlodipine single-pill combination (SPC) in outpatients with uncontrolled ISH aged over 55 years in real-life clinical practice.Methods: This was a post-hoc analysis of the subgroup of patients with ISH from ARBALET, a 3-month, multicenter, observational, open-label study conducted in Russia among patients with grade I or II hypertension who were either uncontrolled on previous antihypertensive treatment or treatment-naïve. The effectiveness of indapamide/amlodipine SPC was assessed by the change in office systolic blood pressure (SBP) and the rate of target SBP (<140 mmHg) achievement at 2 weeks, 1 month and 3 months, in four age groups: 55-59 years, 60-69 years, 70-79 years, and 80 years or older.Results: The ARBALET study recruited 2217 patients, of whom 626 had ISH and were included in this post-hoc analysis (mean age 66.1±7.8 years; 165 men [26.36%] and 461 women [73.64%]). Target SBP <140 mmHg was achieved in 43%, 75% and 93% of patients at 2 weeks, 1 and 3 months, respectively. SBP decreased from baseline by 18.8±10.5 mmHg, 27.2±10.6 mmHg and 31.8±9.9 mmHg at 2 weeks, 1 month and 3 months, respectively. In the groups of patients aged 55-59, 60-69, 70-79, and ≥80 years, SBP reductions at 3 months compared with baseline were -30.3±9.4, -32.4±9.7, -32.5±10.7, and -28.9±9.6 mmHg, respectively. Conclusion: This post-hoc analysis of the observational ARBALET study showed that indapamide/amlodipine SPC was associated with significant reductions in BP and high rates of target BP achievement in a broad age range of patients with ISH treated in routine clinical practice.Trial registration number: ISRCTN40812831

scholarly journals Effect of lorcaserin in different age groups: a post hoc analysis of patients from the BLOOM, BLOSSOM and BLOOM‐DM studies

2019 ◽  
Vol 5 (2) ◽  
pp. 120-129 ◽  
Author(s):  
K. Fujioka ◽  
M. Malhotra ◽  
C. Perdomo ◽  
C. M. Apovian
Keyword(s):  
Age Groups ◽  
Post Hoc Analysis ◽  
Post Hoc

scholarly journals Metabolismo Óseo

2019 ◽  
Vol 6 (2S) ◽  
pp. 85-90
Author(s):  
Asociación Colombiana de Endocrinología Diabetes y Metabolismo
Keyword(s):  
Clinical Trial ◽  
Osteoporotic Fractures ◽  
Patient Characteristics ◽  
Post Hoc Analysis ◽  
Vitamina D ◽  
Major Osteoporotic Fractures ◽  
Resistencia A La Insulina ◽  
Factores De Riesgo ◽  
Previously Treated ◽  
Post Hoc

Listado: Bajos niveles de vitamina D y su relación con la alteración de lípidos sanguíneos en mujeres posmenopáusicas de 2 municipios del departamento del Atlántico.  Becerra JE, Rebolledo RC, Pabón AC, Suárez M, Sarmiento LA. Déficit de vitamina D en hombres y mujeres con deseo sexual hipoactivo. Estudio de prevalencia.   Espitia F, Orozco L. Determinación del consumo diario de calcio en la población colombiana.   Arenas HM, Arias D, López VJ, Arias DR. Efficacy of Teriparatide Compared with Risedronate on Frax®- Defined Major Osteoporotic Fractures: a Post-Hoc Analysis of the VERO Clinical Trial.   Body JJ1 , Marin F2 , Geusens P3 , Zerbini C4 , FahrleitnerPammer A5 , Moericke R6 , et al. Osteoporosis y baja masa ósea en mediciones de densitometría en Villavicencio, Meta, durante el 2018.   Rosero FO, Garcés H, Beltrán A, Guerrero JF, Escobar LM, Galeano D, et al. Osteoporosis, sarcopenia y correlación entre SARC-F y masa muscular por DXA en población colombiana: estudio piloto.   Castrillón MP, Flórez AM, Vergara JE, Roa A, Quintero J, Parra G, et al. Patient Characteristics and Fracture Outcomes in Patients Previously Treated with Bisphosphonates or TreatmentNaïve in The Teriparatide Versus Risedronate VERO Clinical Trial.   Hadji P1 , Marin F2 , Kendler DL3 , Geusens P4 , Russo L5 , Malouf J6 , et al. Prevalencia del déficit de vitamina D y factores de riesgo asociados en gestantes del Quindío.   Espitia F, Orozco L. Prevalencia del déficit de vitamina D en mujeres posmenopáusicas de Armenia.   Espitia F, Orozco Santiago L. Relación entre el índice TG/ HDL-C, la resistencia a la insulina y la vitamina D sérica en mujeres posmenopáusicas del departamento del Atlántico, Colombia.   Sarmiento LA1 , Becerra JE1 , Rebolledo R2 , Suárez M1 , Barragán M1 , Sánchez L1 Tabaquismo y vitamina D: una vía a la fragilidad.   Pérez MU1, 2, Patiño D1, 3, Borda MG1, 4.

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