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. ? ?
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