The Aging Skeleton
Regular price
77.750 KD
inc. VAT
Couldn't load pickup availability
Table of contents
- Copyright Pageiv
- Contentsv
- Contributorsxiii
- Forewordxvii
- Prefacexix
- Part I: General Aspects and Models of Aging1
- Chapter 1. Aging through the Ages3
- Introduction3
- Evolutionary Forces and Aging4
- Genetics and Longevity5
- Primates6
- Changing Demographics through the Ages6
- Low Bone Mass in Past Populations7
- Altering the Human Life Span8
- Chapter 2. Human Aging at the Millennium11
- Aging Is Highly Variable11
- Aging and Body Composition12
- Physiological and Functional Changes12
- Preventing Frailty and Promoting Successful Aging15
- Population Aging15
- Chapter 3. Aging and Calcium Balance19
- Introduction19
- The Calcium Requirement20
- The Calcium Economy22
- Summary26
- Chapter 4. Constraints of Experimental Paradigms Used to Model the Aging Skeleton27
- Introduction: Bone as a Complex System27
- The Aging Human: Bone Mineral Density Is Only Part of Fracture Risk28
- The Aging Rat: Using Animal Models to Study Aging in Humans29
- What Is an Aging Cell?31
- An Alternative Approach to Cellular Aging32
- Summary33
- Chapter 5. Animal Models of the Aging Skeleton37
- Characteristics of Human Skeletal Aging37
- The Animal Model Paradox38
- Characteristics of a Good Animal Model38
- Why Animal Models of the Aging Skeleton Are Required39
- Candidate Animal Models of Aging Bone Loss39
- Other Animal Models of Bone Loss45
- Large Nonrodent Animal Models of Aging Bone Loss46
- Summary48
- Chapter 6. Human Diseases as Models of Accelerated Aging51
- The Aging Imperative51
- The Mechanism of Aging51
- Diseases That Can Accelerate the Aging Process53
- Summary57
- Chapter 7. Cellular Models of Human Aging59
- Introduction59
- Replicative Senescence59
- Telomere Length62
- Gene Expression64
- Functional Senescence in Vitro66
- Cellular Aging in Progeria and Werner Syndromes68
- Summary69
- Part II: Determinants of Peak Bone Mass; Maintenance of Peak Bone Mass75
- Chapter 8. Genetic Determinants of the Population Variance in Bone Mineral Density77
- The Question77
- Is "BMD" a Suitable Phenotypic End Point?78
- Relative Growth in Bone Mass and Size Determines Volumetric BMD78
- Polymorphisms and Growth80
- Hip Axis Length and Genotypes82
- Issues in Study Design That May Partly Account for Discrepant Associations between BMD and Genotypes83
- Bone Loss and Genotypes84
- Vagaries of the Notion of Bone "Loss"85
- Calcium Absorption and Genotypes85
- Biochemical Measurements of Bone Turnover and Genotypes86
- BMD Responses to Intervention and Genotypes86
- Fracture Rates and Genotypes86
- Confounding87
- The Misleading Notion of Heritability87
- Genetic and Environmental Components of Variance in Areal BMD88
- Summary91
- Chapter 9. Nutritional Determinants of Peak Bone Mass95
- Timing of Adolescent Bone Gain95
- Secular Trends in Diets of Young Women95
- Candidate Nutrient–Bone Relationships96
- Nutrient Intake Assessments96
- Relationships among Adolescent Bone Gain and Specific Nutrients96
- Total Body Bone Gain and Calcium Intake by Adolescent Females during Ages 12–1897
- Total Body Bone Gain and Hip Density as a Function of Sodium Intake97
- Total Body Bone Gain and Hip Density as a Function of the Calcium/Protein Ratio98
- Total Calories per Kilogram during Ages 12-18 and Bone Gain98
- Discussion99
- Other Nutrients and Adolescent Bone Gain100
- Calcium Intakes, Absorbability, Retention, and Bone Accretion100
- Chapter 10. Mechanical Determinants of Peak Bone Mass105
- Introduction105
- Mechanical Mechanisms of Bone Mass Acquisition106
- Clinical Studies of Accretion of Bone Mass110
- Summary112
- Chapter 11. Hormonal Influences on the Establishment of Peak Bone Mass115
- Introduction115
- Formation of Bone Mass115
- Models Where Peak Bone Mass Is Altered116
- Summary122
- Chapter 12. Racial Determinants of Peak Bone Mass127
- Introduction127
- African Americans127
- Asian Indians and Pakistanis131
- Other Races131
- Summary132
- Chapter 13. Determinants of Maintenance of Bone Mass137
- Introduction137
- Premenopausal Bone Loss137
- Dietary Calcium and Premenopausal Bone Loss138
