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      Frequency and Associated Factors of Bone Fractures in Russians: The Ural Eye and Medical Study

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          Abstract

          With information about frequency of bone fractures in Russia mostly missing, we assessed the frequency of previous bone fractures in a Russian population. The population-based study Ural Eye and Medical Study included 5899 (80.5%) out of 7328 eligible individuals (mean age: 59.0 ± 10.7 years; range: 40–94 years). The history of previous bone fractures was assessed in a standardized interview for 5397 (91.5%) individuals. Mean frequency of any previous bone fracture was 1650/5397 (30.6%; 95% confidence interval (CI): 29, 3, 31.8). In multivariate analysis, higher frequency of bone fractures was associated with male sex ( P < 0.001; odds ratio (OR): 1.67; 95% CI: 1.41, 2.00), urban region ( P < 0.001; OR: 1.45; 95% CI: 1.23, 1.72), higher prevalence of vigorous activity during leisure ( P < 0.001; OR: 1.42; 95% CI: 1.20, 1.68), current smoking ( P = 0.001; OR: 1.46; 95% CI: 1.16, 1.82) and higher prevalence of cardiovascular disease ( P = 0.007; OR: 1.29; 95% CI: 1.07, 1.56), low blood pressure episodes with hospital admission ( P = 0.001; OR: 2.08; 95% CI: 1.37, 3.16), tumbling ( P < 0.001; OR: 2.58; 95% CI: 1.37, 3.16) and thoracic spine pain ( P < 0.001; OR: 1.43; 95% CI: 1.18, 1.73). In women, menopause ( P < 0.001; OR: 2.17; 95% CI: 1.47, 3.22) was additionally associated. The most common single-bone fractures involved leg and knee (229/5397; 4.2%), hand in general (n = 169; 3.1%) or hand wrist only (n = 97; 1.8%), arm (n = 94; 1.7%) and ankle (n = 67; 1.2%). Severe fractures included spine (n = 35; 0.6%), os sacrum (n = 10; 0.2%), skull (n = 6; 0.1%), pelvis (n = 5; 0.1%) and hip (n = 22; 0.4%). Most frequent combined fractures included as most important part the leg (n = 90; 1.7%), spine (n = 18; 0.3%), and hip (n = 18; 0.3). These data give hints on the epidemiology of bone fractures in Russia.

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          Exercise interventions to reduce fall-related fractures and their risk factors in individuals with low bone density: a systematic review of randomized controlled trials.

          Exercise can reduce falls and fall-related fractures in healthy individuals; however, evidence for individuals with low BMD is limited. The results from this systematic review indicate that exercise interventions for individuals with low BMD to reduce falls and fractures should include balance, muscle strengthening, and weight-bearing exercises. The purpose of this systematic review was to investigate which exercise interventions are effective in individuals with low bone mineral density (BMD; osteopenia or osteoporosis) in reducing (1) falls and fractures and (2) risk factors for falls and fractures. Databases were searched for relevant studies between 1996 and June 2008. Methodological quality was assessed with the Jadad score and the PEDro scale. Of the 1,369 publications found, 23 met the inclusion criteria. Five additional articles were included after checking reference lists and searching author's names and related articles. Interventions with balance exercises reduced falls or fall-related fractures and improved balance in the majority of the studies. Muscle strengthening exercises were effective in improving lower extremity strength and back extensor strength; however, not all RCT's reported positive effects. Bone strength was improved by weight-bearing aerobic exercise with or without muscle strengthening exercise when the duration of the intervention was at least a year. Exercise can reduce falls, fall-related fractures, and several risk factors for falls in individuals with low BMD. Exercise interventions for patients with osteoporosis should include weight-bearing activities, balance exercise, and strengthening exercises to reduce fall and fracture risk.
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            Remaining lifetime and absolute 10-year probabilities of osteoporotic fracture in Swiss men and women.

