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OBJECTIVES: To examine the association between 8-foot time walk and change in cognitive function over time in older Mexican Americans. DESIGN: Data used are from the Hispanic Established Population for the Epidemiological Study of the Elderly (1993–2001). SETTING: Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California. PARTICIPANTS: Two thousand seventy noninstitutionalized Mexican-American men and women aged 65 and older who had a Mini-Mental State Examination (MMSE) score of 21 or greater at baseline. MEASUREMENTS: Sociodemographic factors (age, sex, education, marital status), MMSE score, 8-foot walk time, body mass index, medical conditions (stroke, heart attack, diabetes mellitus, depression, and hypertension), and near and distant visual impairment. RESULTS: Using general linear mixed models, it was found that subjects with the slowest 8-foot walk time had a significantly greater rate of cognitive decline over 7 years than subjects with the fastest 8-foot walk time. There was a significant 8-foot walk time–by-time interaction with MMSE scores. Subjects in the lowest 8-foot walk time quartile had a greater cognitive decline over 7 years (estimate=−0.32, SE=0.08; P

OBJECTIVES: To review published, randomized trials examining the effect of androgen treatment on muscle strength in older men. DESIGN: Systematic review using meta-analysis procedures. SETTING: Computerized and manual searches. PARTICIPANTS: MEDLINE, EMBASE, CINAHL, and the Cochrane Register were searched for trials. Key words included testosterone, androgen, sarcopenia, muscle loss, aged, aging, elderly, older, geriatric, randomized controlled trials, and controlled clinical trials. Sixty-five nonoverlapping studies were found. Meta-analysis methods were used to evaluate the 11 randomized, double-blind trials. INTERVENTION: Testosterone or dihydrotestosterone (DHT) replacement therapy in healthy men aged 65 and older. MEASUREMENTS: Tests of muscle strength. RESULTS: The studies included 38 statistical comparisons. The mean g-index (gi) adjusted for sample size was 0.53 (95% confidence interval (CI)=0.21–0.86). Subanalyses revealed larger effects for measures of lower extremity muscle strength (gi=0.63, 95% CI=0.03–1.28) than for upper extremity muscle strength (gi=0.47, 95% CI=0.12–0.84). A larger mean g-index was found for injected (gi=0.95, 95% CI=0.33–1.58) than topical (gi=0.26, 95% CI=0.08–0.42) or oral (gi=−0.21, 95% CI=−1.40–1.02) administration of testosterone/DHT. Effect sizes were related to study characteristics such as subject attrition and design-quality ratings. Sensitivity analyses revealed that the elimination of one study reduced the mean g-index from 0.53 to 0.23. CONCLUSION: The results suggest that testosterone/DHT therapy produced a moderate increase in muscle strength in men participating in 11 randomized trials. One study influenced the mean effect size.

OBJECTIVES: To examine the interactive effect of cognition and body weight on hip fracture. DESIGN: A 7-year (1993–2000) prospective cohort study. SETTING: Five southwestern states (Texas, New Mexico, Arizona, Colorado, and California). PARTICIPANTS: Noninstitutionalized Mexican Americans (N=2,653) aged 65 and older and free of hip fracture at baseline interview. MEASUREMENTS: Incidence of hip fracture at 2-, 5-, and 7-year follow-up interviews. Body weight and cognition were measured using body mass index (BMI) and Mini-Mental State Examination score, respectively. Covariates included sociodemographics, self-reported medical conditions, visual acuity, and Short Physical Performance Battery. RESULTS: A significant interaction between BMI and hip fracture was found in persons with cognitive impairment (hazard ratio =0.91, 95% confidence interval=0.85–0.98; P=.02), after adjusting for covariates. In the lowest BMI category, the hip fracture rate in cognitively impaired subjects was more than four times the hip fracture rate for subjects who were not cognitively impaired with the same BMI (34.6% vs 8.7%). Hip fracture rates in the highest BMI category were similar in persons with and without cognitive impairment (9.3% vs 6.1%). CONCLUSION: Low cognitive function increased the conditional association between BMI and hip fracture in older Mexican Americans. The relationship between BMI and cognition is potentially important in identifying persons at risk for hip fracture and supports the need to include cognitive and anthropometric measures in the assessment of hip fracture risk into osteoporosis screening programs.