This is a proposal to continue the Rancho Bernardo Study (RBS) of osteoporosis, a prospective study of sex specific rates of and risk factors for bone loss and fracture in community-dwelling older adults. Men and women have had concurrent dual enelgy x-ray absorptiometry (DXA) at the hip and spine three previous times at four-year intervals. Over 1,500 men and women aged 50+ were studied in 1988-91 and 1992-95 under NIA MERIT awards. Over 1,000 are being re-evaluated with a third NIA grant in 1998-2002. Multiple behavioral and biological risk factors for osteoporosis have been assessed. Recently completed assays performed on blood obtained at earlier visits include IGF-1, IGFBP1, IL-6, C-reactive protein, PTH and 25 OH and 1,25 (OH)2 vitamin D. We have found similar bone loss rates in men and women, despite sex differences in the association of diabetes, insulin, IGF-1 and sex hormones with BMD, height loss, and fracture. We have also found sex differences in bone size, bone integrated strength (a combination of bone size and density), and kyphotic posture. Using this award, we will determine the sex-specific timing, frequency, antecedents, and consequences over age and time of (1) bone loss, (2) vertebral morphometric fractures, (3) clinical osteoporotic fractures, (4) changes in bone size and integrated strength;and (5) changes in kyphosis in 800 to 1,000 previously studied ambulatory men and women aged 50 +. We will 1) repeat DXA at the hip and spine;spine radiographs;bone size/strength estimates, and kyphosis assessment, 2) continue follow-up for new clinical fractures;and 3) reassess medical and functional status, quality of life and fall-related co-morbidities (vision, depressed mood, cognition, and muscle mass and strength). We will measure for the first time morphometric spine fractures by DXA-IVA, and serum osteoprotegerin (OPG) levels. Using these data, we will 1) assess the age and sex related pattern of change in body size, lean body mass, BMD, NTX, bone size, bone geometry, and kyphotic posture, 2) assess the independent or co-dependent predictive value of previously assayed novel or understudied risk factors (IL-6, IGF-1 &IGFBP1, PTH, vitamin D) for these changes and for incident fractures, 3) assess the consequences of fracture, and 4) develop recommendations for the diagnosis and prevention of osteoporosis in elderly men and women.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Method to Extend Research in Time (MERIT) Award (R37)
Project #
5R37AG007181-22
Application #
7800271
Study Section
Special Emphasis Panel (NSS)
Program Officer
Sherman, Sherry
Project Start
1987-08-01
Project End
2012-03-31
Budget Start
2010-04-15
Budget End
2012-03-31
Support Year
22
Fiscal Year
2010
Total Cost
$376,011
Indirect Cost
Name
University of California San Diego
Department
Family Medicine
Type
Schools of Medicine
DUNS #
804355790
City
La Jolla
State
CA
Country
United States
Zip Code
92093
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Katzman, Wendy B; Huang, Mei-Hua; Kritz-Silverstein, Donna et al. (2017) Diffuse Idiopathic Skeletal Hyperostosis (DISH) and Impaired Physical Function: The Rancho Bernardo Study. J Am Geriatr Soc 65:1476-1481
Reas, Emilie T; Laughlin, Gail A; Bergstrom, Jaclyn et al. (2017) Effects of Sex and Education on Cognitive Change Over a 27-Year Period in Older Adults: The Rancho Bernardo Study. Am J Geriatr Psychiatry 25:889-899
Kritz-Silverstein, D; Laughlin, G A; McEvoy, L K et al. (2017) Sex and Age Differences in the Association of Blood Pressure and Hypertension with Cognitive Function in the Elderly: The Rancho Bernardo Study. J Prev Alzheimers Dis 4:165-173
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Anthony, Ericha G; Kritz-Silverstein, Donna; Barrett-Connor, Elizabeth (2016) Optimism and Mortality in Older Men and Women: The Rancho Bernardo Study. J Aging Res 2016:5185104
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Abd Alamir, Moshrik; Ellenberg, Susan S; Swerdloff, Ronald S et al. (2016) The Cardiovascular Trial of the Testosterone Trials: rationale, design, and baseline data of a clinical trial using computed tomographic imaging to assess the progression of coronary atherosclerosis. Coron Artery Dis 27:95-103

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