These data show contrasts in the effects of sex on the micro-architecture and strength of upper and lower limb bones with ageing. The faster decline in cortical bone thickness and density in women than men after age 50 and consistently lower trabecular bone density in women have implications for the excess risks of wrist and hip fractures in women.

No abstract

Objectives:The relationship between obesity and grip strength, a key indicator of sarcopenia, has been inconsistently reported. We aimed to examine associations between grip strength and both body mass index (BMI), a clinical indicator of total adiposity, and waist circumference (WC), an indicator of central adiposity. Design: Cross-sectional study. Setting and Participants: Data collected from 8,441 men and women, aged 48-92 years old, who attended the third health examination of the European Prospective Investigation into Cancer-Norfolk study was used. Measurements: Maximum grip strength (Smedley dynamometer), BMI (weight/ height 2 ) and WC (measured at the natural waist) were ascertained at a research clinic. The associations between grip strength and adiposity measures were explored using linear regression with adjustment for age, height, social class, physical activity, prevalent disease, smoking status and alcohol intake. Results: Men and women were examined separately and those in the upper quartile of BMI were 2.70kg (95%CI 2.07, 3.33) and 1.46kg (95%CI 1.05, 1.86) stronger respectively than those in the bottom quartile (P trends <0.001). Grip strength also increased weakly with increasing WC. However, including both BMI and WC in the same regression model revealed an inverse association between grip strength and WC, whilst the previously observed association with BMI strengthened. For every 10cm increase in WC, grip strength was 3.56kg (95%CI 3.04, 4.08) lower in men and 1.00kg (95%CI 0.74, 1.24) lower in women. Conclusions: Larger overall body mass, indicated by higher BMI, is associated with stronger grip strength but high WC, a clinical indicator of central obesity, is associated with lower grip strength. Abdominal fat is the most metabolically active adipose tissue and this provides a clue to potential mechanisms underlying relationships between fat and skeletal muscle. Additionally, it reinforces the recommendation to measure WC in clinical practice, especially when BMI is below obese ranges. Key words:Grip strength, central obesity, sarcopenia, aging. The divergent conclusions reported to date reflect the challenging issues in the study of this association. Firstly, the most commonly used marker of obesity is body mass index (BMI), a measure which incorporates both fat and fatfree mass in its calculation. Therefore, increases in BMI indicate increases in lean as well as fat mass (16), which are additionally highly correlated measures (17). Co-variables used to account for lean mass in analyses differ between studies and may contribute to the inconsistency of results (12,14,18). Secondly, BMI does not indicate fat distribution. It is important to consider fat distribution since the properties of adipose tissue are not homogenous throughout the body and different associations of fat with health outcomes have been observed, based on the site of fat accumulation (19,20). Centrally deposited adipose tissue is most closely associated with the metabolic consequences of obesity and increased wai...

Refractive error in this predominantly white older UK population was associated with axial biometry and sociodemographic characteristics. Educational status was the strongest determinant of axial length.

The European Prospective Investigation of Cancer (EPIC) is a 10-country collaborative study in which EPIC-Norfolk is one of the UK centres. EPIC-Norfolk examined 25 639 men and women resident in East Anglia (aged 40–79 years), between 1993 and 1997. The EPIC collaboration was set up to examine the dietary determinants of cancer, but the remit in the EPIC-Norfolk cohort was broadened from the outset to include determinants of other health conditions and chronic diseases. EPIC-Norfolk completed a third round of health examinations (EPIC-Norfolk 3 or 3HC) in December 2011, on 8623 participants in the age range 48–92 years. EPIC-Norfolk focused on objective measures of cognitive function, physical capability and visual health, adapting this existing mid-life cohort to the current need to investigate healthy and independent living for ageing societies. With a wealth of longitudinal data and a biobank (including DNA) collected at up to three separate time points, EPIC-Norfolk offers the unique opportunity to investigate the association of lifestyle and biological factors, including genetic exposures, with a range of health outcomes in middle and later life. Information for data access can be found on the study website, details as given in this cohort profile.