- Exercise, Menstrual Status, and Premenopausal Bone Mass139
- Summary140
- Part III: Mechanisms of Age-Related Bone Loss143
- Chapter 14. Cellular Mechanisms of Age-Related Bone Loss145
- Introduction145
- Bone Turnover and Aging145
- Osteoblastic Cells146
- Osteoclasts152
- Summary154
- Chapter 15. Sex Steroids, Bone, and Aging159
- Introduction159
- Menopause159
- Andropause163
- Adrenopause167
- Summary169
- Chapter 16. Parathyroid Hormone175
- Introduction175
- Parathyroid Hormone and Normal Aging175
- Parathyroid Hormone and Osteoporosis177
- Parathyroid Hormone and Estrogen180
- Summary181
- Chapter 17. Vitamin D185
- Introduction185
- Consequences of Vitamin D Deficiency186
- Vitamin D Requirements in the Elderly189
- Summary190
- Chapter 18. Cytokines and Prostaglandins in the Aging Skeleton195
- Cytokines and the Aging Skeleton195
- Prostaglandins and the Aging Skeleton200
- Chapter 19. Role of Growth Hormone/Insulin-like Growth Factor Axis209
- Introduction209
- Role of GH/IGF Axis in the Regulation of Bone Formation209
- Age Changes in GH Secretion: Potential Mechanisms212
- Age Changes in IGF System Components: Potential Mechanisms213
- Model of Age Changes in the GH/IGF Axis and the Age-Related Impairment in Bone Formation215
- Summary217
- Chapter 20. Other Pharmacologic Agents Influencing Bone Loss221
- Introduction221
- General Pharmacokinetic Issues221
- Pharmacologic Agents222
- Summary225
- Chapter 21. Nutritional Mechanisms of Age-Related Bone Loss229
- Introduction to Nutrient-Induced Osteopenia229
- Excessive Animal Protein Intake229
- Excessive Sodium Intake and Inadequate Potassium Intake230
- Inadequacies of Other Nutrients230
- Excessive Fluoride Ingestion231
- Bone-Related Food Issues of the Elderly in Technologically Advanced Nations231
- Intake Recommendations for Bone Health232
- Summary233
- Part IV: Quantifiable Manifestations of Age-Related Bone Loss235
- Chapter 22. Racial/Ethnic Influences on Risk of Osteoporosis237
- Introduction237
- Factors Affecting Bone Mass238
- Bone Geometry243
- Ethnic Differences in Rates of Hip Fracture243
- Summary245
- Chapter 23. Histomorphometric Manifestations of Age-Related Bone Loss251
- Introduction251
- Bone Remodeling and Turnover251
- Mechanisms of Bone Loss252
- Effects of Bone Loss on Bone Structure252
- Histomorphometric Assessment of Age-Related Bone Loss in Humans253
- Techniques and Limitations of Bone Histomorphometry253
- Histomorphometric Assessment of Bone Turnover254
- Histomorphometric Assessment of Remodeling Balance254
- Histomorphometric Assessment of Mineralization255
- Assessment of Cancellous Bone Structure255
- Age-Related Changes in Cancellous and Cortical Bone255
- Age-Related Changes in Bone Turnover255
- Age-Related Changes in Mineralization256
- Age-Related Changes in Remodeling Balance256
- Age-Related Changes in Cancellous Bone Structure257
- Microfractures259
- Relationship of Primary Osteoporosis to Age-Related Bone Loss259
- Chapter 24. Densitometric Manifestations in Age-Related Bone Loss263
- Introduction263
- Effect of Aging on the Vertebral Skeleton265
- Effect of Aging on the Proximal Femur266
- Effect of Aging on Total Skeleton Bone Mineral Density269
- Effect of Age on Ultrasound Values270
- Effect of Aging on Bone Mineral Density by QCT272
- Summary273
- Chapter 25. Biochemical Dynamics277
- Introduction277
- Biochemical Markers of Bone Formation278
- Biochemical Markers of Bone Resorption281
- Effects of Normal Aging on Bone Turnover284
- Biochemical Dynamics of Bone Turnover in Postmenopausal and Age-Related Osteoporosis285
- Summary291
- Chapter 26. Biomechanical Measurements in Age-Related Bone Loss301
- Introduction301
- Biomechanical Measurements and Concepts301
- Mechanical Strength of Bone Declines with Age302
- Quality of Bone Tissue Deteriorates with Age304
- Fracture Toughness of Human Bone Declines with Age306
- Fatigue Properties of Bone Decrease with Age307
- Age-Related Structural Compensations for Reduced Mechanical Strength307
- Summary309
- Part V: Fractures: A Consequence of the Aging Skeleton313
- Chapter 27. Application of Biomechanics to the Aging Human Skeleton315
