Heritability of impaired balance: a nationwide cohort study in twins

Wagner, Helene; Melhus, Håkan; Pedersen, Nancy L.; Michaëlsson, Karl

doi:10.1007/s00198-008-0710-3

Cited by 13 publications

(11 citation statements)

References 31 publications

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“…The aetiology of most health conditions is multi-factorial, with familial links (i.e. genetic and shared environment factors) identified in cardiovascular and metabolic diseases (Ordovas, 2009), malignancies (Hemminki & Czene, 2002), psychopatholgies (Nomura et al, 2002), impaired balance (Pajala et al, 2004;Wagner et al, 2009) and low back pain (LBP) (Matsui et al, 1997;Battie et al, 2007;O'Sullivan et al, 2008). Therefore, interventions targeted at a familial level may be a useful strategy for optimising health and preventing the onset or persistence of some conditions, including LBP.…”

Section: Introductionmentioning

confidence: 99%

An exploration of familial associations in spinal posture defined using a clinical grouping method

et al. 2011

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The primary aim of this study was to examine familial associations in spinal posture, defined using postural angles and a clinical classification method. A secondary aim was to investigate the reliability of clinical postural classification. Postural angles were calculated from sagittal photographs, while two experienced clinicians made use of standing sagittal images to classify participants into one of four postural groups (sway, flat, hyperlordotic, neutral). Parent-child associations in postural angles and postural groups were evaluated using Pearson's correlation and Fisher's exact test, respectively. Inter-rater reliability was expressed using percentage agreement and Kappa coefficients (K). Daughters whose father or mother had a hyperlordotic posture were 4.0 or 3.5 times, respectively, more likely to have a hyperlordotic posture than daughters whose parents did not have a hyperlordotic posture. These participants in the hyperlorotic group had a significantly higher body mass index than members of the other postural groups (p < 0.03). Percentage agreement between clinicians was 63.5% (K = 0.48). These results provide preliminary evidence of a familial association in the hyperlordotic posture and support the use of postural classification.

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Section: Introductionmentioning

confidence: 99%

An exploration of familial associations in spinal posture defined using a clinical grouping method

et al. 2011

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“…Previous twin studies have demonstrated that individual differences in visual acuity (Lopes, Andrew, Carbonaro, Spector, & Hammond, 2009), hearing acuity (Christensen, Frederiksen, & Hoffman, 2001;Viljanen et al, 2007;Wingfield et al, 2007), postural balance (El Haber et al, 2006;Pajala et al, 2004;Wagner, Melhus, Pedersen, & Michaelsson, 2009), as well as falls (Pajala et al, 2006), are either modestly or largely accounted for by familial factors, that is, by either additive genetic factors or common environmental factors.…”

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confidence: 99%

Accumulation of Sensory Difficulties Predicts Fear of Falling in Older Women

et al. 2013

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Objectives: To explore whether the accumulation of sensory difficulties predicts fear of falling (FOF), and whether the traits correlate with each other regardless of familial factors. Methods: Self-reported hearing, vision and balance difficulties, and FOF were assessed using structured questionnaires at the baseline and after a 3-year follow-up in 63-to 76-year-old women (n = 434). Results: Among the women without FOF at baseline (n = 245), 41% reported FOF at follow-up. Increasing numbers of sensory difficulties at baseline predicted higher incidence of FOF. The relationship between accumulated sensory difficulties and FOF was not mediated by familial factors. Discussion: The accumulation of multiple sensory difficulties may hinder older people from receiving compensatory information about body position and environment, thus jeopardizing a person's confidence

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“…What is the explanation for the apparent discrepancy between the strong heritability of bone traits in cross-sectional studies and the low heritability of fracture risk? As noted above, fractures are mainly caused by falling [ 8 ] and the genetic liability of impaired balance (propensity to falling) is modest [ 28 , 29 ], at best. Accordingly, it is highly unlikely that genetic tests will substantially improve the identification of individuals at high risk of fractures, especially at older age.…”

Section: Pathophysiologymentioning

confidence: 99%

Osteoporosis: the emperor has no clothes

et al. 2015

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Current prevention strategies for low-trauma fractures amongst older persons depend on the notions that fractures are mainly caused by osteoporosis (pathophysiology), that patients at high risk can be identified (screening) and that the risk is amenable to bone-targeted pharmacotherapy (treatment). However, all these three notions can be disputed.PathophysiologyMost fracture patients have fallen, but actually do not have osteoporosis. A high likelihood of falling, in turn, is attributable to an ageing-related decline in physical functioning and general frailty.ScreeningCurrently available fracture risk prediction strategies including bone densitometry and multifactorial prediction tools are unable to identify a large proportion of patients who will sustain a fracture, whereas many of those with a high fracture risk score will not sustain a fracture.TreatmentThe evidence for the viability of bone-targeted pharmacotherapy in preventing hip fracture and other clinical fragility fractures is mainly limited to women aged 65–80 years with osteoporosis, whereas the proof of hip fracture-preventing efficacy in women over 80 years of age and in men at all ages is meagre or absent. Further, the antihip fracture efficacy shown in clinical trials is absent in real-life studies. Many drugs for the treatment of osteoporosis have also been associated with increased risks of serious adverse events. There are also considerable uncertainties related to the efficacy of drug therapy in preventing clinical vertebral fractures, whereas the efficacy for preventing other fractures (relative risk reductions of 20–25%) remains moderate, particularly in terms of the low absolute risk reduction in fractures with this treatment.

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Heritability of impaired balance: a nationwide cohort study in twins

Cited by 13 publications

References 31 publications

An exploration of familial associations in spinal posture defined using a clinical grouping method

An exploration of familial associations in spinal posture defined using a clinical grouping method

Accumulation of Sensory Difficulties Predicts Fear of Falling in Older Women

Osteoporosis: the emperor has no clothes

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