8 results on '"Eisman JA"'
Search Results
2. Cognitive decline is associated with an accelerated rate of bone loss and increased fracture risk in women: a prospective study from the Canadian Multicentre Osteoporosis Study
- Author
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Bliuc, D, Tran, T, Adachi, JD, Atkins, GJ, Berger, C, van den Bergh, J, Cappai, R, Eisman, JA, van Geel, T, Geusens, P, Goltzman, D, Hanley, DA, Josse, R, Kaiser, S, Kovacs, CS, Langsetmo, L, Prior, JC, Nguyen, TV, Solomon, LB, Stapledon, C, Center, JR, and Canadian Multicentre Osteoporosis Study (CaMos) Research Group
- Subjects
Male ,Canada ,Bone Density ,Risk Factors ,06 Biological Sciences, 09 Engineering, 11 Medical and Health Sciences ,Humans ,Osteoporosis ,Cognitive Dysfunction ,Female ,Prospective Studies ,Anatomy & Morphology - Abstract
Cognitive decline and osteoporosis often coexist and some evidence suggests a causal link. However, there are no data on the longitudinal relationship between cognitive decline, bone loss and fracture risk, independent of aging. This study aimed to determine the association between: (i) cognitive decline and bone loss; and (ii) clinically significant cognitive decline (≥3 points) on Mini Mental State Examination (MMSE) over the first 5 years and subsequent fracture risk over the following 10 years. A total of 1741 women and 620 men aged ≥65 years from the population-based Canadian Multicentre Osteoporosis Study were followed from 1997 to 2013. Association between cognitive decline and (i) bone loss was estimated using mixed-effects models; and (ii) fracture risk was estimated using adjusted Cox models. Over 95% of participants had normal cognition at baseline (MMSE ≥ 24). The annual % change in MMSE was similar for both genders (women -0.33, interquartile range [IQR] -0.70 to +0.00; and men -0.34, IQR: -0.99 to 0.01). After multivariable adjustment, cognitive decline was associated with bone loss in women (6.5%; 95% confidence interval [CI], 3.2% to 9.9% for each percent decline in MMSE from baseline) but not men. Approximately 13% of participants experienced significant cognitive decline by year 5. In women, fracture risk was increased significantly (multivariable hazard ratio [HR], 1.61; 95% CI, 1.11 to 2.34). There were too few men to analyze. There was a significant association between cognitive decline and both bone loss and fracture risk, independent of aging, in women. Further studies are needed to determine mechanisms that link these common conditions. © 2021 American Society for Bone and Mineral Research (ASBMR).
- Published
- 2021
3. A risk assessment tool for predicting fragility fractures and mortality in the elderly
- Author
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Tran, T, Bliuc, D, Pham, HM, van Geel, T, Adachi, JD, Berger, C, van den Bergh, J, Eisman, JA, Geusens, P, Goltzman, D, Hanley, DA, Josse, RG, Kaiser, SM, Kovacs, CS, Langsetmo, L, Prior, JC, Nguyen, TV, Center, JR, and CaMos Research Group
- Subjects
06 Biological Sciences, 09 Engineering, 11 Medical and Health Sciences ,Anatomy & Morphology - Abstract
Existing fracture risk assessment tools are not designed to predict fracture-associated consequences, possibly contributing to the current under-management of fragility fractures worldwide. We aimed to develop a risk assessment tool for predicting the conceptual risk of fragility fractures and consequences. The study involved 8965 people aged ≥60 years from the Dubbo Osteoporosis Epidemiology Study and the Canadian Multicentre Osteoporosis Study. Incident fracture was identified from X-ray reports and questionnaires, and death ascertained though contact with a family member or obituary review. We used multistate model to quantify the effects of the predictors on the transition risks to an initial and subsequent incident fracture, and mortality, accounting for their complex inter-relationships, confounding effects and death as a competing risk. There were 2364 initial fractures, 755 subsequent fractures, and 3300 deaths during a median follow up of 13 years (IQR: 7, 15). The prediction model included gender, age, BMD, history of falls within 12 previous months, prior fracture after the age of 50 years, cardiovascular diseases, diabetes mellitus, chronic pulmonary diseases, hypertension and cancer. The model accurately predicted fragility fractures up to 11 years of follow up, and post-fracture mortality up to 9 years, ranging from 7 years following hip fractures to 15 years following non-hip fractures. For example, a 70-year old woman with a T-score of -1.5 and without other risk factors would have 10% chance of sustaining a fracture and an 8% risk of dying in 5 years. However, after an initial fracture, her risk of sustaining another fracture or dying doubles to 33%, ranging from 26% following a distal to 42% post hip fracture. A robust statistical technique was used to develop a prediction model for individualisation of progression to fracture and its consequences, facilitating informed decision making about risk and thus treatment for individuals with different risk profiles. This article is protected by copyright. All rights reserved.
