Papaioannou A, Adachi JD, Winegard K, Ferko N, Parkinson W, Cook RJ, Webber C,
McCartney N
Efficacy of home-based exercise for improving quality of life among elderly
women with symptomatic osteoporosis-related vertebral fractures.
Osteoporos Int 2003 Jul 22;.
This randomized controlled trial was designed to investigate the effect of a
6-month home-based exercise program versus control (usual activities) on
quality of life for postmenopausal women with osteoporosis who had at least one
vertebral fracture. Twelve-month assessments of outcomes were completed to
determine if women would continue exercising with minimal supervision and if
benefit could be sustained. The home exercise program followed a "lifestyle
exercise" approach where participants completed exercises 60 min per day, 3
days a week and could complete exercises in small periods of time throughout
the day. Exercise activities included stretching, strength training and
aerobics (i.e. walking). Participants were assessed at baseline, 6 months, and
12 months using the Osteoporosis Quality of Life Questionnaire (OQLQ), the
Sickness Impact Profile (SIP), a balance test, and the Timed Up And Go test.
Bone mineral density was assessed at baseline and12 months for both the lumbar
spine and femoral neck. Quality of life (OQLQ) improved over 6 months in the
exercise group compared to the control group in the domains of symptoms (
P=0.003), emotion ( P=0.01) and leisure( P=0.03). Results from the balance test
indicated a greater effect in the exercise group over 12 months ( P<0.05).
There were no significant differences between groups in measures of Timed Up
and Go, SIP at 6 and 12 months, and femoral neck and lumbar spine bone mineral
density at 12 months. Home-based exercise with minimal supervision improves
quality of life in elderly women with vertebral fractures. Future research is
needed to determine if home exercise programs reduce falls and fall-related
injuries in the elderly.
Rozenfeld S, Camacho LA, Veras P
Medication as a risk factor for falls in older women in Brazil [Los
medicamentos como factor de riesgo de caidas en mujeres mayores de Brasil].
Rev Panam Salud Publica 2003 Jun;13(6):369-75.
OBJECTIVE: To assess the prevalence of falls and their association with the use
of medications among elderly women in the city of Rio de Janeiro, Brazil. Falls
among the elderly are likely to gain additional public health importance in
Brazil and many other developing countries given the rapidgrowth of the elderly
populations in those nations. METHODS: A cross-sectional study was carried out
with women who were participating in the educational, cultural, and medical
care activities of the Open University of the Third Age (OUTA), a group that
works to promote the welfare of elderly people in the city of Rio de Janeiro.
The women in the study were all 60 years old or older, were able to walk, had
no cognitive impairment, and were living in the community (rather than living
in a facility exclusively for older persons). A questionnaire was used that
asked about falls within the 12 months prior to the interview, medications used
in the previous 15 days, current and past health problems, and demographic
characteristics. Women who were interviewed face-to-face also had their blood
pressure checked. Two outcome variables were defined: (1) "fallers," who had
suffered one or more falls (contrasted with "nonfallers") and (2) "recurrent
fallers," who had had two or more falls (contrasted with those who had had one
or no falls, called"nonrecurrent fallers"). RESULTS: A total of 634 women were
interviewed face-to-face at the OUTA facilities. Among these in-person
interviewees, 23.3% reported one fall in the previous year, and 14.0% reported
two or more falls in that period. Considering both prescribed drugs and
over-the-counter drugs, only 9.1% of these women were not using any
medications, 52.7% were using 1 to 4 medications, 34.4% were using 5 to 10, and
3.8% were using 11 to 17 medications. In comparison to nonusers, users of
diuretics who also suffered from musculoskeletal disease were 1.6 times as
likely to report having suffered a single fall in the preceding year, after
adjusting for cardiovascular disease. Recurrent falls were reported 2.0 times
as often among beta-blocker users as among nonusers, after adjusting for
cardiovascular disease. The risk of recurrent falls among users of
anxiolytics/sedatives who had postural hypotension was 4.9 times as high as
among nonusers. CONCLUSIONS: Our data indicate an association between single
falls and recurrent falls and several groups of medications. Some falls could
be avoided through the more rational use of drugs, and measures should be
developed and implemented to encourage this.
Lima-Costa MF, Barreto SM, Firmo JO, Uchoa E
Socioeconomic position and health in a population of Brazilian elderly: the
Bambui Health and Aging Study (BHAS) [Situacion socioeconomica y salud en una
poblacion de adultos mayores brasilenos: el Estudio de Salud y Envejecimiento
de Bambui].
Rev Panam Salud Publica 2003 Jun;13(6):387-94.
OBJECTIVE: Despite the vast scientific literature on the social determinants of
health, there is still a debate on the extent to which this relationship
remains in old age. The objective of this study was to examine theassociation
between socioeconomic circumstances and health among older adults in a small
town in Brazil. METHODS: The study was carried out in Bambui, a town of around
15 000 inhabitants that is located in the state of MinasGerais, which is in
southeastern Brazil. From 1 177 residents aged 65 years or older, 1 074 of them
(91.2%) were interviewed and 997 (84.7%) were examined (physical measurements
and blood tests). Those in the lowest third ofthe distribution of total
household monthly income, with an income of lessthan US$ 240 per month, were
compared with those who had an income above that level. RESULTS: Lower family
income was independently associated with: (1) some lifestyle risk factors (less
consumption of fresh fruits or vegetables and less frequent exercise during
leisure time in the preceding 30 days), (2) several indicators of worse health
status (General Health Questionnaire score, self-rated health, self-rated
visual acuity, level of difficulty in walking 300 meters, inability to perform
routine activities because ofa health problem in the preceding 2 weeks, and
seropositivity for Trypanosoma cruzi), (3) a higher number of nonprescribed
medications used in the preceding 3 months, and (4) a higher number of
hospitalizations in the preceding 12 months. Obesity was more frequent in the
higher-income group. CONCLUSIONS: The results of this study do not confirm
observations in some developed countries of a lack of association between
socioeconomic status and health among the aged. Our results showed that a small
difference in monthly family income was sufficiently sensitive to identify
elderly persons in worse health, even within a community that appears to be
uniformly poor
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