Skip to main content
Erschienen in: Osteoporosis International 4/2009

01.04.2009 | Original Article

Heritability of impaired balance: a nationwide cohort study in twins

verfasst von: H. Wagner, H. Melhus, N. L. Pedersen, K. Michaëlsson

Erschienen in: Osteoporosis International | Ausgabe 4/2009

Einloggen, um Zugang zu erhalten

Abstract

Summary

In this large population-based twin study, a self-estimated impaired balance, an important risk factor for osteoporotic fractures, had a modest heritability of 0.27. Individual-specific environmental influences seem to be the dominating cause for impaired balance.

Introduction

The principal causal components of an osteoporotic fracture are falls and weakened bone strength. While bone strength has a strong genetic origin, the heritable influences on impaired balance that contribute to the risk of injurious falls at older age are uncertain.

Methods

To evaluate the heritability and environmental influence on self-reported impaired balance in older men and women, we used data from a sample of 22,998 Swedish twins, 55 to 99 years of age.

Results

An impaired balance was reported by 2,890 (12.3%) of the twins. The tetrachoric correlation for impaired balance was only slightly lower for like-sex dizygotic twins (0.31) compared to monozygotic twins (0.36). These correlations indicate a modest familial (genetic and shared environmental) influence. Model fitting results indicate that the age- and sex-adjusted heritability for impaired balance was 0.27 (95%CI = 0.01–0.45). Individual-specific environmental influences differed only slightly by sex and age.

