CRP is a significant predictor of osteoporotic fracture in elderly Asian women who have substantially lower CRP levels than Caucasians. Mechanisms explaining such an association should be further studied.

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Sufficient vitamin D status, i.e., serum 25(OH)D ≥ 71 nmol/L, is associated with low limb and vertebral fracture risk in community-dwelling elderly women.

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Japan has a rapidly growing elderly population. The proportion of citizens aged 65 years and over was 22.1% in 2008, and is projected to as high as 27% by 2015 (Health and Welfare Statistics Association 2009). In accordance, elderly individuals requiring care are also increasing. To cope with this situation, the long term care service system was implemented in Japan in 2000. Since then, the number of elderly requiring care doubled from 2.2 to 4.4 million (Health and Welfare Statistics Association 2008).One of the important challenges for people requiring care is how to prevent a decrease in activities of daily living (ADL). To address this issue, we initiated the Yamato Study, a population-based study of individuals utilizing the long term care service system, to develop preventive methods for diminishing ADL levels (Nishiwaki et al. 2005(Nishiwaki et al. , 2007.Another critical risk for people requiring care is increased mortality. Kuzuya et al. (2006) demonstrated that decreased ADL is associated with higher mortality rates while Takeda (2004) showed that higher requisite care levels are associated with higher mortality rates. These studies suggest that ADL level is an important predictor of mortality in elderly requiring care. A number of studies targeting independent elderly people in the community have also indicated that body stature (Grabowski and Ellis 2001;Al Snih et al. 2007), muscle strength (Al Snih et al. 2002), and serum albumin levels (Sahyoun et al. 1996;Okamura et al. 2008) are significant predictors of mortality. To date, however, only a few studies have explored risk factors for mortality other than ADL in elderly people requiring care to date (Enoki et al. 2007a(Enoki et al. , 2007b. This study aimed to clarify multiple risk factors for two-year mortality through follow-up of the Yamato Study elderly cohort who utilize the long term care service system.