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Background. The objective of this study was to determine the prevalence of lower back pain and associated leg pain/ numbness in postmenopausal Caucasian women and the relationship of these symptoms to health status and function. Methods. A convenience sample of 573 white women enrolled in the Observational Study of the Women's Health Initiative (WHI) in Pittsburgh completed a questionnaire on low back pain (LBP) and leg pain (LP) and its impact on their daily activity. For data analysis, this information was merged with that obtained under the standard WHI protocol. Results. Almost half of the women (49%) reported having had LBP during the previous month: 8% had LBP only, while 41% had both LBP and LP. In 9% of women, the leg and back symptoms were alleviated by sitting. Among women with LBP during the previous month, those who also had leg pain were five times more likely to have had functional limitations, two to four times more likely to have consulted a clinician or taken medications, and more likely to have had prior spinal surgery or hospitalization than the women with no LP. Based on the Short Form-36, women with LBP/LP had significantly lower scores for physical function, physical role, and bodily pain than women with no LBP or with LBP alone. Conclusions. Low back pain that radiates into the hip, buttock, or leg is relatively common in postmenopausal Caucasian women living in the community and is associated with decreased physical health status and with physical limitations.

Postmenopausal women with high bone density may be risking breast cancer if they begin taking estrogen replacement therapy. This was the implication of a study that examined bone density and the incidence of breast cancer in 6,854 women 65 and older. Ninety-seven women had breast cancer. Women with the highest bone density had twice the risk of breast cancer compared to those with the lowest bone density. High bone density indicates that the woman has been exposed to estrogen for long periods of time, which is a risk factor for breast cancer., Objective.--To test the hypothesis that bone mineral density (BMD) is associated with the risk of developing breast cancer in older women. Design.--Prospective cohort study with mean (SD) follow-up of 3.2 (1.6) years. Setting.--Four clinical centers, one each located in the following areas: Baltimore, Md; Minneapolis, Minn; Portland, Ore; and the Monongahela Valley in Pennsylvania. Participants.--A total of 6854 nonblack women who were 65 years of age or older and enrolled in the Study of Osteoporotic Fractures. Measurements.--Radius and calcaneus BMD by single photon absorptiometry at baseline; hip and spine BMD by dual-energy x-ray absorptiometry 2 years later. Main Outcome Measure.--Breast cancer confirmed by medical record review. Results.--A total of 97 women developed breast cancer. In the multivariate model, adjusting for age, the degree of obesity, and other important covariates, the risk of breast cancer was about 30% to 50% higher per 1 SD increase in BMD (relative risk, distal radius BMD=1.50; 95% confidence interval, 1.16-1.95). The age-adjusted incidence rate of breast cancer per 1000 person-years among women in the lowest quartile of distal radius BMD was 2.46, compared with 5.99 among women with the highest BMD. Women with BMD above the 25th percentile were at 2.0 to 2.5 times increased risk of breast cancer compared with women below the 25th percentile. Results were consistent across all BMD sites. Conclusions.--Bone mineral density predicts the risk of breast cancer in older women. The magnitude of the association is similar to that observed between BMD and all fractures. Our findings suggest a link between 2 of the most common conditions affecting a woman's health. Identifying a common denominator for these conditions should substantially improve our understanding of their etiology and prevention. JAMA. 1996;276:1404-1408

Elderly women with a low ankle/arm blood pressure index (AAI) may have higher risk of death from cardiovascular disease. AAI is a measurement used to detect the presence of arterial disease in the lower extremities. A low AAI is a reading of less than 0.9. Among 1,492 healthy white women over 65 years old, 5.5% had a low AAI. Most women with a low AAI did not have any other symptoms such as limping or lameness. Women with a low AAI had a higher risk of dying from all causes within four years than women with a higher AAI. Individuals with a low AAI also had a higher risk of dying from cancer, heart disease and different types of cardiovascular disease., Objective. - To evaluate the relationship of the ankle/arm blood pressure index to short-term mortality in women 65 years of age or older. Design. - Prospective cohort study with average follow-up of 4.3 years. Setting. - Rural community near Pittsburgh, Pa. Participants. - A total of 1492 white women 65 year's of age or older, living in the community and ambulatory without the help of another person. Outcome Measures. - All-cause and cause-specific mortality. Results. - The ankle/arm index (the systolic pressure in the posterior tibial artery divided by that in the brachial artery) was measured in 1986 through 1988 and found to be 0.9 or less in 82 (5.5%) of the women, 67 of whom reported no symptoms of claudication. Comparing women with an index of 0.9 or less with those with an index greater than 0.9, the relative risk for all-cause mortality 4 years later (after adjustment for age, smoking, and other risk factors) was 3.1 (95% confidence interval [Cl], 1.7 to 5.5); for heart disease, 3.7 (95% Cl, 1.2 to 11.6); for cardiovascular diseases, 4.0 (95% Cl, 1.3 to 8.5); for cancer, 3.3 (95% Cl, 1.3 to 8.5); and for all other causes, 1.1 (95% Cl, 0.1 to 9.2). Similar levels of risk were found after excluding women with symptoms of claudication and/or a history of cardiovascular disease at baseline. Conclusions. - Healthy, older women with an ankle/arm index of 0.9 or less are at high risk of death and therefore may be considered for aggressive therapy to modify cardiovascular risk factors.