            Remaining lifetime and absolute 10-year probabilities for osteoporotic fractures were determined by gender, age, and BMD values. Remaining lifetime probability at age 50 years was 20.2% in men and 51.3% in women and increased with advancing age and decreasing BMD. The study validates the elements required to populate a Swiss-specific FRAX model. Switzerland belongs to high-risk countries for osteoporosis. Based on demographic projections, burden will still increase. We assessed remaining lifetime and absolute 10-year probabilities for osteoporotic fractures by gender, age and BMD in order to populate FRAX algorithm for Switzerland. Osteoporotic fracture incidence was determined from national epidemiological data for hospitalised fractured patients from the Swiss Federal Office of Statistics in 2000 and results of a prospective Swiss cohort with almost 5,000 fractured patients in 2006. Validated BMD-associated fracture risk was used together with national death incidence and risk tables to determine remaining lifetime and absolute 10-year fracture probabilities for hip and major osteoporotic (hip, spine, distal radius, proximal humerus) fractures. Major osteoporotic fractures incidence was 773 and 2,078 per 100,000 men and women aged 50 and older. Corresponding remaining lifetime probabilities at age 50 were 20.2% and 51.3%. Hospitalisation for clinical spine, distal radius, and proximal humerus fractures reached 25%, 30% and 50%, respectively. Absolute 10-year probability of osteoporotic fracture increased with advancing age and decreasing BMD and was higher in women than in men. This study validates the elements required to populate a Swiss-specific FRAX model, a country at highest risk for osteoporotic fractures.
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              Risk factors for proximal humerus, forearm, and wrist fractures in elderly men and women: the Dubbo Osteoporosis Epidemiology Study.

              Fractures of the proximal humerus, forearm, and wrist account for approximately one third of total osteoporotic fractures in the elderly. Several risk factors for these fractures were evaluated in this prospective study of 739 men and 1,105 women aged > or =60 years in Dubbo, Australia. During follow-up (1989-1996), the respective incidences of humerus and of forearm and wrist fractures, per 10,000 person-years, were 22.6 and 33.8 for men and 54.8 and 124.6 for women. Independent predictors of humerus fracture were femoral neck bone mineral density (FNBMD) (relative risk (RR) = 2.3, 95% confidence interval (CI): 1.2, 4.5) in men and FNBMD (RR = 2.4, 95% CI: 1.7, 3.5) and height loss (RR = 1.1, 95% CI: 1.0, 1.2) in women. For forearm and wrist fractures, risk factors were FNBMD (men: RR = 1.5, 95% CI: 1.0, 2.3; women: RR = 1.5, 95% CI: 1.2, 1.9) and height loss (men: RR = 1.2, 95% CI: 1.0, 1.3; women: RR = 1.1, 95% CI: 1.0, 1.2). In addition, dietary calcium (men: RR = 2.0, 95% CI: 1.0, 3.6) and a history of falls (women: RR = 1.9, 95% CI: 1.4, 2.6) were also significant. These data suggest that elderly men and women largely share common risk factors for upper limb fractures and that FNBMD is the primary risk factor.
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                Author and article information

                Contributors
                Bikbov.m@gmail.com
                Jost.Jonas@medma.uni-heidelberg.de
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                10 May 2018
                10 May 2018
                2018
                : 8
                : 7483
                Affiliations
                [1 ]ISNI 0000 0004 0389 9736, GRID grid.482657.a, Ufa Eye Research Institute, ; Ufa, Bashkortostan Russia
                [2 ]ISNI 0000 0001 2190 4373, GRID grid.7700.0, Department of Ophthalmology, , Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, ; Heidelberg, Germany
                Author information
                http://orcid.org/0000-0002-9476-8883
                http://orcid.org/0000-0002-0569-1264
                http://orcid.org/0000-0001-5537-4278
                http://orcid.org/0000-0003-2972-5227
                Article
                25928
                10.1038/s41598-018-25928-1
                5945615
                29749378
                0b41ee7e-4fc3-4ccd-a141-556586c87229
                © The Author(s) 2018

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 24 November 2017
                : 2 May 2018
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