Prevalence of osteoporotic vertebral fracture among community-dwelling elderly in Shanghai.
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ABSTRACT:
SUBMITTER: Gao C
PROVIDER: S-EPMC6759100 | biostudies-literature | 2019 Jul
REPOSITORIES: biostudies-literature
Publications
Prevalence of osteoporotic vertebral fracture among community-dwelling elderly in Shanghai.
Gao Chao C Xu Yang Y Li Li L Gu Wen-Qin WQ Yi Chun-Tao CT Zhu Qiong Q Gu Hong-An HA Chen Bi-Hua BH Wang Qing-Qing QQ Tang Feng F Xu Ju-Liang JL Hou Jian-Miao JM Song Hui-Jiang HJ Wang Hui H Wang Zhi-Liang ZL Zhang Zhen-Lin ZL
Chinese medical journal 20190701 14
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Project description:A vertebral deformity (VD) is not always a vertebral fracture (VF). Because of lack of a completely satisfactory "gold standard", there is no consensus on the exact de?nition of a VF. Therefore, it may sometimes be dif?cult, especially in mild cases, to discriminate the prevalent VF from a non-fracture deformity or short vertebral height (SVH). A combined standardized approach based on qualitative and semiquantitative (SQ) vertebral assessment may be the most option to correctly identify a VD as a VF. However this visual approach for VF identi?cation is subjective, therefore it is mandatory an adequate training and experience of radiologist to reach a good sensitivity and speci?city. Vertebral morphometry, objective and reproducible method, could be used only to evaluate the severity of VFs but requires the availability of reference values of vertebral height ratios. There is actually an evidentiary basis for suggesting that a qualitative approach by expert radiologists to morphological vertebral assessment, combined SQ and morphometric methods seem to be the preferred option for the correct diagnosis of VF as endplate or/and cortex fracture (ECF) or severe vertebral height loss.
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Project description:ObjectiveThe objective of this study was to evaluate the factors associated with the health status of older Chinese people living in the community, in order to inform strategies to expand access to healthcare.MethodsTwo-phase stratified cluster sampling was applied; 2000 older people participated in this study. Face-to-face interviews were conducted in Shanghai between June and August, 2011. Descriptive analysis was used to examine the respondents' characteristics. Based on Andersen's healthcare utilization model, a chi-squared test and multiple logistic regression were performed to examine the influences of predisposing, enabling, need, and contextual factors on healthcare utilization.ResultsWe found that 44.5% of the older people in the sample had good self-reported health status, while 12.8% were poor, 14.5% had visited hospitals or clinics as outpatients in the previous two weeks, and 16.5% had been hospitalized in the previous year. Logistic regression analysis revealed that outpatient health services were more likely to be used by women and those whose income was from friends or social relief, who had poor to good self-reported health status, who were experiencing declining health, who engaged in volunteer activities, and who had chronic diseases. Meanwhile, hospitalization was more likely among those in the older age groups, those with pension income, living in outer suburbs, with poor self-reported health status, experiencing difficulty with activities of daily living and outdoor activities, or having a chronic disease.ConclusionsThe results showed the impact of economic status, health status, demographic and social characteristics, and other factors on the health service utilization of elderly people living in the community in Shanghai. Need variables were the strongest predictors of health service use, although contextual factors also contributed.
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Project description:BACKGROUND:Cognitive training may contribute to the ability to maintain cognitive function in healthy elderly adults. Whether genotype modifies training effects remains unknown. OBJECTIVE:Assess influence of APOE on cognitive function over time in community-dwelling elderly adults participating in multi-domain cognitive training. METHODS:Healthy individuals ?70 years of age were screened from one urban community in Shanghai. 145 healthy Chinese older adults met inclusion criteria and were assigned to intervention (n?=?88) or control (n?=?57) groups. Multi-domain cognitive training involved 24 sessions of different content taking place over 12 weeks. Neuropsychological testing was administered at baseline, immediately after training, six months and twelve months post-intervention; composite measures of cognitive function were identified via factor analysis. RESULTS:Three factors explained the majority of variance in function (verbal memory, processing speed, executive function). The intervention attenuated 12-month declines in processing speed, regardless of APOE genotype (p?=?0.047). Executive function declined in APOE?4 carriers over 12 months, regardless of intervention (p?=?0.056). There was a significant interaction after 12 months where intervention ?4 carriers had better processing speed than ?4 controls (p?=?0.003). Intervention ?2 carriers had better executive function immediately after training (p?=?0.02) and had better verbal memory 6-months post-intervention (p?=?0.04). These effects remained significant after false-discovery rate correction. CONCLUSION:Multi-domain cognitive training reduces declines in processing speed over time. APOE?4 is associated with reductions in executive function over time, and training may attenuate ?4-associated declines in processing speed. APOE?2 carriers may also benefit from training, particularly on measures of executive function and verbal memory.
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Project description:Brace is one of the most commonly used interventions to manage osteoporotic vertebral fracture. However, its authentic effectiveness remains unclear. The aim of this study was to investigate the efficacy of brace in patients with osteoporotic vertebral fractures. We conducted a literature review and meta-analysis following the guideline and handbook of the Cochrane collaboration. Ten published articles were included in this study and data from 4 randomized controlled trials were analyzed. Low quality evidence proved using Spinomed brace could bring large and significant beneficial effect to patients with sub-acute osteoporotic vertebral fractures. Very low quality evidence proved no significant difference between Spinomed orthosis, rigid brace and soft brace when they were used in patients with acute fractures. Therefore, it might be applicable to recommend middle term use of Spinomed orthosis to patients with subacute fracture. In addition, this study emphasized the need for high quality randomized controlled trials.
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