Abstract
The Gambian Bone and Muscle Ageing Study is a prospective observational study investigating bone and muscle ageing in men and women from a poor, subsistence farming community of The Gambia, West Africa. Musculoskeletal diseases, including osteoporosis and sarcopenia, form a major part of the current global non-communicable disease burden. By 2050, the vast majority of the world’s ageing population will live in low- and middle-income countries with an estimated two-fold rise in osteoporotic fracture. The study design was to characterise change in bone and muscle outcomes and to identify possible preventative strategies for fracture and sarcopenia in the increasing ageing population. Men and women aged ≥40 years from the Kiang West region of The Gambia were recruited with stratified sampling by sex and age. Baseline measurements were completed in 488 participants in 2012 who were randomly assigned to follow-up between 1.5 and 2 years later. Follow-up measurements were performed on 465 participants approximately 1.7 years after baseline measurements. The data set comprises a wide range of measurements on bone, muscle strength, anthropometry, biochemistry, and dietary intake. Questionnaires were used to obtain information on health, lifestyle, musculoskeletal pain, and reproductive status. Baseline cross-sectional data show preliminary evidence for bone mineral density and muscle loss with age. Men had greater negative differences in total body lean mass with age than women following adjustments for body size. From peripheral quantitative computed tomography scans, greater negative associations between bone outcomes and age at the radius and tibia were shown in women than in men. Ultimately, the findings from The Gambian Bone and Muscle Ageing Study will contribute to the understanding of musculoskeletal health in a transitioning population and better characterise fracture and sarcopenia incidence in The Gambia with an aim to the development of preventative strategies against both.
Highlights
Health priorities in low and middle-income countries (LMICs) have until recently focused on infectious diseases
Individuals were ranked according to the accuracy of date of birth ascertained from the Kiang West Demographic Surveillance System (KWDSS), from most to least accurate, where recruitment priority was given to those with the most accurate
Kiang West residents are mainly Muslim [3]; Gambian Bone and Muscle Ageing Study (GamBAS) participants reported that they pray five times a day and most men and women were able to perform these prayers without physical difficulty (Table 1)
Summary
Health priorities in low and middle-income countries (LMICs) have until recently focused on infectious diseases. As these populations undergo social, economic, and environmental transition, non-communicable diseases (NCDs) of older age are becoming prevalent. As life expectancy is increasing, within 35 years the vast majority of the world’s older population will live in LMICs, with a consequent increase in associated NCDs [1, 2]. The current cohort provides a baseline from which to characterise these changes as the population undergoes transition and to determine the individual, societal, and economic impact of osteoporosis and sarcopenia, and the associated increase in falls/fragility fractures, disability, morbidity, and mortality—all of which are currently unknown
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