Conclusion

These results imply that a self-reported impaired balance, an independent risk factor for osteoporotic fractures, has a modestly heritable etiology in older subjects. Our observation can partly explain the previously observed modest heritability for osteoporotic fractures even though there is a high heritability for bone mineral density.
Literatur
1.
Zurück zum Zitat Ahlborg HG, Johnell O, Turner CH et al (2003) Bone loss and bone size after menopause. N Engl J Med 349:327–334PubMedCrossRef Ahlborg HG, Johnell O, Turner CH et al (2003) Bone loss and bone size after menopause. N Engl J Med 349:327–334PubMedCrossRef
2.
Zurück zum Zitat Peacock M, Turner CH, Econs MJ et al (2002) Genetics of osteoporosis. Endocr Rev 23:303–326PubMedCrossRef Peacock M, Turner CH, Econs MJ et al (2002) Genetics of osteoporosis. Endocr Rev 23:303–326PubMedCrossRef
3.
Zurück zum Zitat Kannus P, Palvanen M, Kaprio J, Parkkari J, Koskenvuo M (1999) Genetic factors and osteoporotic fractures in elderly people: prospective 25 year follow up of a nationwide cohort of elderly Finnish twins. BMJ 319:1334–1337PubMed Kannus P, Palvanen M, Kaprio J, Parkkari J, Koskenvuo M (1999) Genetic factors and osteoporotic fractures in elderly people: prospective 25 year follow up of a nationwide cohort of elderly Finnish twins. BMJ 319:1334–1337PubMed
4.
Zurück zum Zitat Michaëlsson K, Melhus H, Ferm H et al (2005) Genetic liability to fractures in the elderly. Arch Intern Med 165:1825–1830PubMedCrossRef Michaëlsson K, Melhus H, Ferm H et al (2005) Genetic liability to fractures in the elderly. Arch Intern Med 165:1825–1830PubMedCrossRef
5.
Zurück zum Zitat El Haber N, Hill KD, Cassano AM et al (2006) Genetic and environmental influences on variation in balance performance among female twin pairs aged 21–82 years. Am J Epidemiol 164:246–256PubMedCrossRef El Haber N, Hill KD, Cassano AM et al (2006) Genetic and environmental influences on variation in balance performance among female twin pairs aged 21–82 years. Am J Epidemiol 164:246–256PubMedCrossRef
6.
Zurück zum Zitat Pajala S, Era P, Koskenvuo M et al (2007) Genetic and environmental contribution to postural balance of older women in single and dual task situations. Neurobiol Aging 28:947–954PubMedCrossRef Pajala S, Era P, Koskenvuo M et al (2007) Genetic and environmental contribution to postural balance of older women in single and dual task situations. Neurobiol Aging 28:947–954PubMedCrossRef
7.
Zurück zum Zitat Pajala S, Era P, Koskenvuo M et al (2004) Contribution of genetic and environmental effects to postural balance in older female twins. J Appl Physiol 96:308–315PubMedCrossRef Pajala S, Era P, Koskenvuo M et al (2004) Contribution of genetic and environmental effects to postural balance in older female twins. J Appl Physiol 96:308–315PubMedCrossRef
8.
Zurück zum Zitat Baloh RW, Spain S, Socotch TM et al (1995) Posturography and balance problems in older people. J Am Geriatr Soc 43:638–644PubMed Baloh RW, Spain S, Socotch TM et al (1995) Posturography and balance problems in older people. J Am Geriatr Soc 43:638–644PubMed
9.
Zurück zum Zitat Vellas BJ, Wayne SJ, Romero LJ et al (1997) Fear of falling and restriction of mobility in elderly fallers. Age Ageing 26:189–193PubMedCrossRef Vellas BJ, Wayne SJ, Romero LJ et al (1997) Fear of falling and restriction of mobility in elderly fallers. Age Ageing 26:189–193PubMedCrossRef
10.
Zurück zum Zitat Alexander NB, Guire KE, Thelen DG et al (2000) Self-reported walking ability predicts functional mobility performance in frail older adults. J Am Geriatr Soc 48:1408–1413PubMed Alexander NB, Guire KE, Thelen DG et al (2000) Self-reported walking ability predicts functional mobility performance in frail older adults. J Am Geriatr Soc 48:1408–1413PubMed
11.
Zurück zum Zitat Rathouz PJ, Kasper JD, Zeger SL et al (1998) Short-term consistency in self-reported physical functioning among elderly women: the Women’s Health and Aging Study. Am J Epidemiol 147:764–773PubMed Rathouz PJ, Kasper JD, Zeger SL et al (1998) Short-term consistency in self-reported physical functioning among elderly women: the Women’s Health and Aging Study. Am J Epidemiol 147:764–773PubMed
12.
Zurück zum Zitat Guralnik JM, Simonsick EM, Ferrucci L et al (1994) A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49:M85–M94PubMed Guralnik JM, Simonsick EM, Ferrucci L et al (1994) A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 49:M85–M94PubMed
13.
Zurück zum Zitat Ferrer M, Lamarca R, Orfila F et al (1999) Comparison of performance-based and self-rated functional capacity in Spanish elderly. Am J Epidemiol 149:228–235PubMed Ferrer M, Lamarca R, Orfila F et al (1999) Comparison of performance-based and self-rated functional capacity in Spanish elderly. Am J Epidemiol 149:228–235PubMed
15.
Zurück zum Zitat Cummings SR, Nevitt MC, Browner WS et al (1995) Risk factors for hip fracture in white women. Study of osteoporotic fractures research group. N Engl J Med 332:767–773PubMedCrossRef Cummings SR, Nevitt MC, Browner WS et al (1995) Risk factors for hip fracture in white women. Study of osteoporotic fractures research group. N Engl J Med 332:767–773PubMedCrossRef
16.
Zurück zum Zitat Dargent-Molina P, Favier F et al (1996) Fall-related factors and risk of hip fracture: the EPIDOS prospective study. Lancet 348:145–149PubMedCrossRef Dargent-Molina P, Favier F et al (1996) Fall-related factors and risk of hip fracture: the EPIDOS prospective study. Lancet 348:145–149PubMedCrossRef
