Graduate Thesis Or Dissertation

 

A prospective study of functional performance balance self-efficacy, and bone mineral density in community-dwelling elderly women Public Deposited

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https://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/c247dw23n

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  • 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.
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