Lecture 26 - Bone Health, Falls and Fractures

Question 1

by what age is the skeleton completely hardened

Answer 1

25

Question 2

how many bones are in the human body

Answer 2

206

Question 3

bone resorption is the action of what

Answer 3

osteoclasts and parathyroid hormone

Question 4

bone deposition is the action of what

Answer 4

osteoblasts and calcitonin

Question 5

bone resorption and bone deposition is regulated by

Answer 5

thyroid and parathyroid glands

Question 6

an osteoblast ….

Answer 6

forms new bone tissue

Question 7

an osteoclast …..

Answer 7

breaks down old bone tissue

Question 8

what plays vital roles in bone development, growth and repair

Answer 8

vitamin A, vitamin D, calcium and other hormones

Question 9

rates of bone growth is highest when

Answer 9

infancy and pubertal growth spurt

Question 10

velocity of bone growth doubles when

Answer 10

adolescence critical period

Question 11

~40% of peak bone mass is laid down when

Answer 11

end of puberty

Question 12

at age 20 what % of peak bone mass is attained

Answer 12

90-95%

Question 13

what happens to bone mass after your mid 30s (also how does men and women bone mass change throughout their life)

Answer 13

you begin to slowly lose bone mass

women lose bone mass faster after menopause, but it happens to men too

Question 14

what are the determinants of bone strength

Answer 14

• bone mineral density
• geometry

Question 15

what is the most important effect of stress on the bone and what is this

Answer 15

strain

measurement of deformation of bone to external load

Question 16

what is said about your ground reaction forces if you are lighter

Answer 16

the lighter you are the smaller your ground reaction forces are

Question 17

peripheral skeleton bone strength is positively associated with what

Answer 17

total and dairy protein intake in healthy postmenopausal women

Question 18

in elderly ……
- inadequate intake of protein
- reduced ability to use available protein
- greater need for protein

leads to what

Answer 18

loss of functionality

• muscle
• bone
• immune system

Question 19

the RDA of 0.8g/kg BW is not adequate for elderly, what is recommended

Answer 19

1.1 - 1.3 g/kg BW

Question 20

what is the strategy to maximise and protect bone mass in children

Answer 20

achieve peak bone mass

Question 21

what is the strategy to maximise and protect bone mass in adults

Answer 21

maintain bone maass

Question 22

what is the strategy to maximise and protect bone mass in older adults

Answer 22

slowing bone loss

reducing falls and fractures

Question 23

osteoporosis NZ estimates how many older kiwis have broken a bone since their 50th birthday

Answer 23

> 180,000

Question 24

annually how many people sustain a hip fracture, and how many are admitted to hospital with other fractures

Answer 24

~3,700 hip fractures

~13,800 admitted to hospital with other fractures

Question 25

what are the three types of osteoporosis

Answer 25

age associated / post menopausal

idiopathic

secondary

Question 26

what are the risk factors of osteoporosis

Answer 26

family history

Question 27

what are some diseases / genetics that are considered secondary risk factors for osteoporosis

Answer 27

• multiple myeloma
• metastatic bone cancer
• rheumatoid arthritis
• pagets disease

Question 28

what % of hip fractures are due to falls

Answer 28

> 95%

Question 29

what is the 5th leading cause of death in older adults

Answer 29

falls

Question 30

what are some risks for falls in older adults

Answer 30

• muscle weakness
• poor balance / physical activity
• poor eyesight
• benzodiazepine use

Question 31

what are the risks for fractures in falls for older people

Answer 31

• failure to break a fall
• falling to the side
• age : increased risk of osteoporosis
• low bone mass

Question 32

a prior fracture at any skeletal sight does what

Answer 32

doubles future fracture risk

Question 33

what does sarcopenia and osteoporosis lead to increased likeliness of

Answer 33

fracture

Question 34

does NZ have strength and balance programs to prevent falls in elderly

Answer 34

yes

Question 35

trials show what about vitamin D supplements and bone density

Answer 35

vitamin D supplements found to increase bone density

Question 36

what is found from clinical trials about vitamin D supplements and non skeletal endpoints

Answer 36

not demonstrated benefits on muscle mass or function

Question 37

calcium supplements in healthy individuals are ……

Answer 37

not needed

nor required in most people receiving treatment for osteoporosis

Question 38

current evidence says what about the use of vitamin D or Ca+ supplements in healthy community dwelling adults

Answer 38

evidence does not support

although it may be warranted in frail older adults in nursing homes with low vitamin D

Question 39

vitamin D supplementation is / isnt found to reduce risk of fractures

Answer 39

isnt

Question 40

the findings of vitamin D supplementation not being effective may not apply to ….

Answer 40

individuals with very low 25(OH)D levels, gastrointestinal disorders causing malabsorption or those with osteoporosis

Question 41

sarcopenia increases risk of ….. and osteoporosis increases risk of ….

Answer 41

sarcopenia increases risk of falls and osteoporosis increases risk of fractures

they both link together

Question 42

sarcopenia and osteoporosis share

Answer 42

an underlying pathology

Question 43

what happens to the prevalence of osteoporosis in those with sarcopenia compared to those who dont

Answer 43

increased prevalence of osteoporosis in those with sarcopenia

Question 44

co-occurrence (osteosarcopenia) is common and associated with a

Answer 44

higher degree of malnutrition than osteoporosis or sarcopenia alone