Osteoporotic Fractures in Men (MrOS) - Portland

描述(申请人提供)：与年龄相关的骨骼、肌肉和身体功能的恶化，表现为骨质疏松症、骨质疏松症和残疾，是老年人发病率和死亡率的主要原因。当务之急是了解肌肉骨骼表型和体力活动如何随年龄变化，导致这些变化的因素，以及变化如何影响临床上重要的健康结果。MROS是一项对5994名老年男性进行的独特的前瞻性研究，在扩大我们对与年龄相关的肌肉骨骼健康变化的理解方面非常有成效。它始于2000年，包括对骨骼、肌肉、体能、体力活动和健康结果的广泛的纵向、客观和最先进的评估，以及生物显微镜和成像档案。我们建议扩展这些资源，以便全面和综合地了解在15年期间所研究的老年男性肌肉骨骼老化和体力活动减少的过程和后果。该项目的总体长期目标是确定可能从预防措施和康复中受益的有不良健康后果风险的男性，发现治疗和防止肌肉骨骼健康和活动量下降的新目标，并提高我们对最佳老龄化的理解(在平均总随访15年的时间内保持其肌肉骨骼健康和活动水平的男性)。具体地说，我们将利用我们的重复测量来定义肌肉骨骼健康、体能和体力活动表型中与年龄相关的轨迹，以确定预测这些轨迹并对其做出贡献的因素。我们将测试以下假设，即肌肉骨骼健康的良好轨迹与较低的跌倒、骨折、残疾和死亡风险相关，以及与年龄相关的骨骼、肌肉和身体表现的恶化可以同时发生；综合恶化放大了不良功能和健康结果的风险。其次，我们将使用我们重复的最先进的问卷来描述老年男性活动水平的变化和轨迹，并客观地评估加速计的能量消耗。第三，我们将利用MRO与医疗保险索赔数据的联系来确定肌肉骨骼表型和活动的轨迹与住院和疗养院相关医疗保健利用的关联。第四，我们将通过使用高分辨率外周定量计算机断层扫描测量皮质孔隙度来检查可能导致年龄相关骨骼脆性的皮质骨的新特征。我们将把肌肉骨骼健康和活动的轨迹与皮质骨的这些测量联系起来，并测试皮质骨孔隙度增加是否与骨折有关。最后，我们将继续利用MRO作为新科学和调查人员培训的平台。我们的申请与NIA和NIAMS的使命是一致的，即进行与衰老过程和肌肉骨骼衰老相关的疾病和条件相关的研究，并促进该科学领域新研究科学家的发展。

DESCRIPTION (provided by applicant): Age-related deterioration in bone, muscle and physical performance, manifested as osteoporosis, sarcopenia, and disability, are major causes of morbidity and mortality in the elderly. It is a priority to understand how musculoskeletal phenotypes and physical activity change with age, the factors that contribute to these changes, and how changes impact clinically important health outcomes. MrOS is a unique prospective study of 5994 older men that has been extremely productive in expanding our understanding of age-related change in musculoskeletal health. Initiated in 2000, it includes extensive longitudinal, objective, state-of-the-art assessments of bone, muscle, physical performance, physical activity and health outcomes, as well as biospecimen and imaging archives. We propose to extend these resources to allow a comprehensive and integrated understanding of the processes and consequences of musculoskeletal aging and decline in physical activity in older men studied over a 15 year period. The overall long term goal of the project is to identity men at risk of adverse health outcomes who may benefit from preventive measures and rehabilitation, discover new targets for treating and preventing declines in musculoskeletal health and activity, and improve our understanding of optimal aging (men who maintain their musculoskeletal health and activity levels over an average overall follow-up of 15 years). Specifically, we will leverage our repeated measurements to define age- related trajectories in phenotypes of musculoskeletal health, physical performance, and physical activity in order to determine factors that predict and contribute to these trajectories. We will test the hypotheses that favorable trajectories in musculoskeletal health are associated with lower risks of incident falls, fractures, disability and mortality and that age-related deterioration in bone, muscle and physical performance can occur concurrently; combined deterioration magnifies the risk of poor functional and health outcomes. Second, we will characterize change and trajectories in activity levels in older men using our repeated state-of-the-art questionnaire and objectively assessed energy expenditure from accelerometry. Third, we will take advantage of a linkage of MrOS with Medicare Claims data to determine the association of trajectories in musculoskeletal phenotypes and activity with inpatient and nursing home related health care utilization. Fourth, we will examine novel characteristics of cortical bone that may cause age-related skeletal fragility by using high resolution peripheral quantitative computed tomography to measure cortical porosity. We will relate trajectories of musculoskeletal health and activity to these measures of cortical bone and test whether increased cortical porosity is related to fractures. Finally, we will continue to leverage MrOS as a platform for new science and the training of investigators. Our application is consistent with the mission of the NIA and NIAMS to conduct research related to the aging process and diseases and conditions associated with musculoskeletal aging, and foster the development of new research scientists in this scientific area.