Activity Gait and Efficacy (AGE) in Order Women

描述（由申请人提供）：骨质疏松症是一个重大的公共卫生问题。非裔美国人在骨质疏松性骨折方面提供了一定的保护，主要是由于骨骼依赖因素，如较高的骨量、密度和较短的髋轴长度；然而，我们实验室的试点数据也表明，在独立于骨骼的骨折危险因素方面存在种族差异，包括步态、平衡和社会认知因素，如害怕跌倒。然而，据我们所知，目前还没有研究在不同种族的老年绝经后妇女样本中研究骨依赖性和独立骨折危险因素之间的相互关系。此外，很少有研究前瞻性地检查黑人和白人绝经后妇女骨依赖和独立危险因素之间的关系。这是一项重要的工作，因为黑人女性是人口增长最快的部分之一，令人担忧的证据表明，尽管黑人女性患骨质疏松性骨折的人数较少，但她们因髋部骨折并发症死亡的可能性几乎是常人的三倍。因此，本前瞻性研究的主要目的是将生理骨健康结果（骨量、骨密度和超声衰减）、身体活动模式、平衡和步态能力与社会认知结果（包括自我效能感和期望）结合起来，进一步阐明这种骨折率种族差异的原因。其次，骨骼健康的身体组成决定因素（即脂肪和无脂肪量）的种族差异将在基线和前瞻性的方式进行探讨。根据父母资助设计（1R01AG020118-01A1），将招募大量老年（60 - 80岁）白人（N = 150）和黑人（N = 150）女性，并在基线、1年和2年评估结果。通过双能x线吸收仪（DXA）评估骨骼和身体成分。此外，定量超声（QUS）将被用作骨质量的指标。这项研究具有很高的公共卫生优先级，因为必须了解影响骨质疏松性骨折风险的骨依赖和独立因素，以便为公共卫生议程和计划实施有效的计划，特别是关于种族差异，从而优化所有个体的计划。

DESCRIPTION (provided by applicant): Osteoporosis is a major public health issue. Being African-American affords some protection from osteoporotic fracture primarily due to bone dependent factors such as a higher bone mass, density and shorter hip axis length; however, pilot data from our laboratory also suggests a racial difference in bone independent fracture risk factors including gait, balance and social cognitive factors such as fear of falling. However, to our knowledge, no research has studied the interrelationship between bone dependent and independent fracture risk factors in an older racially diverse sample of postmenopausal women. Additionally, little research has prospectively examined the relation between and among bone dependent and independent risk factors in black and white postmenopausal women. This is important work because black women are among the fastest growing segment of the population and alarming evidence suggests that although fewer black women sustain osteoporotic fractures, they have nearly a three-times greater likelihood of death due to complications from hip fracture. Thus, the primary purpose of this prospective study is to combine physiological bone health outcomes (bone mass, density and ultrasound attenuation), physical activity patterns, and balance and gait abilities with social cognitive outcomes including self-efficacy and expectations, to further elucidate the causes of this racial discrepancy in fracture rate. Secondarily, racial differences in body composition determinants (i.e. fat and fat-free mass) of bone health will be explored at baseline and in a prospective fashion. Per the parent grant design (1R01AG020118-01A1), a large sample of older (60 - 80 yrs) white (N = 150) and black (N = 150) women will be recruited with outcomes assessed at baseline, 1 year and 2 years. Bone and body composition will be assessed by dual energy X-ray absorptiometry (DXA). Additionally, quantitative ultrasound (QUS) will be used as an index of bone quality. This research has high public health priority because bone dependent and independent factors that influence the risk of osteoporotic fracture risk must be understood to implement effective programs for public health agendas and programs, specifically with regards to racial differences thereby optimizing programming for all individuals.