Shari Tyson, BSc, MSc

Contrary to popular belief, osteoporosis (OP) is not just an aging woman's ailment. About 8% of men can also expect to develop this disease. In fact, hip fractures in elderly men account for approximately one third of all hip fractures sustained due to OP. In addition, one third of those who have suffered such a fracture will not survive beyond a year. Yet despite the large numbers of men affected, and the millions of health care dollars allocated to the care of individuals with this disease, osteoporosis in men remains under-diagnosed, infrequently reported, and inadequately studied.

OP affects women to a greater extent than men. However, for several key reasons, men develop this disease at a much later age than women. For the first thirty years of life, the rate of bone formation exceeds the rate of resorption resulting in general bone growth and thickening. After peaking at age 30 for both sexes, the opposite is true; there is an increased rate of bone resorption and a general loss of bone mass. This rate is further accelerated in women when a dramatic decrease in estrogen production occurs at menopause.

Both estrogen and testosterone have been shown to play key roles in preventing the resorption process. The exact manner in which testosterone performs this function has yet to be discerned.

Kim Wilson BSc, MSc and Geriatrics & Aging Staff

A myocardial infarction (MI) is generally caused by a thrombus obstructing a coronary artery, resulting in death of heart muscle. Thrombi are usually caused by rupture of an atherosclerotic plaque on the wall of the coronary artery. About 50% of patients hospitalized for an acute myocardial infarction are elderly.¹ The majority of patients who develop complications (such as congestive heart failure) or die from their first MI are also over the age of 65. Clearly coronary artery disease is a significant cause of morbidity and mortality in seniors.

Primary prevention refers to risk factor modification to prevent a first MI, and includes education, lifestyle changes, and possibly pharmacological therapy in both younger and older men and women.

Sandra MacMillan, RN, BScN,
Irene Swinson, RN, BScN,
Angela Pisan, RN, BScN,
Jennifer Fuller, RN, BScN, MEd
The North York Public Health Department

Introduction

Falls are a leading cause of morbidity and mortality in seniors. In Ontario, falls cause 600 deaths annually for those over the age of 65.¹ In North York, falls are the second leading cause of hospitalization in females over the age of 65, and the fifth leading cause for males of the same age.² Hill et al. reported that one third of seniors experience one or more falls each year.³ The City of North York Public Health Department has developed and implemented a Falls Prevention Program in conjunction with community partners, designed to reduce the incidence of falls in seniors. The newest component of this program is the Fall Prevention Clinics which have been modelled after the Fall Prevention Project conducted at the Ottawa-Carleton Health Department and the Community Health Research Unit, University of Ottawa. Preliminary results from the Ottawa study suggest that it was successful in reducing the number of falls, however, a final report is pending. North York Public Health Nurses have worked closely with The Bernard Betel Centre for Creative Living, North York Seniors Centre and Taylor Place.