- Introduction315
- Age-Related Changes in the Mechanical Properties of Bone as a Material316
- Age-Related Changes in Bone Geometry318
- Biomechanics of Hip Fractures320
- Biomechanics of Vertebral Fractures324
- Summary326
- Chapter 28. What Is a Fragility Fracture?333
- Trauma Categorization333
- Bone Density Categorization333
- Fracture Classification334
- Prognostic Implications of a Fragility Fracture336
- Chapter 29. Epidemiology and Consequences of Osteoporotic Fractures339
- Health Care Costs of Osteoporotic Fractures339
- How Common Is Osteoporosis?339
- Mortality and Morbidity341
- Risk Factors for Bone Loss and Fractures342
- Chapter 30. Osteoporosis and Fragility Fractures in the Elderly349
- Introduction349
- Frequency of Osteoporosis and Low Bone Mass349
- Frequency and Economic Cost of Osteoporotic Fractures351
- Lifetime Risk of Fracture352
- Heterogeneity in the Relationship of Different Types of Fractures to Gender, Age, and Bone Density353
- Possible Causes of Heterogeneity in Age-Related Fractures354
- Summary355
- Chapter 31. The Aging Maxiilofacial Skeleton359
- Introduction359
- Skeletal Changes from Birth to Maturity359
- Skeletal Changes after Maturity Associated with Tooth Loss361
- Skeletal Changes after Maturity without Tooth Loss362
- Changes in the Temporomandibular Joint Associated with Aging363
- Changes in Bite Force and Chewing Efficiency with Age364
- Osteoporosis and Metabolic Bone Disease: Effects on the Maxilla and Mandible365
- Changes in Dentition with Aging368
- Summary369
- Chapter 32. Fractures: Effects on Quality of Life373
- Introduction373
- Osteoporotic Fractures373
- Quality of Life: A Definition374
- Dimensions of Quality of Life374
- Future Directions380
- Chapter 33. General Orthopedic Principles383
- Introduction383
- Fractures in the Aging Skeleton383
- Guidelines for the Management of Osteoporotic Fractures384
- Lower Extremity Fractures384
- Upper Extremity Fractures392
- Spine and Pelvis Fractures395
- Future Directions in the Treatment of Osteoporotic Fractures396
- Summary396
- Chapter 34. Nutritional Approaches to Healing Fractures in the Elderly399
- Introduction399
- Protein and Bone Mineral Mass Acquisition399
- Protein Malnutrition400
- Nutritional Control of Insulin-like Growth Factor-I and Bone Homeostasis401
- Outcome of Fracture of the Proximal Femur403
- Summary405
- Chapter 35. Analgesic Management411
- Introduction411
- Fractures and Pain Assessment411
- Treatment Modalities412
- Summary417
- Part VI: Therapeutics419
- Chapter 36. Complications of Joint Replacement in the Elderly421
- Introduction421
- Results of Joint Replacement421
- Patient Considerations422
- Surgical Considerations425
- Summary437
- Chapter 37. Shape and Size of an Osteoporotic Woman441
- Introduction441
- Musculoskeletal Consequences of Osteoporosis441
- Hyperkyphosis and Falls445
- Camouflaging Postural Disfiguration447
- Exercise and the Osteoporotic Spine449
- Chapter 38. Prevention of Falls453
- Introduction453
- Epidemiology of Falls453
- Etiology of Falls454
- Clinical Approach457
- Treatment and Prevention459
- Clinical Guidelines463
- Summary464
- Chapter 39. The Impact of Physical Activity on Age-Related Bone Loss467
- Introduction467
- The Nature of Age-Related Bone Loss467
- Skeletal Effects of Mechanical Loading468
- Effects of Physical Activity on Aging Bone469
- Impact of Physical Activity on Falling and Fracture474
- Therapeutic Recommendations474
- Summary475
- Chapter 40. The Rationale for Calcium Supplementation in the Therapeutics of Age-Related Osteoporosi479
- Calcium and the Aging Skeleton: Rationale for Increasing Dietary Calcium Intake479
- Calcium Balance: Extracellular Space versus Whole Body479
- Determinants of Gut Calcium Absorption482
- Role of the Kidney in Extracellular Calcium Balance487
- Clinical Data on the Effectiveness of Calcium Supplementation489
- Chapter 41. Estrogen495
- Introduction495
- Estrogen and Growth495
- Premenopausal Women496
- Postmenopausal Women496
- Estrogen Replacement498
- Fracture Outcomes499
- Estrogens in Older Age501
