In the United States, falls are the leading cause of unintentional
death with one of every three people 65 years and older falling each year. Falls
account for approximately 95% of hip fractures among older adults and falls to the
side predominate hip fracture related falls in this population. However, risk factors
for side and frequent falls are poorly understood. Furthermore, few data exist to
explain differences in bone mineral density among older postmenopausal women.
In particular, data regarding the timing of hormone replacement therapy (HRT)
among older women is scarce. In the first aim of this dissertation, we examined
changes in mobility and balance-related risk factors for side falls as well as
differences in these risk factors according to fall status in a population of 107
independent, elderly women (>70 yrs), who were followed over 2 years. We found
hip abduction strength decreased (p<.001) in all subjects, with side-fallers
exhibiting weaker hip abduction strength (p=.008), greater sway velocity (p=.027),
and slower performances on the tandem walk (p=.039) and Get Up and Go
(p<.001) compared to non-fallers. For the second study, in the same population, we
examined 2-year changes in balance self-efficacy (BSE) and the relationship of
BSE to side fall risk factors and falls incidence. Results showed BSE at baseline
was predictive of Get Up and Go, hip abduction strength and tandem walk at
follow-up (p<.008), but that BSE decreased only among the non-fallers (p=.013).
In the third study, we examined 3-yr hip bone mineral density (BMD) changes in
women with distinct hormone replacement therapy (HRT) profiles: 1) no hormone
replacement therapy (N0HRT), 2) HRT continually since menopause (Continual),
3) HRT begun 10 years after menopause (Late), 4) HRT initiated within 5 years
(New), and compared the change in BMD of the hip across HRT groups. Only the
NoHRT group lost bone over the 3 years (p=.014). We also assessed BMD of the
lateral spine across levels of estrogen use in a sub-sample of participants and found
long-term HRT users had significantly higher lateral spine BMD (p=.041)
compared to women who had never been on HRT. / Graduation date: 2003
| Identifer | oai:union.ndltd.org:ORGSU/oai:ir.library.oregonstate.edu:1957/32548 |
| Date | 05 September 2002 |
| Creators | Gunter, Katherine B. |
| Contributors | Snow, Christine M. |
| Source Sets | Oregon State University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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