Lower extremity physical performance and hip bone mineral density in elderly black and white men and women: cross-sectional associations in the Health ABC Study.
Lower extremity physical performance and hip bone mineral density in elderly black and white men and women: cross-sectional associations in the Health ABC Study.
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DOI：
10.1093/gerona/58.10.m934
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发表时间：
2003-10
期刊：
影响因子：
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通讯作者：
D. Taaffe;E. Simonsick;M. Visser;S. Volpato;M. Nevitt;J. Cauley;F. Tylavsky;T. Harris
中科院分区：
文献类型：
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作者：
D. Taaffe;E. Simonsick;M. Visser;S. Volpato;M. Nevitt;J. Cauley;F. Tylavsky;T. Harris
背景：衰老的特征是体能和骨密度(BMD)下降，两者都会增加骨折的风险。然而，目前尚不清楚这些因素在老年人中是否共存或独立，以及是否存在关系，是否因性别和/或种族而异。方法数据来自847名白人女性，723名黑人女性，927名白人男性和544名黑人男性，年龄在70-79岁之间，参与健康老龄化和身体成分(ABC)研究，这是一个功能正常的社区老年人队列。用双能X线骨密度仪测定股骨颈和粗隆的骨密度(g/cm(2))。体能测量包括膝关节伸展力量、重复椅子站立、步速(6m)、步行耐力(400m)和站立平衡。结果在连续测量BMD的分析中，黑人女性粗隆部位的BMD和体能表现最一致，即使在调整了体型和包括体力活动在内的几个协变量后也是如此。在每项表现指标上，处于底部四分位数的黑人女性(S)的骨密度低于位于顶部四分位数的黑人女性(S)。对于股骨颈，除了400米步行外，与运动任务有显著的相关性。相比之下，在白人女性中，只有椅子抬起能力与股骨颈骨密度、膝关节伸肌力量、椅子抬起能力以及与粗隆的平衡有关。对于白人和黑人男性，只有膝伸肌力量较差的人才有骨密度降低的趋势。结论：在这组功能正常的中青年老年人中，体能与髋部骨密度只有一定程度的相关性。这种关联在黑人女性中最强，她们作为一个群体在队列中表现出最差的功能能力。我们的数据显示，尽管较差的身体表现和低BMD都是骨折的风险因素，但在功能正常的年轻人中，它们基本上是独立的，黑人女性除外。这种独立性表明，减少骨折发生率的干预措施应该以改善体能和骨密度为目标。
BACKGROUND Aging is characterized by declines in physical capacity and bone mineral density (BMD), both of which contribute to increased risk for fracture. However, it is unclear if these factors coexist or are independent in elderly people, and if a relationship does exist, whether it varies by sex and/or race. METHODS Data are from 847 white women, 723 black women, 927 white men, and 544 black men aged 70-79 years participating in the Health Aging and Body Composition (ABC) Study, a cohort of well-functioning community-dwelling elders. BMD (g/cm(2)) of the hip (femoral neck and trochanter) was determined by dual X-ray absorptiometry. Physical capacity measures included knee extensor strength, repeated chair-stands, gait speed (6 m), walking endurance (400 m), and standing balance. RESULTS In analyses of BMD as a continuous measure, BMD and physical performance were most consistently related at the trochanter in black women, even after adjusting for body size and several covariates including physical activity. For each performance measure, black women in the bottom quartile(s) had lower BMD than those in the top quartile(s). For the femoral neck, there was a significant association with performance tasks, except for the 400-m walk. In comparison, only chair-rise performance was related to BMD at the femoral neck, and knee extensor strength, chair-rise performance, and balance with the trochanter in white women. For white and black men, trends existed only for lower BMD in those with poorer knee extensor strength. CONCLUSIONS In this cohort of well-functioning young-old seniors, physical capacity is only modestly related to BMD at the hip. The association was strongest in black women, who as a group exhibited the poorest functional capacity in the cohort. Our data show that, although both poorer physical performance and low BMD are risk factors for fracture, they remain largely independent in the well-functioning young-old, except in black women. This independence suggests that interventions to reduce fracture incidence should be targeted at improving both physical performance and bone density.