17.
Zurück zum Zitat Nguyen ND, Pongchaiyakul C, Center JR et al (2005) Identification of high-risk individuals for hip fracture: a 14-year prospective study. J Bone Miner Res 20:1921–1928PubMedCrossRef Nguyen ND, Pongchaiyakul C, Center JR et al (2005) Identification of high-risk individuals for hip fracture: a 14-year prospective study. J Bone Miner Res 20:1921–1928PubMedCrossRef
18.
Zurück zum Zitat Wagner H, Melhus H, Gedeborg R, Pedersen NL, Michaëlsson K (2008) Simply ask them about their balance—future fracture risk in a nationwide cohort study in twins. Am J Epidemiol (in press) Wagner H, Melhus H, Gedeborg R, Pedersen NL, Michaëlsson K (2008) Simply ask them about their balance—future fracture risk in a nationwide cohort study in twins. Am J Epidemiol (in press)
19.
Zurück zum Zitat Pedersen NL, Lichtenstein P, Svedberg P (2002) The Swedish Twin Registry in the third millenium. Twin Res 5:427–432PubMedCrossRef Pedersen NL, Lichtenstein P, Svedberg P (2002) The Swedish Twin Registry in the third millenium. Twin Res 5:427–432PubMedCrossRef
20.
Zurück zum Zitat Lichtenstein P, De Faire U, Floderus B et al (2002) The Swedish Twin Regsitry: a unique resource for clinical, epidemiologic and genetic studies. J Intern Med 252:184–205PubMedCrossRef Lichtenstein P, De Faire U, Floderus B et al (2002) The Swedish Twin Regsitry: a unique resource for clinical, epidemiologic and genetic studies. J Intern Med 252:184–205PubMedCrossRef
21.
Zurück zum Zitat Boomsma D, Busjahn A, Peltonen L (2002) Classical twin studies and beyond. Nat Genet 3:872–882CrossRef Boomsma D, Busjahn A, Peltonen L (2002) Classical twin studies and beyond. Nat Genet 3:872–882CrossRef
22.
Zurück zum Zitat Neale MC (1997) MX: statistical modeling. Department of Psychiatry, Virginia Commonwealth University, Richmond, VA Neale MC (1997) MX: statistical modeling. Department of Psychiatry, Virginia Commonwealth University, Richmond, VA
23.
Zurück zum Zitat Rankinen T, Bray MS, Hagberg JM et al (2006) The human gene map for performance and health-related fitness phenotypes: the 2005 update. Med Sci Sports Exerc 38:1863–1888PubMedCrossRef Rankinen T, Bray MS, Hagberg JM et al (2006) The human gene map for performance and health-related fitness phenotypes: the 2005 update. Med Sci Sports Exerc 38:1863–1888PubMedCrossRef
24.
Zurück zum Zitat Evans WJ (1999) Exercise training guidelines for the elderly. Med Sci Sports Exerc 31:12–17PubMedCrossRef Evans WJ (1999) Exercise training guidelines for the elderly. Med Sci Sports Exerc 31:12–17PubMedCrossRef
25.
Zurück zum Zitat Fiatarone MA, O’Neill EF, Ryan ND et al (1994) Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 330:1769–1775PubMedCrossRef Fiatarone MA, O’Neill EF, Ryan ND et al (1994) Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 330:1769–1775PubMedCrossRef
26.
Zurück zum Zitat Buchner DM, Cress ME, de Lateur BJ et al (1997) A comparison of the effects of three types of endurance training on balance and other fall risk factors in older adults. Aging 9:112–119PubMed Buchner DM, Cress ME, de Lateur BJ et al (1997) A comparison of the effects of three types of endurance training on balance and other fall risk factors in older adults. Aging 9:112–119PubMed
27.
Zurück zum Zitat Szulc P, Beck TJ, Marchand F et al (2005) Low skeletal muscle mass is associated with poor structural parameters of bone and impaired balance in elderly men—the MINOS study. J Bone Miner Res 20:721–729PubMedCrossRef Szulc P, Beck TJ, Marchand F et al (2005) Low skeletal muscle mass is associated with poor structural parameters of bone and impaired balance in elderly men—the MINOS study. J Bone Miner Res 20:721–729PubMedCrossRef
28.
Zurück zum Zitat Province MA, Hadley EC, Hornbrook MC et al (1995) The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT trials. JAMA 273:1341–1347PubMedCrossRef Province MA, Hadley EC, Hornbrook MC et al (1995) The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT trials. JAMA 273:1341–1347PubMedCrossRef
29.
Zurück zum Zitat Pahor M, Blair SN, Espeland M et al (2006) Effects of a physical activity intervention on measures of physical performance: results of the lifestyle interventions and independence for Elders Pilot (LIFE-P) study. J Gerontol A Biol Sci Med Sci 61:1157–1165PubMed Pahor M, Blair SN, Espeland M et al (2006) Effects of a physical activity intervention on measures of physical performance: results of the lifestyle interventions and independence for Elders Pilot (LIFE-P) study. J Gerontol A Biol Sci Med Sci 61:1157–1165PubMed
30.
Zurück zum Zitat Shumway-Cook A, Patla A, Stewart AL et al (2005) Assessing environmentally determined mobility disability: self-report versus observed community mobility. J Am Geriatr Soc 53:700–704PubMedCrossRef Shumway-Cook A, Patla A, Stewart AL et al (2005) Assessing environmentally determined mobility disability: self-report versus observed community mobility. J Am Geriatr Soc 53:700–704PubMedCrossRef
Metadaten
Titel
Heritability of impaired balance: a nationwide cohort study in twins
verfasst von
H. Wagner
H. Melhus
N. L. Pedersen
K. Michaëlsson
Publikationsdatum
01.04.2009
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 4/2009
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-008-0710-3

Weitere Artikel der Ausgabe 4/2009

Osteoporosis International 4/2009 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.