The Australian Study Of Cost And Utilities Related To Osteoporotic Fractures
Funder
National Health and Medical Research Council
Funding Amount
$411,627.00
Summary
The research will quantify the cost and quality of life impact of fragility fractures in Australia. The study design is based on an international study - International Costs and Utilities Related to Osteoporotic Fracutres Study (ICUORS) that aims to investigate the impact of osteoporosis-related fractures of the hip, spine and wrist. Results can be used to compare cost-effectiveness of different drugs and lifestyle interventions aiming to decrease the burden of osteoporosis in Australia.
Osteoporosis is a disease associated with a progressive rise in the number of fractures in the elderly. These fractures are so common that around 1 in 3 women and 1in 4 men will be affected. They cause pain, disability that can be permanent and are associated with loss of independence even premature death. Current treatments are able to partially restore bone strength in osteoporotic patients but can not return bone strength to normal. Some new treatments can restore bone strength to some extent ....Osteoporosis is a disease associated with a progressive rise in the number of fractures in the elderly. These fractures are so common that around 1 in 3 women and 1in 4 men will be affected. They cause pain, disability that can be permanent and are associated with loss of independence even premature death. Current treatments are able to partially restore bone strength in osteoporotic patients but can not return bone strength to normal. Some new treatments can restore bone strength to some extent but these are limited by expense and safety concerns. We have discovered a pathway in the brain that when blocked, results in a doubling of the amount of bone in key bone sites and dramatic increases in bone strength. This occurs due to a marked increase in the amount of new bone formed. In fact, genetic manipulation of this pathway was able to double the speed at which bone is made by the skeleton. Excitingly, these increases in bone were possible in adult mice, suggesting such changes could be potential therapy for human patients. We went on to test the effectiveness of this pathway in animal models of human skeletal weakness and have shown that it is capable of remarkable benefits. However, in order to be able to harness this pathway we must understand what molecules within the bone that are responding to the signals from the brain. Our proposal aims to identify the nerve signalling molecule(s) and pathways for these signals within the bone that initiate the increase in bone formation. This project ultimately aims to identify a target for new therapies that could achieve this beneficial effect by administration in osteoporotic women and menRead moreRead less
Primary Care Prevention Of Falls And Fractures In The Elderly By Annual Vitamin D Supplementation
Funder
National Health and Medical Research Council
Funding Amount
$305,750.00
Summary
While Australia has one of the highest rates of skin cancer, many of us are not receiving enough sun exposure to adequately maintain necessary blood levels of vitamin D. For years it was assumed that vitamin D deficiency was rarely seen in Australia where sunlight abounds for most of the year. Although few foods are high in vitamin D, it was thought that only certain cultural groups where women are always veiled in public, very dark-skinned people and the housebound elderly, were at risk of vita ....While Australia has one of the highest rates of skin cancer, many of us are not receiving enough sun exposure to adequately maintain necessary blood levels of vitamin D. For years it was assumed that vitamin D deficiency was rarely seen in Australia where sunlight abounds for most of the year. Although few foods are high in vitamin D, it was thought that only certain cultural groups where women are always veiled in public, very dark-skinned people and the housebound elderly, were at risk of vitamin D deficiency. Lower vitamin D levels following wintertime have now been reported in many populations including those living near the Mediterranean and in Geelong, Victoria. Vitamin D insufficiency is associated with an increased risk of falling through increased body sway and muscle weakness. Low levels of the vitamin also encourage the removal of calcium from bones and will predispose to bone fracture for two reasons - increased likelihood of falling and increased bone fragility and osteoporosis. Osteoporotic fractures are amongst the most important causes of ill-health among elderly people, causing an estimated 65,000 fractures in 2000-01. If nothing is done, fracture rates are estimated to increase from one every 8.1 minutes in 2001, to one every 3.7 minutes in 2021. Falls among the elderly are also a major health with about a third of people over 70years falling at least once every year. Almost 90% of all hip fractures result from the impact of a fall. This project will trial an annual dose of vitamin D to the elderly at high risk of vitamin D deficiency, falls and fractures. Fifteen hundred women will be supplemented with either vitamin D or a placebo dummy pill at the beginning of winter for five years. The supplementation will take place through their local doctor and researchers will expect to see fewer falls and bone fractures occurring in those receiving vitamin D than in the group receiving the placebo.Read moreRead less
Epidemiology Of Osteoporotic Fractures In The Very Frail Elderly: Risk Factors, Quality Of Life And Mortality
Funder
National Health and Medical Research Council
Funding Amount
$340,550.00
Summary
Osteoporosis, a disease characterised by skeletal fragility, is a major public health problem. The direct costs alone of treating osteoporotic fractures have been estimated at more than $800 million in Australia. Hip fractures are the most costly to treat and are due to a fall or injury in over 90% of cases. The frail elderly are at particular risk of osteoporotic fractures but little is known about risk fractures in this 'at risk' group or the effect of fracture on quality of life. This study i ....Osteoporosis, a disease characterised by skeletal fragility, is a major public health problem. The direct costs alone of treating osteoporotic fractures have been estimated at more than $800 million in Australia. Hip fractures are the most costly to treat and are due to a fall or injury in over 90% of cases. The frail elderly are at particular risk of osteoporotic fractures but little is known about risk fractures in this 'at risk' group or the effect of fracture on quality of life. This study is examining risk factors for fractures in the frail and institutionalised older person by asessment of quantitative bone ultrasound, falls risk, vitamin D status and other biochemical markers of bone in an attempt to identify predictors that can be modified to reduce fractures, improve quality of life and reduce mortality due to osteoporotic fractures.Read moreRead less
