DHEA, Bone Mineral Density, Older Adults

Researchers writing in the medical journal The Journal of Clinical Endocrinology & Metabolism, say that DHEA replacement therapy for one year improved hip Bone Mineral Density in older adults and spine Bone Mineral Density in older women.

Jankowski CM, Gozansky WS, Schwartz RS, Dahl DJ, Kittelson JM, Scott SM, Pelt RE, Kohrt WM. Effects of DHEA Replacement Therapy on Bone Mineral Density in Older Adults: A Randomized, Controlled Trial. J Clin Endocrinol Metab. 2006 May 30

The Importance of Strength Training Exercises in Aging

Researchers writing in the medical journal Aging Clinical and Experimental Research say that “although aerobic exercise is important in maintaining overall health, the resistance type of muscle training may be more applicable to the basic rules of bone adaptation and site-specific effects of exercise, have more favorable effects in maintaining or improving bone mass and architecture, and be safe and feasible for older people.”

Suominen H. Muscle training for bone strength. Aging Clin Exp Res. 2006 Apr;18(2):85-93.

From the abstract:
“The main function of bone is to provide the mechanical integrity for locomotion and protection; accordingly, bone mass and architecture are adjusted to control the strains produced by mechanical load and muscular activity.

Age-related patterns involve peak bone mass during growth, a plateau in adulthood, and bone loss during aging. The decline in bone mass and structural integrity results in increased risk of fractures, particularly in post-menopausal women.

Although aerobic exercise is important in maintaining overall health, the resistance type of muscle training may be more applicable to the basic rules of bone adaptation and site-specific effects of exercise, have more favorable effects in maintaining or improving bone mass and architecture, and be safe and feasible for older people.

It has been suggested that there is an opportunity for resistance training, for improved effects on BMD (Bone Mass Density) in postmenopausal women in bones which have less daily loading. In addition to BMC and BMD, bone geometry and mass distribution may also change as a result of training and other treatment, such as hormonal replacement therapy, thereby further improving bone strength and reducing fracture risk. Appropriate training regimens may reduce the risk of falls and the severity of fall-related injuries, and also constitute potential therapy to improve functional ability and the quality of life in osteoporotic patients. However, further research is needed on dose-response relationships between exercise and bone strength, the feasibility of high-load, high-speed and impact-type of physical training, and the risks and benefits of intensive exercisein elderly individuals.

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Maintaining Muscle Strength May Counteract Postmenopausal Bone Loss

Sirola J, Rikkonen T, Tuppurainen M, Honkanen R, Jurvelin JS, Kroger H. Maintenance of muscle strength may counteract weight-loss-related postmenopausal bone loss-a population-based approach. Osteoporos Int. 2006 Feb 21.

Researchers writing in the medical journal Osteoporosis International say that maintaining muscle strength may counteract postmenopausal bone loss related to weight loss and that exercise that improves muscle strength may be encouraged for postmenopausal women with weight loss intentions for other health reasons.

From the study abstract:
INTRODUCTION: “Weight loss significantly increases postmenopausal bone loss, but the effects of muscle strength change on weight-loss-associated bone loss remain unclear. The study population, 587 peri- and postmenopausal women, was a random sample of the original Osteoporosis Risk Factor and Prevention Study (OSTPRE) study cohort in Kuopio, Finland.

Bone mineral density (BMD) at the lumbar spine (LS) and femoral neck (FN) was measured with dual x-ray absorptiometry, and grip strength was measured with a pneumatic squeeze dynamometer at baseline in 1989-1991 and at the 10-year follow-up in 1999-2001.

METHODS: Women were divided into three groups according to change in age-grouped grip-strength quartile in both of the measurements: “decreased”, “maintained” , and “improved”.

In addition, the study sample was divided into two groups according to weight change during the follow-up: weight losers and weight gainers.

RESULTS: There were no differences in the change status of grip (muscle) strength between the weight loss and weight gain groups.

Women losing weight during the follow-up and within the improved grip-strength-change group had a significantly lower bone loss rate compared with those in the maintained and decreased grip-strength-change groups.

This was in contrast to women who gained weight during the follow-up (not significant between any grip-strength-change groups). Furthermore, women who lost body weight and were in the improved grip-strength-change group had a bone loss rate comparable with that of the women who gained body weight (not significant).

CONCLUSION: The present study suggests that maintaining muscle strength may counteract postmenopausal bone loss related to weight loss. Accordingly, exercise that improves muscle strength may be encouraged for postmenopausal women with weight loss intentions for other health reasons.”

Testosterone and the Aging Male

A published report in the medical journal Aging Male says “The wide-ranging benefits of testosterone therapy in young and old men are clear and it appears that the route of administration (intramuscular, oral, or transdermal) does not alter this fact, but future work could illustrate even more profound effects of testosterone (e.g., in reducing cardiovascular risk) that could result in its recommended use in a wider range of patients.”

Abstratct:

Kohn FM. Testosterone and body functions. Aging Male. 2006 Dec;9(4):183-8

Testosterone supplementation can help reduce many of the symptoms associated with androgen deficiency in the aging male by its effects on various parts of the body.

Bone mineral density can decrease in the hypogonadal man and this may contribute to the increased fracture rate in the elderly. Testosterone therapy can improve bone mineral density and bone architecture by increasing bone formation and decreasing bone resorption – the possible benefits on fracture rate are unknown.

Testosterone also improves body composition by reducing body fat mass and increasing lean body mass, and by increasing epidermal thickness, but its effects on muscle strength are still debated.

In patients with diabetes and androgen deficiency, testosterone supplementation appears to reduce blood glucose and this could have important implications for cardiovascular risk reduction in patients with diabetes or the metabolic syndrome.

The wide-ranging benefits of testosterone therapy in young and old men are clear and it appears that the route of administration (intramuscular, oral, or transdermal) does not alter this fact, but future work could illustrate even more profound effects of testosterone (e.g., in reducing cardiovascular risk) that could result in its recommended use in a wider range of patients.