- Chapter 42. Selective Estrogen Receptor Modulators507
- Introduction507
- Concept of a SERM507
- Mechanism of Action of SERMs508
- Tamoxifen512
- Raloxifene514
- Chapter 43. Androgens521
- Mechanisms of Androgen Action in Bone: The Androgen Receptor521
- Metabolism of Androgens in Bone: Aromatase and 5a-Reductase Activities522
- Effects of Androgens on the Cellular Biology of Bone522
- Androgen Effects on Bone: Animal Studies523
- Effects of Androgens on the Skeleton in Men525
- Influence of Androgens on Bone in Women528
- Androgen Therapy: Potentially Useful Androgen Effects529
- Androgen Replacement in Hypogonadal Adult Men530
- Androgen Therapy in Eugonadal Men532
- Androgen Replacement in Adolescence532
- Androgen Replacement in Aging Men533
- Androgen Therapy in Secondary Forms of Metabolic Bone Disease533
- Androgen Therapy in Women534
- Therapy with Other Androgens535
- Research Directions535
- Chapter 44. Bisphosphonates541
- Introduction541
- Chemistry and Pharmacology541
- Bisphosphonates in Osteoporosis544
- Antifracture Efficacy of Bisphosphonate Treatment544
- Glucocorticoid-Induced Osteoporosis545
- Safety and Tolerability546
- Summary547
- Chapter 45. Calcitonin551
- Introduction551
- Effects of Aging and Hormonal Status on Calcitonin552
- Efficacy of Calcitonin in the Prevention and Treatment of Postmenopausal Osteoporosis553
- Summary558
- Chapter 46. Parathyroid Hormone563
- Introduction563
- Advantages of Anabolic Agents for Reversal of Osteoporosis563
- Potential Mechanisms of Anabolic Action564
- Animal Models of PTH Effects on Bone Metabolism565
- Clinical Experience of PTH Therapy in Osteoporotic Subjects566
- Analysis of Concurrent Therapies Used with PTH Protocols572
- Pharmacokinetics of PTH Administration573
- Immunological Responses to Exogenous PTH574
- Side Effects during PTH Therapy574
- Summary574
- Chapter 47. Growth Hormone and Insulin-like Growth Factor I as Therapeutic Modalities for Age-Relate579
- Introduction579
- IGF-I and Its Regulatory Components580
- IGF-I and Age-Related Osteoporosis580
- GH or IGF-I as Therapeutic Options for Osteoporosis582
- GH/IGF-I as Short-Term Treatment of Catabolic States Associated with Osteoporosis583
- Disadvantages of rhGH or rhlGF-I Treatment for Age-Related Osteoporosis584
- Summary584
- Chapter 48. Fluoride Therapy of Established Osteoporosis587
- Introduction587
- Anabolic Actions of Fluoride587
- Fluoride Pharmacokinetics591
- Therapeutic Serum Level of Fluoride593
- Skeletal Response to Fluoride Therapy595
- Side Effects of Fluoride Therapy599
- Efficacy of Fluoride Therapy601
- Strategies to Improve Fluoride Therapy604
- Summary607
- Chapter 49. Vitamin D613
- Introduction613
- Evidence for Altered Vitamin D Metabolism in Aging613
- Vitamin D Efficacy in the Treatment of Osteoporosis617
- Summary620
- Index623
- Color Plate Section643
The Aging Skeleton is a comprehensive and timely book on all aspects of the skeleton as it ages, including basic mechanisms and pathways as well as pathobiology. Chapters cover general aspects and models of aging, determinants and maintenance of peak bone mass, mechanisms of age-related bone loss, quantifiable manifestations of age-related bone loss, fractures, and therapeutics.
Key Features
* Covers all aspects of the aging skeleton in one comprehensive volume
* Looks at the influence of genetics, nutrition, environment, hormones, and other factors on bone mass
* Provides a thorough discussion of fractures, one of the major consequences of the aging skeleton
* Reviews current therapeutic approaches and methods
* Written by internationally renowned authors and edited by leaders in the field
* Is the only book available on this subject
Key Features
* Covers all aspects of the aging skeleton in one comprehensive volume
* Looks at the influence of genetics, nutrition, environment, hormones, and other factors on bone mass
* Provides a thorough discussion of fractures, one of the major consequences of the aging skeleton
* Reviews current therapeutic approaches and methods
* Written by internationally renowned authors and edited by leaders in the field
* Is the only book available on this subject