Background:The association between depressive disorders and subsequent cognitive decline is controversial. We tested the hypothesis that elderly women (aged 65 years and older) without dementia but with depressive symptoms have worse cognitive function and greater cognitive decline than women with few or no symptoms.

Older women with low bone density have an increased risk of fracture, cardiovascular disease, and mortality. However, it is not known whether this association is caused by ongoing bone loss or by lower bone mass earlier in life. To determine whether rate of bone loss is associated with total and cause-specific mortality, we prospectively studied 6046 women aged 65 years or older who had serial bone mineral density (BMD) measurements as a part of the Study of Osteoporotic Fractures. Rates (mean ؎ SD) of loss of BMD at the heel (for a mean of 5.7 years) and hip (for a mean of 3.5 years) were estimated. Cause-specific mortality was ascertained from death certificates and hospital records. BMD loss at the heel was 5.9 ؎ 6.0 mg/cm 2 per year (1.5 ؎ 1.5%) and BMD loss at the hip was 4.1 ؎ 10.2 mg/cm 2 per year (0.6 ؎ 1.4%). During an average follow-up of 3.2 years after the second measurement of BMD, 371 deaths occurred. Each SD increase in BMD loss at the hip was associated with a 1.3-fold (95% CI, 1.1-1.4) increase in total mortality, adjusted for age, baseline BMD, diabetes, hypertension, incident fractures, smoking, physical activity, health status, weight loss, and calcium use. In particular, hip BMD loss was associated with increased mortality from coronary heart disease (relative hazard [RH] ‫؍‬ 1.3 per SD; 95% CI, 1.0 -1.8) and pulmonary diseases (RH ‫؍‬ 1.6 per SD; 95% CI, 1.1-2.5). The findings were similar for bone loss at the heel, except there was no significant association with pulmonary mortality. These results raise the possibility that bone loss may share common etiologies with coronary and pulmonary diseases. (J Bone Miner Res 2000; 15:1974 -1980)

Despite having increased BMD compared with controls, subjects with OA did not have a significantly reduced risk of osteoporotic fracture, although there was a trend toward a reduced risk of femoral neck fractures in subjects with severe radiographic OA. The failure of the observed increase in BMD to translate into a reduced fracture risk may be due, in part, to the number and type of falls sustained by subjects with OA. Patients with OA should not be considered to be at a lower risk of fracture than the general population. Physicians should be aware that a high BMD in patients with OA may be falsely reassuring.

Objective. The purpose of this study was to determine the relationship of serum levels of 25-vitamin D and 1,25-vitamin D to incident changes of radiographic hip osteoarthritis (OA) among elderly white women.Methods. Baseline and followup hip radiographs of 237 subjects were obtained an average of 8 years apart. Hips were scored for individual radiographic features (IRF) and assigned a summary grade based on the number and type of IRF present. Serum 25-and 1,25-vitamin D levels from baseline samples were analyzed by radioimmunoassay. Logistic and linear regression were used to examine the association of 25-and 1,25-vitamin D levels with radiographic changes, adjusting for age, health status, physical activity, weight, vitamin D supplement use, and calcaneal bone mineral density.Results. The risk of incident hip OA defined as the development of definite joint space narrowing was increased for subjects who were in the middle (odds ratio [OR] 3.21, 95% confidence interval [95% CI] 1.06, 9.68) and lowest (OR 3.34, 95% CI 1.13, 9.86) tertiles for 25-vitamin D compared with subjects in the highest tertile. Vitamin D levels were not associated with incident hip OA defined as the development of definite osteophytes or new disease according to the summary grade. No association between serum 1,25-vitamin D and changes in radiographic hip OA was found. Conclusion. Low serum levels of 25-vitamin D may be associated with incident changes of radiographic hip OA characterized by joint space narrowing.Osteoarthritis (OA) is the most common cause of musculoskeletal disability in the elderly, with a prevalence of 10-30% in persons over the age of 65 (1-3). It is characterized radiographically by loss of articular cartilage and changes in the bone surrounding the joint. Normal bone and cartilage metabolism depends on the presence of vitamin D. Suboptimal levels of vitamin D have been shown to have adverse effects on calcium metabolism, osteoblastic activity, matrix ossification, bone density, and articular cartilage turnover (4-7). A recent study of radiographic knee OA showed that low levels of serum and dietary vitamin D were associated with an increase in radiographic progression (8). Since hip OA and low levels of vitamin D are both common in elderly women, we investigated the hypothesis that low serum levels of vitamin D are associated with changes in the incidence of radiographic hip OA in older women. SUBJECTS AND METHODSSubjects. Subjects were participants in the Study of Osteoporotic Fractures (SOF), a multicenter cohort study of the risk factors for fractures in 9,704 women. Participants were all age 65 and above at the baseline examination and were recruited between September 1986 and October 1988 from population-based listings in 4 areas of the US:

Acetabular dysplasia, defined by a decrease in the center-edge angle, is associated with a modestly increased risk of incident hip OA in elderly white women.