Jones G, Nguyen T, Sambrook P, Kelly P J, Eisman J A
Bone and Mineral Division, Garvan Institute of Medical Research, St Vincent's Hospital, Darlinghurst, New South Wales, Australia.
BMJ. 1994 Sep 17;309(6956):691-5.
To determine prospectively the rates of change in bone mineral density in elderly people and to examine the relation between lifestyle and demographic factors and these rates of change.
Longitudinal population based study.
Dubbo, New South Wales, Australia.
Representative sample (n = 769) of residents aged > or = 60 on 1 January 1989.
Rates of change in bone mineral density measured prospectively (mean scan interval 2.5 years) at the femoral neck and lumbar spine by dual energy x ray absorptiometry.
Summary rates of loss in the femoral neck were 0.96% per year (95% confidence interval 0.64% to 1.28%) in women and 0.82% per year (0.52% to 1.12%) in men. Importantly, rates of loss at the femoral neck (both percentage and absolute) increased in both sexes with advancing age. No significant loss was evident in either sex at the lumbar spine, probably because of coexistent osteoarthritis. Lifestyle factors had only modest effects on rates of loss at either site.
These data show that bone density of the femoral neck declines at an increasing rate in elderly people, and as this site is predictive of fracture suggest that treatment to minimise bone loss may be important even in very elderly people.
前瞻性地确定老年人骨矿物质密度的变化率，并研究生活方式和人口统计学因素与这些变化率之间的关系。
基于人群的纵向研究。
澳大利亚新南威尔士州达博。
1989年1月1日年龄≥60岁居民的代表性样本（n = 769）。
采用双能X线吸收法前瞻性测量股骨颈和腰椎骨矿物质密度的变化率（平均扫描间隔2.5年）。
女性股骨颈每年的平均骨量丢失率为0.96%（95%可信区间0.64%至1.28%），男性为0.82%（0.52%至1.12%）。重要的是，随着年龄的增长，男女两性股骨颈骨量丢失率（百分比和绝对值）均增加。腰椎在两性中均未出现明显的骨量丢失，可能是由于并存骨关节炎。生活方式因素对两个部位的骨量丢失率影响较小。
这些数据表明，老年人股骨颈骨密度下降速度加快，由于该部位可预测骨折，因此即使对高龄老人而言，采取治疗措施尽量减少骨质流失可能也很重要。