Is Periosteal Bone Formation Responsible For Sexual Dimorphism In Bone Fragility
Funder
National Health and Medical Research Council
Funding Amount
$316,320.00
Summary
Men and women sustain fractures as they age because their bones become fragile. Women sustain fractures more often than men. Bone thinning occurs in both sexes but it is usually believed that this thinning or loss of bone is greater in women than men. We have evidence to suggest that this may not be correct. In fact, it is likely that men and women lose a similar amount of bone, about half what they started with, but during ageing, men lay down more bone on the outside surface of the bone than w ....Men and women sustain fractures as they age because their bones become fragile. Women sustain fractures more often than men. Bone thinning occurs in both sexes but it is usually believed that this thinning or loss of bone is greater in women than men. We have evidence to suggest that this may not be correct. In fact, it is likely that men and women lose a similar amount of bone, about half what they started with, but during ageing, men lay down more bone on the outside surface of the bone than women compensating for the similar amount lost on the inside of the bone. We also have evidence to suggest than men and women who get spine fractures do so because the process of laying down bone may fail to occur normally. We will study these processes of bone loss inside the bone and bone gain outside the bone to try to better understand why bones become weak. We will measure the bone size and its density in healthy men and women and patients with fractures to determine how the increasing size of the bone produced by laying down bone on its outside helps to keep it strong and to preserve the bone that would otherwise be lost if it didn't occur or if a disease developed that might reduce the compensatoryRead moreRead less
Geelong Osteoporosis Study: Fracture Risk Prediction Based On Twenty Years Of Prospective Data.
Funder
National Health and Medical Research Council
Funding Amount
$1,107,758.00
Summary
In this population-based study we will generate evidence, both environmental and genetic, for defining fracture risk in Australian men and women. This will help identify individuals likely to sustain fragility fractures so that suitable therapies can be recommended. The data will be useful for developing prognostic models in both a clinical setting and for genetic screening programmes.
Effects Of Vitamin D And Calcium On Bone Strength, Balance And Falls In Elderly Women
Funder
National Health and Medical Research Council
Funding Amount
$230,900.00
Summary
Many osteoporotic fractures occur as a result of bone fragility and falls. Both falls and fractures are huge public health problems in Australia. Falls are the leading cause of injury-related hospitalization and death in person older than 65 years of age. During 1996 almost 36,000 people attended a hospital after a fall and 5% of these resulted in fracturing a bone. The incidence of fall-related hospital admission increases exponentially with age, reaching 4% per annum for men and 7% per annum f ....Many osteoporotic fractures occur as a result of bone fragility and falls. Both falls and fractures are huge public health problems in Australia. Falls are the leading cause of injury-related hospitalization and death in person older than 65 years of age. During 1996 almost 36,000 people attended a hospital after a fall and 5% of these resulted in fracturing a bone. The incidence of fall-related hospital admission increases exponentially with age, reaching 4% per annum for men and 7% per annum for women aged 85 years and older. In the community approximately one third of older people fall each year. Compared to men, women are three times more likely to be hospitalized or one and half times more likely to die from a fall-related injury. Importantly women have an increased risk of fracture and over 40% of women over the age of 50 will break a bone. Previous European and American studies suggest that calcium replacement may improve bone strength while vitamin D may reduce falls. However, the separation of these two effects has never been studied. We have previously studied elderly falling women who attended the Emergency Department of large teaching hospitals in Perth and have shown that many are calcium and vitamin D deficient. We are undertaking a short term randomized controlled trial of calcium alone or calcium with vitamin D, to study the effects on bone strength as measured non-invasively, balance and falls in this high risk group of subjects. We have already recruited 100 subjects and six subjects have completed their 6 months assessment. We plan to recruit the remaining 200 subjects during the following 12 months and give all subjects one year of treatment. At the end of this study we should be able to offer clear treatment guidelines for this high risk group of patients.Read moreRead less
Improving Outcomes In Osteoporosis And Bone Health
Funder
National Health and Medical Research Council
Funding Amount
$348,494.00
Summary
Osteoporotic fractures are a common and increasing problem as the population ages. They are associated with increased risk of re-fracture and early death yet most patients remain untreated. This proposal will identify which fracture patients are at highest risk of re-fracture and premature death (b) identify whether osteoporosis treatment decreases this risk and (c) increase osteoporosis awareness and treatment uptake by general practitioners with an integrated fracture risk prediction tool.
Does An Annual High Dose Vitamin D Supplement Decrease Healthcare Utilisation In Older Women?
Funder
National Health and Medical Research Council
Funding Amount
$104,995.00
Summary
The shorter bleaker days of winter can cause a vitamin D deficiency in Australian women, increasing their risk of osteoporosis and broken bones including hip fracture. New research suggests that the low winter levels of the vitamin may not be good for us in many ways and the NHMRC is funding a Geelong-based study to determine if Austrlia's elderly can improve their overall health by taking a once-a-year dose of vitamin D tablets.