Determinants of bone density in 30- to 65-year-old women: A co-twin study

Introduction: Reported effects of body composition and lifestyle of bone mineral density in pre-elderly adult women have been inconsistent.

Methods: In a co-twin study of 146 female twin pairs aged 30 to 65 years, DXA was used to measure bone mineral density at the lumbar spine, total hip, and forearm, total body bone mineral content, and lean and fat mass. Height and weight were measured. Menopausal status, dietary calcium intake, physical activity, current tobacco use, and alcohol consumption were determined by questionnaire. Within-pair differences in bone measures were regressed through the origin against within-pair differences in putative determinants.

Results: Lean mass and fat mass were associated with greater bone mass at all sites. A discordance of 10 pack-years smoking was related to a 2.3-3.3% (SE, 0.8-1.0) decrease in bone density at all sites except the forearm, with the effects more evident in postmenopausal women. In all women, a 0.8% (SE, 0.3) difference in hip bone mineral density was associated with each hour per week difference in sporting activity, with effects more evident in premenopausal women. Daily dietary calcium intake was related to total body bone mineral content and forearm bone mineral density (1.4 ± 0.7% increase for every 1000 mg). Lifetime alcohol consumption and walking were not consistently related to bone mass.

Conclusion: Several lifestyle and dietary factors, in particular tobacco use, were related to bone mineral density. Effect sizes varied by site. Characterization of determinants of bone mineral density in midlife and thereafter may lead to interventions that could minimize postmenopausal bone loss and reduce osteoporotic fracture risk.

Discharge planning: from the acute sector for people over the age of 65

This paper reports the findings relating to discharge planning from a larger study (Hegney et al 2001) that aimed to investigate options to improve care co-ordination between the aged, community, acute and primary care sectors for the elderly residents of a large provincial town. The data, which were collected from a wide variety of aged care stakeholders in the region, are consistent with previous Australian studies. First, it appears that inappropriate discharge from acute hospitals occurs in Toowoomba because there is a perceived lack of information regarding the available community care options and a lack of suitable models to support people's care needs within their own homes. Second, inappropriate discharge practices from acute hospitals occur due to a lack of knowledge and communication on the part of health professionals employed in these settings with regard to the on- going health care needs of elderly people. Third, there is little discharge planning occurring that includes the general practitioner in post-discharge care. Finally, inappropriate discharge can also be attributed to the lack of sub-acute/step-down/rehabilitation options and long waiting lists for community home care services in the region.

Quality of life amongst people over 65 years of age : does constipation make a difference?

Aims
The aims of this study was to determine whether quality of life for people 65 years and over is affected by constipation and laxative use and to identify dimensions or functions of quality of life that were specifically affected by constipation.

Method
Of the 79 subjects who completed the pre-screening questionnaire to determine their bowel function and laxative use status , 58 agreed to participate in the phase of the study (73%) of which 22 were females and 36 were males. Subjects completed a quality of life questionnaire, comprising of ComQoL questions and SF36 questions during a face to face interview conducted in their own homes.

Results
ComQoL importance and satisfaction scores were compared by bowel health status and gender. The most important dimensions for all subjects were health (mean score 9.4), family (mean score 9.3) and their own happiness (mean score 8.7). The total mean for satisfaction score for the whole group was 69%, fractionally lower that the bottom end of the normative range (70-80%). Constipated subjects scored satisfaction with their health significantly lower than the not constipated group (p =0.02) and subjects who took laxatives once a fortnight or more also had significantly lower satisfaction with their health (p=0.03).

Conclusion
Overall the subjects reported a high level of satisfaction with their lives, constipation and laxative use affected their satisfaction with their health. Further exploration is needed to determine how this will affect lifestyle and health behaviours.

Fluoride-assisted synthesis of mullite (Al5.65 Si0.35 O9.175) nanowires

Novel silicon-deficient mullite (Al_5.65Si_0.35O_9.175) single crystal nanowires were synthesized in large quantities on mica substrates assisted by the intermediate fluoride species. The nanowires have diameters in the range 50–100 nm and typical lengths of several µm. Aligned nanowires were observed at the substrate edge. The nanowires have strong photoluminescence (PL) emission bands at 310, 397, 452 and 468 nm.

Socio-economic inequalities in mortality persist into old age in New Zealand : study of all 65 years plus, 2001-04

A number of studies have explored the relationship between socioeconomic status (SES) and mortality, although these have mostly been based on the working age population, despite the fact that the burden of mortality is highest in older people. Using Poisson regression on linked New Zealand census and mortality data (2001 to 2004, 1.3 million person years) with a comprehensive set of socioeconomic indicators (education, income, car access, housing tenure, neighourhood deprivation) we examined the association of socioeconomic characteristics and older adult mortality (65+ years) in New Zealand. We found that socioeconomic mortality gradients persist into old age. Substantial relative risks of mortality were observed for all socioeconomic factors, except housing tenure. Most relative risk associations decreased in strength with aging (e.g. most deprived compared to least deprived rate ratio for males reducing from 1.40 (95% CI 1.28 to 1.53) for 65-74 year olds to 1.13 (1.00 to 1.28) for 85+ year olds), except for income and education among women where the rate ratios changed little with increasing age. This suggests individual level measures of SES are more closely related to mortality in older women than older men. Comparing across genders, the only statistically significantly different association between men and women was for a weaker association for women for car access.

Associations between the perceived environment and physical activity among adults aged 55-65 years : does urban-rural area of residence matter?

This study aimed to determine whether associations between the perceived environment and physical activity are moderated by urban-rural status among midolder aged adults. Environmental (safety, aesthetics, physical activity environment) and physical activity (total, leisure, transport) data from 3,888 adults (55 to 65 years) from urban and rural areas of Victoria, Australia, were analyzed. Multinomial logistic regression examined interactions between urban-rural status and environments in associations with physical activity. Significant (P < .05) interactions were evident and indicated positive associations only among older rural adults for both safety and aesthetics with total and transport physical activity (e.g., rural adults reporting higher safety were 91% to 118% more likely to have higher activity than rural adults reporting low safety). In contrast, the physical activity environment was positively associated with leisure activity among only urban adults. Findings suggest that some tailoring of physical activity promotion strategies targeting the environment may be required for urban and rural midolder aged adults.