In community-dwelling women frailty is associated with imminent risk of osteoporotic fractures.

Frailty reflects an accelerated health decline. Frailty is a consequence of fracture and contributes to fracture. Greater frailty was associated with higher fracture risk. Frail women were at immediate risk (within 24 months) of a hip or major fracture. Fracture prevention could be improved by considering frailty status. INTRODUCTION: Frailty encompasses the functional decline in multiple systems, particularly the musculoskeletal system. Frailty can be a consequence of and contribute to fracture, leading to a cycle of further fractures and greater frailty. This study investigates this association, specifically time frames for risk, associated fracture types, and how grade of frailty affects risk. METHODS: The study is performed in the OPRA cohort of 1044, 75-year-old women. A frailty index was created at baseline and 5 and 10 years. Women were categorized as frail or nonfrail and in quartiles (Q1 least frail; Q4 most frail). Fracture risk was assessed over short (1 and 2 years) and long terms (5 and 10 years). Fracture risk was defined for any fracture, major osteoporotic fractures (MOFs), and hip and vertebral fracture, using models including bone mineral density (BMD) and death as a competing risk. RESULTS: For women aged 75, frailty was associated with higher risk of fracture within 2 years (Hip SHRadj. 3.16 (1.34-7.47)) and MOF (2 years SHRadj. 1.88 (1.12-3.16)). The increased risk continued for up to 5 years (Hip SHRadj. 2.02 (1.07-3.82)); (MOF SHRadj. 1.43 (0.99-2.05)). Grade of frailty was associated with increased 10-year probability of fracture (p = 0.03). Frailty predicted fracture independently of BMD. For women aged 80, frailty was similarly associated with fracture. CONCLUSION: Frail elderly women are at immediate risk of fracture, regardless of bone density and continue to be at risk over subsequent years compared to identically aged nonfrail women. Incorporating regular frailty assessment into fracture management could improve identification of women at high fracture risk.

Prevalence and predictors of falls and dizziness in people younger and older than 80 years of age--a longitudinal cohort study.

The objectives were to investigate the prevalence and predictors for falls and dizziness among people younger and older than 80 years of age. The sample was drawn from the Swedish National study on Aging and Care (SNAC) and comprised 973 and 1273 subjects with data on the occurrence of falls and dizziness respectively at baseline. Follow-ups were made after 3- and 6-years. Data included socio-demographics, physical function, health complaints, cognition, quality of life and medications. The prevalence of falls was 16.5% in those under aged 80 and 31.7% in those 80+ years while dizziness was reported by 17.8% and 31.0% respectively. Predictors for falls in those under aged 80 were neuroleptics, dependency in personal activities of daily living (PADL), a history of falling, vision impairment and higher age, and in those 80+ years a history of falling, dependency in instrumental activities of daily living (IADL), fatigue and higher age. Factors predicting dizziness in those under aged 80 were a history of dizziness, feeling nervous and reduced grip strength and in those 80+ years a history of dizziness and of falling. Predictors for falls and dizziness differed according to age. Specific factors were identified in those under aged 80. In those 80+ years more general factors were identified implying the need for a comprehensive investigation to prevent falls. This longitudinal study also showed that falling and dizziness in many older people are persistent and therefore should be treated as chronic conditions.

High-performance liquid chromatographic analysis of hippuric acid in human blood plasma.

A method has been developed for the isocratic high-performance liquid chromatographic analysis of hippuric acid in human blood plasma. After the addition of an internal standard (3-methoxysalicylic acid), plasma samples (1 ml) were made alkaline and extracted stepwise with methylene chloride and ethyl acetate. The detection limit was 50 pmol of hippuric acid per ml of plasma. The concentrations of hippuric acid in plasma from house painters (n = 8), with long-term exposure to solvent vapours from alkyd paints, were in the range 1-21 nmol/mol (median 11 nmol/ml). These values were statistically significantly higher than those for controls (n = 9): 2-8 nmol/ml (median 3 nmol/ml).

Determination of platelet-megakaryocyte regeneration time in painters occupationally exposed to organic solvents.

An improved method for the determination of the regeneration time of human platelets is presented. The platelet-megakaryocyte regeneration times of painters exposed to organic solvents (n = 5; age range 23-48 years) were compared with a reference group (n = 5; age range 23-46 years) not occupationally exposed to solvents. After purification and extraction of the samples, they were analysed by high-performance liquid chromatography. The results showed that the painters have a shorter regeneration time (range 4.4-5.2 days) than the reference group (range 5.2-6.9 days) and indicate that solvent exposure may be associated with an increase in platelet turnover in man.

Effect on the uptake kinetics of serotonin (5-hydroxytryptamine) in platelets from workers with long-term exposure to organic solvents. A pilot study.

Six workers from a paint industry were examined concerning the concentration of solvents in the breathing zone, the platelet count and kinetic uptake of serotonin [5-hydroxytryptamine (5-HT)], the serum concentration of calcium, potassium and sodium, and pH. The degree of exposure was found to be moderate. The results showed a decrease in platelet count in whole blood and platelet-rich plasma. The maximum uptake rate for serotonin in platelets (Vmax) was significantly increased compared to that of nonexposed subjects. No changes in the ionic concentration and pH of serum were observed. One worker was reexamined after a six-week period of nonexposure. Though the measured platelet variables were still aberrant, the values approached normal.