Is postmenopausal estrogen therapy associated with neuromuscular function or falling in elderly women? Study of Osteoporotic Fractures Research Group

Seeley, Dana G.; Cauley, JA; Grady, D.; Browner, Warren S.; Nevitt, Michael C.; Cummings, Steven R.

doi:10.1001/archinte.155.3.293

Cited by 40 publications

(19 citation statements)

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“…In agreement with the findings of a large observation study, The Study of Osteoporotic Fractures, we found that postmenopausal HT use did not significantly reduce the risk of falling 28. HT was associated with a non-significant risk reduction in both falls and fractures between years 3 and 6.…”

Section: Discussionsupporting

confidence: 90%

Effect of hormone therapy on lean body mass, falls, and fractures

et al. 2011

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Objective-Loss of lean body mass with aging may contribute to falls and fractures. The objective of this analysis was to determine if taking postmenopausal hormone therapy (HT: estrogen plus progestogen therapy, EPT or estrogen therapy alone, ET) favorably affects agerelated changes in lean body mass and if these changes partially account for decreased falls or fractures with HT.Methods-Participants randomly assigned to either EPT (n=543) or control (n=471) and ET (n= 453) or control (n= 474) and receiving dual-energy X-ray absorptiometry (DXA) scans to estimate body composition during the Women's Health Initiative (WHI) were evaluated. Falls and fracture occurrence were obtained by annual self-report. Fractures were confirmed by clinical chart review.Results-At 6yrs post-randomization, lean body mass was not different between HT and control groups. Although lean body mass positively influenced BMD, independent of HT status, the preserved lean body mass observed in the HT arms in the first 3 years did not significantly contribute to models evaluating HT influence on falls and fractures between years 3 and 6. Women taking at least 80% of their medication in the HT arms demonstrated fewer falls compared to placebo; this difference was not attributable to change in lean body mass.Correspondence Address: Jennifer W. Bea, Arizona Cancer Center, 1515 N. Campbell Ave., P.O. Box 245024, Tucson, AZ 85724-5024, Phone: (520) 626-0912, Fax: (520) 626-9275, jbea@azcc.arizona.edu. Disclaimers: The authors have no commercial, proprietary, or financial interest in the products or instruments described in this article. 1 Reprint Requests: Reprints will not be made available. NIH Public Access Author ManuscriptMenopause. Author manuscript; available in PMC 2012 January 1. Published in final edited form as:Menopause. 2011 January ; 18(1): 44-52. doi:10.1097/gme.0b013e3181e3aab1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptConclusions-Despite early preservation of lean body mass with HT (3years), HT did not ameliorate long-term (6 years) loss in lean body mass with aging.Keywords estrogen therapy; estrogen plus progestogen therapy; menopause; muscle; falling; fractures Women after menopause often experience a decrease in lean body mass,1 an increase in body fat mass and a shift to central or android fat distribution 2 , which may increase their risk for sarcopenia, diabetes and cardiovascular diseases. These body composition changes are believed to be, at least in part, due to a sudden decline in endogenous estrogen production at the time of menopause. Therefore, it has been hypothesized that menopausal hormone therapy (HT) may help counter these changes in body composition among postmenopausal women. 2-4 most of the previous investigations in this area have been limited to observational studies and clinical trials, with small sample sizes or short intervention times. Techniques for assessing body composition have varied widely across the studies and many findings have been based on anthropometr...

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Section: Discussionsupporting

confidence: 90%

Effect of hormone therapy on lean body mass, falls, and fractures

et al. 2011

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“…Substantial improvements in postural balance after later initiation of HT seem to be more doubtful, and significant effects have not been observed in women older than 69 and 65 years of age in other studies. 35,36 Additional prospective studies are required to examine whether HT can improve postural balance when initiated in older women and, if improvements are possible, to find the relevant therapeutic dose range and optimal duration of therapy to substantially improve postural balance.…”

Section: Discussionmentioning

confidence: 99%

Early postmenopausal hormone therapy improves postural balance

Naessén

Lindmark²,

Lagerström³

et al. 2007

Menopause

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Initiation of HT soon after menopause rapidly improved postural balance to levels normally seen in young women. We suggest that improved postural balance can contribute to the protection against fractures associated with HT and explain the more substantial reduction in hip fracture risk after HT initiated sooner, compared with later, after menopause. Further study is required to confirm these results.

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“…The same protocol for measuring grip strength was used at the follow-up visit. Previous studies have shown a high reproducibility of grip strength in older adults [19][20][21]. Change in grip strength (baseline -follow-up) was calculated as absolute values as well as percent change during follow-up.…”

Section: Methodsmentioning

confidence: 99%

Patterns and determinants of muscle strength change with aging in older men

Forrest¹,

Zmuda²,

Cauley³

2005

DAGM

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Decreased muscle strength with aging is associated with functional disability in older adults. However, few studies have longitudinally evaluated the rate of muscle strength loss and the risk factors for the loss in older men. This study examined the patterns and determinants of muscle strength change with aging in a healthy older male population. The study participants were 321 men (age range 51-84 yrs) recruited from population-based listings in the Pittsburgh region, USA. Grip strength was measured at baseline and after an average of 7-years of follow-up. The amount of longitudinal rate of grip strength loss was 2.8% per year (a total of 20% decline during 7-year follow-up). Although all age groups experienced a decline in strength during follow-up, the rate of loss accelerated with age. After adjusting for baseline measurement, grip strength loss ranged from 2.0% decline per year for men aged < 60 years to 3.4% decline per year for men aged 70 years or older (p < .0001). Multivariate analyses revealed that besides older age, other risk factors also contributed to the loss of muscle strength in older men, including back pain, use of calcium channel blockers, caffeine intake, and height and weight loss.

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Is postmenopausal estrogen therapy associated with neuromuscular function or falling in elderly women? Study of Osteoporotic Fractures Research Group

Abstract: We found no evidence that postmenopausal estrogen use has beneficial effects on muscle strength or neuromuscular function or that it reduces the risk of falling.

Cited by 40 publications

References 0 publications

Effect of hormone therapy on lean body mass, falls, and fractures

Effect of hormone therapy on lean body mass, falls, and fractures

Early postmenopausal hormone therapy improves postural balance

Patterns and determinants of muscle strength change with aging in older men

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