Activity Gait and Efficacy (AGE) in Order Women

描述(申请人提供)：骨质疏松症是一个主要的公共卫生问题。非洲裔美国人对骨质疏松性骨折提供了一些保护，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，骨骼独立骨折风险因素存在种族差异，包括步态、平衡和害怕摔倒等社会认知因素。然而，据我们所知，还没有研究在年龄较大、种族多样的绝经后妇女样本中，骨依赖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研究绝经后黑人和白人女性的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，令人震惊的证据表明，尽管患有骨质疏松性骨折的黑人女性较少，但她们死于髋部骨折并发症的可能性几乎高出三倍。因此，这项前瞻性研究的主要目的是将生理性骨健康结果(骨量、密度和超声衰减)、体力活动模式、平衡和步态能力与包括自我效能和期望在内的社会认知结果结合起来，进一步阐明骨折发生率的种族差异的原因。其次，将在基线和前瞻性的方式中探索骨骼健康的身体成分决定因素(即脂肪和脱脂质量)的种族差异。根据家长赠款设计(1R01AG020118-01A1)，将招募一大批年龄较大(60-80岁)的白人(N=150)和黑人(N=150)妇女，评估基线、1年和2年的结果。骨和身体成分将通过双能X射线吸收测量仪(DXA)进行评估。此外，定量超声(QUS)将被用作骨质量的指标。这项研究具有高度的公共卫生优先地位，因为必须了解影响骨质疏松性骨折风险的骨骼依赖和独立因素，以实施公共卫生议程和计划的有效计划，特别是关于种族差异，从而优化所有个人的计划。

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.