Ageing Muscles and Bone

Question 1

As we age there is a gradual decline in muscle mass, estimated to be 1-2% after 50y/o. Which of the following factors have not been linked with determinants involved in the reduction in muscle mass?

1 - genetics
2 - gender
3 - early life growth and peak muscle mass
4 - maintaining muscle mass in later life
5 - factors to reduce muscle loss

Answer 1

2 - gender

Question 2

In ageing there is a reduction in muscle fibre number. Specifically which type of muscle fibre is reduced?

1 - fast twitch type 1
2 - fast twitch type 2
3 - fast twitch type 2a
4 - all fibre types are reduced

Answer 2

2 - fast twitch type 2
- also linked with reduced neurons and reduction in myocytes

Question 3

What 2 of the following is said to infiltrate the muscles in ageing?

1 - Ca2+
2 - fat
3 - connective tissue
4 - Iron

Answer 3

2 - fat
3 - connective tissue

Question 4

Which of the hormones below is NOT, linked to muscle mass have been shown to be reduced in ageing?

1 - Reduction in Testosterone in men
2 - Reduction in Growth Hormone
3 - Reduction in Oestrogen in women
4 - Reduction in Cortisol

Answer 4

4 - Reduction in Cortisol

Question 5

Sarcopenia has been defined as an age related, involuntary loss of skeletal muscle mass and strength. There are 3 criteria, which of the following is NOT one of them?

1 - low muscle mass
2 - low type 2 fibres
3 - low quality and quantity of muscle
4 - low physical performance

Answer 5

2 - low type 2 fibres

Question 6

Sarcopenia has been defined as an age related, involuntary loss of skeletal muscle mass and strength. What % of men >80 y/o is sarcopenia common in?

1 - 3%
2 - 15%
3 - 30%
4 - 60%

Answer 6

3 - 30%
- common in those with long immobility

Question 7

Sarcopenia has been defined as an age related, involuntary loss of skeletal muscle mass and strength. Which of the following is sarcopenia NOT associated with?

1 - polypharmacy
2 - falls
3 - fractures
4 - frailty

Answer 7

1 - polypharmacy

Question 8

Which of the following is the MOST important when assessing a patients muscle?

1 - muscle strength (grip strength)
2 - muscle function (timed up and go)
3 - muscle mass (tape measure, MRI)
4 - all equally important

Answer 8

2 - muscle function (timed up and go)

Question 9

Which of the following is NOT currently an approach to treat and prevent sarcopenia?

1 - resistance exercise
2 - testosterone supplementation
3 - nutrition
4 - vitamin D supplementation

Answer 9

2 - testosterone supplementation

Question 10

As we age so to do our joints. Which of the following is the most common?

1 - osteoporosis
2 - osteoarthritis
3 - rheumatoid arthritis
4 - gout

Answer 10

2 - osteoarthritis
- 50% of over 85 year olds have osteoarthritis of the knee

Question 11

Osteoarthritis is the most common disease affecting joints as we age. Which of the following is NOT a key driver in osteoarthritis?

1 - accumulation of mechanical damage to the musculoskeletal system – exacerbated by extrinsic factors such as obesity
2 - human upright posture putting inappropriate stresses on the joints
3 - reduced ability to repair joint damage in older age
4 - vitamin D levels intake and sun exposure

Answer 11

4 - vitamin D levels intake and sun exposure
- this would be correct for osteoporosis

Question 12

Is age classed as a contraindication to a joint replacement?

Answer 12

• no
• providing they are fit and well

Question 13

At what age does peak bone mineral density typically occur?

1 - 10-15 y/o
2 - 15-25 y/o
3 - 25-30 y/o
4 - 30-40 y/o

Answer 13

3 - 25-30 y/o
- once peak BMD has been reached it begins to decline

Question 14

Which of the following factors is NOT a factor affecting peak bone mass development in younger adults?

1 - Genetics
2 - Type of birth
3 - Exercise
4 - Sex
5 - Nutrition
6 - Hormonal status
7 - Diet

Answer 14

2 - Type of birth

Question 15

Which 2 of the following factors increases the loss of bone mass in older adults?

1 - employment type
2 - menopause
3 - social life
4 - chronic illness

Answer 15

2 - menopause
4 - chronic illness

Question 16

All of the following occur in bones as we age that contribute to lower bone mass, EXCEPT which one?

1 - reduced trabecular bone
2 - loss of strength of cortical bone
3 - decreased osteoclastic activity
4 - reduced osteoblastic activity
5 - Vitamin D deficiency

Answer 16

3 - decreased osteoclastic activity
- osteoclasts degrade bone
- typically this increases as we age

Question 17

Vitamin D3 supplements is an important aspect to help maintain bone mineral density. What is the name of the active form of vitamin D once it has been metabolised in the body?

1 - 7-dehydrocholesterol
2 - 1,25-dihydroxyvitamin D
3 - 25 hydroxyvitamin D
4 - ergocalciferol

Answer 17

2 - 1,25-dihydroxyvitamin D
- also known as calciferol

• low vitamin D is linked with osteoporosis and sarcopenia

Question 18

Which of the following is NOT associated with contributing to vitamin D deficiency in ageing?

1 - Decreased Vitamin D3 production by skin
2 - Decreased dietary intake of Vitamin D
3 - Reduced renal function
4 - Liver disease
5 - osteoarthritis

Answer 18

5 - osteoarthritis

Question 19

Although vitamin D deficiency is easy to assess and easy to treat, what % of patients in care homes are estimated to have vitamin D deficiency?

1 - 4%
2 - 14%
3 - 24%
4 - 40%

Answer 19

4 - 40%

Question 20

Fragility fractures, which are fractures caused from a fall at standing height are common in osteoporosis. Which of the following are fragility fractures associated with?

1 - increased mortality – hip fractures have a 20-30% 1 year mortality
2 - Morbidity – chronic pain
3 - Disability
4 - Gait disorder and change in posture
5 - Progression of frailty
6 - all of the above

Answer 20

6 - all of the above

Question 21

Which of the following is NOT an important markers of frailty?

1 - weight loss
2 - reduced muscle strength
3 - reduced gait speed
4 - age

Answer 21

4 - age