- Published
- 2020
4. Post-GWAS Polygenic Risk Score: Utility and Challenges.
- Author
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Nguyen, TV, Eisman, JA, Nguyen, TV, and Eisman, JA
- Abstract
Over the past decade, through genome-wide association studies, more than 300 genetic variants have been identified to be associated with either BMD or fracture risk. These genetic variants are common in the general population, but they exert small to modest effects on BMD, suggesting that the utility of any single variant is limited. However, a combination of effect sizes from multiple variants in the form of the polygenic risk score (PRS) can provide a useful indicator of fracture risk beyond that obtained by conventional clinical risk factors. In this perspective, we review the progress of genetics of osteoporosis and approaches for creating PRSs, their uses, and caveats. Recent studies support the idea that the PRS, when integrated into existing fracture prediction models, can help clinicians and patients alike to better assess the fracture risk for an individual, and raise the possibility of precision risk assessment. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
- Published
- 2020
5. Reduced Bone Loss Is Associated With Reduced Mortality Risk in Subjects Exposed to Nitrogen Bisphosphonates: A Mediation Analysis.
- Author
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Bliuc, D, Tran, T, van Geel, T, Adachi, JD, Berger, C, van den Bergh, J, Eisman, JA, Geusens, P, Goltzman, D, Hanley, DA, Josse, R, Kaiser, S, Kovacs, CS, Langsetmo, L, Prior, JC, Nguyen, TV, Center, JR, CaMOS Research Group, Bliuc, D, Tran, T, van Geel, T, Adachi, JD, Berger, C, van den Bergh, J, Eisman, JA, Geusens, P, Goltzman, D, Hanley, DA, Josse, R, Kaiser, S, Kovacs, CS, Langsetmo, L, Prior, JC, Nguyen, TV, Center, JR, and CaMOS Research Group
- Abstract
Bisphosphonates, potent antiresorptive agents, have been found to be associated with mortality reduction. Accelerated bone loss is, in itself, an independent predictor of mortality risk, but the relationship between bisphosphonates, bone loss, and mortality is unknown. This study aimed to determine whether the association between bisphosphonates and mortality is mediated by a reduction in the rate of bone loss. Participants from the population-based Canadian Multicentre Osteoporosis Study were followed prospectively between1996 and 2011. Comorbidities and lifestyle factors were collected at baseline and bone mineral density (BMD) at baseline and at years 3 (for those aged 40 to 60 years), 5, and 10. Rate of bone loss was calculated using linear regression. Information on medication use was obtained yearly. Bisphosphonate users grouped into nitrogen bisphosphonates (nBP; alendronate or risedronate) and etidronate and non-users (NoRx) were matched by propensity score, including all baseline factors as well as time of treatment. Cox's proportional hazards models, unadjusted and adjusted for annual rate of bone loss, were used to determine the association between nBP and etidronate versus NoRx. For the treatment groups with significant mortality risk reduction, the percent of mortality reduction mediated by a reduction in the rate of bone loss was estimated using a causal mediation analysis. There were 271 pairs of nBP and matched NoRx and 327 pairs of etidronate and matched NoRx. nBP but not etidronate use was associated with significant mortality risk reduction (hazard ratios [HR] = 0.61 [95% confidence interval 0.39-0.96] and 1.35 [95% CI 0.86-2.11] for nBP and etidronate, respectively). Rapid bone loss was associated with more than 2-fold increased mortality risk compared with no loss. Mediation analysis indicated that 39% (95% CI 7%-84%) of the nBP association with mortality was related to a reduction in the rate of bone loss. This finding provides an insight into
- Published
- 2019
6. The Effect of Bisphosphonates on Mortality Risk Reduction is Partly Mediated Through a Reduction in the Rate of Bone Loss
- Author
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Bliuc, D, Tran, T, van Geel, T, Adachi, J, Berger, C, van den Bergh, J, Eisman, JA, Geusens, P, Goltzman, D, Hanley, DA, Josse, RG, Kaiser, SM, Kovacs, CS, Langsetmo, L, Prior, JC, Nguyen, TV, and Center, JR
- Subjects
Anatomy & Morphology - Published
- 2017
7. Bone mineral density in prepubertal asthmatics receiving corticosteroid treatment
- Author
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Harris, M, primary, Hauser, S, additional, Nguyen, TV, additional, Kelly, PJ, additional, Rodda, C, additional, Morton, J, additional, Freezer, N, additional, Strauss, BJG, additional, Eisman, JA, additional, and Walker, JL, additional
- Published
- 2001
- Full Text
- View/download PDF
8. Cognitive decline is associated with an accelerated rate of bone loss and increased fracture risk in women: a prospective study from the Canadian Multicentre Osteoporosis Study
- Author
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Tuan V. Nguyen, David Goltzman, Robert G. Josse, Dana Bliuc, Piet Geusens, Catherine J.M. Stapledon, Roberto Cappai, John A. Eisman, Jerilynn C. Prior, Gerald J. Atkins, Lucian B. Solomon, Christopher S. Kovacs, Thach Tran, Jonathan D. Adachi, Lisa Langsetmo, Claudie Berger, David A. Hanley, Tineke A. C. M. van Geel, Stephanie M. Kaiser, Joop P. W. van den Bergh, Bliuc, D, Tran, T, Adachi, JD, Atkins, GJ, Berger, C, VAN DEN BERGH, Joop, Cappai , R, Eisman, JA, van Geel, T, GEUSENS, Piet, Goltzman, D, Hanley, DA, Josse, R, Kaiser, S, Kovacs, CS, Langsetmo, L, Prior, JC, Nguyen, TV, Solomon, LB, Stapledon, C, Center, JR, Interne Geneeskunde, and RS: NUTRIM - R3 - Respiratory & Age-related Health
- Subjects
Male ,ELDERLY-WOMEN ,medicine.medical_specialty ,Longitudinal study ,Canada ,Endocrinology, Diabetes and Metabolism ,Population ,Osteoporosis ,LONGITUDINAL STUDY ,030209 endocrinology & metabolism ,OSTEOPOROSIS ,COGNITIVE PERFORMANCE ,AGING ,03 medical and health sciences ,REPLACEMENT THERAPY ,0302 clinical medicine ,Interquartile range ,Bone Density ,Risk Factors ,Internal medicine ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Cognitive Dysfunction ,030212 general & internal medicine ,Prospective Studies ,Cognitive decline ,10. No inequality ,education ,education.field_of_study ,Mini–Mental State Examination ,medicine.diagnostic_test ,HIP-FRACTURES ,Proportional hazards model ,business.industry ,DEMENTIA ,Hazard ratio ,MEN ,medicine.disease ,RELIABLE CHANGE INDEXES ,Female ,business ,BONE MINERAL DENSITY - Abstract
Cognitive decline and osteoporosis often coexist and some evidence suggests a causal link. However, there are no data on the longitudinal relationship between cognitive decline, bone loss and fracture risk, independent of aging. This study aimed to determine the association between: (i) cognitive decline and bone loss; and (ii) clinically significant cognitive decline (>= 3 points) on Mini Mental State Examination (MMSE) over the first 5 years and subsequent fracture risk over the following 10 years. A total of 1741 women and 620 men aged >= 65 years from the population-based Canadian Multicentre Osteoporosis Study were followed from 1997 to 2013. Association between cognitive decline and (i) bone loss was estimated using mixed-effects models; and (ii) fracture risk was estimated using adjusted Cox models. Over 95% of participants had normal cognition at baseline (MMSE >= 24). The annual % change in MMSE was similar for both genders (women -0.33, interquartile range [IQR] -0.70 to +0.00; and men -0.34, IQR: -0.99 to 0.01). After multivariable adjustment, cognitive decline was associated with bone loss in women (6.5%; 95% confidence interval [CI], 3.2% to 9.9% for each percent decline in MMSE from baseline) but not men. Approximately 13% of participants experienced significant cognitive decline by year 5. In women, fracture risk was increased significantly (multivariable hazard ratio [HR], 1.61; 95% CI, 1.11 to 2.34). There were too few men to analyze. There was a significant association between cognitive decline and both bone loss and fracture risk, independent of aging, in women. Further studies are needed to determine mechanisms that link these common conditions. (c) 2021 American Society for Bone and Mineral Research (ASBMR). The Canadian Multicentre Osteoporosis Study was funded by the Canadian Institutes of Health Research (CIHR); Merck Frosst Canada Ltd.; Eli Lilly Canada Inc.; Novartis Pharmaceuticals Inc.; The Alliance: sanofi-aventis & Procter and Gamble Pharmaceuticals Canada Inc.; Servier Canada Inc.; Amgen Canada Inc.; The Dairy Farmers of Canada; and The Arthritis Society. This work was supported by the National Health Medical Research Council Australia Projects 1070187, 1008219, and 1073430. Other funding bodies were an Osteoporosis Australia-Amgen grant; the Bupa Health Foundation (formerly MBF Foundation); the Mrs Gibson and Ernst Heine Family Foundation; and untied grants from Amgen, Merck Sharp & Dohme, Sanofi-Aventis, Servier, and Novartis
- Published
- 2021
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