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Trial registered on ANZCTR
Registration number
ACTRN12620000161921
Ethics application status
Approved
Date submitted
31/01/2020
Date registered
14/02/2020
Date last updated
16/09/2022
Date data sharing statement initially provided
14/02/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Why Indigenous Australians Fall and Fracture: Study of Indigenous Muscle and Bone Ageing (SIMBA)
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Scientific title
Why Indigenous Australians Fall and Fracture: Study of Indigenous Muscle and Bone Ageing (SIMBA)
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Secondary ID [1]
300307
0
nil
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Universal Trial Number (UTN)
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Trial acronym
SIMBA
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
osteoporosis
315908
0
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sarcopenia
315910
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Condition category
Condition code
Musculoskeletal
314179
314179
0
0
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Osteoporosis
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Diet and Nutrition
314180
314180
0
0
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Obesity
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Musculoskeletal
314181
314181
0
0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
This is a prospective longitudinal observational study, recruiting Aboriginal and Torres Strait Islander Australians (Indigenous Australians) residing in the Melbourne region (Australia), with a total of 298 adults. Stratified sampling by age and sex will be used to ensure equal distribution of men and women across the four age-bands, namely 35-44, 45-54, 55-64, 65+ years. Recruitment will include: referrals from clinicians at Monash Health; emails and speaking engagements with community groups, including yarning circles, Elders social gatherings, and various committee meetings, by invitation and support from Monash University Elder in residence; advertising posters displayed at various Victorian Aboriginal Health Services and Aboriginal Gathering Places; networking and communicating with various Indigenous communities with the support of the Monash Indigenous Engagement Unit and the Bunurong Health Service.
Participants will come into Monash Medical Centre for a study visit at baseline, follow-up 1 and follow-up 2. The interval between study visits will be 12-15 months.
Data collected will include:
- Questionnaires: demographics, reproductive history, sarcopenia and quality of life (SarQoL), Osteoporosis Knowledge Assessment Tool, Osteoporosis Health Belief Scale, and the International Physical Activity Questionnaire (IPAQ) - Short Form.
- Anthropometry: height, weight, sidedness, blood pressure and pulse.
- Bloods: clinical indicators of diabetes, cardiovascular disease and chronic kidney disease will be measured.
- Food frequency questionnaire (FFQ) from the Victorian Cancer Council (DQES)
- Bone health: dual energy x-ray absorptiometry (DXA), high resolution peripheral quantitative computed tomography (HR-pQCT) and pQCT
- Body composition: DXA and pQCT
- Muscle strength: hand grip strength, jumping mechanography and short physical performance battery (SPPB)
Each study visit will take approximately 1.5-2hrs.
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Intervention code [1]
316582
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Not applicable
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
322703
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Within individual change in areal bone mineral density (aBMD) at the total hip, femoral neck and lumbar spine assessed by Hologic Horizon A dual energy x-ray absorptiometry (DXA)
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Assessment method [1]
322703
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Timepoint [1]
322703
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Baseline, follow-up 1 and 2
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Primary outcome [2]
322704
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Within individual change in cortical and trabecular bone mineral density at the epiphysis and diaphysis of the radius and tibia using HRpQCT (Scanco, XtremeCT-II) and pQCT (Stratec)
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Assessment method [2]
322704
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Timepoint [2]
322704
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Baseline, follow-up 1 and 2
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Secondary outcome [1]
379358
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Whole body fat mass and lean mass assessed by Hologic Horizon A dual energy x-ray absorptiometry (DXA)
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Assessment method [1]
379358
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Timepoint [1]
379358
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At baseline, follow-up 1 and 2
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Secondary outcome [2]
379359
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Peak muscle force and power in the legs assessed by the Leonardo ground reaction force platform
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Assessment method [2]
379359
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Timepoint [2]
379359
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At baseline, follow-up 1 and 2
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Secondary outcome [3]
379360
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Sarcopenia and quality of life status as assessed by the Sarcopenia and Quality of Life (SarQoL) questionnaire
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Assessment method [3]
379360
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Timepoint [3]
379360
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At baseline, follow-up 1 and 2
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Secondary outcome [4]
379361
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Osteoporosis knowledge will be assessed using a modified Osteoporosis Knowledge Assessment Tool (OKAT) questionnaire
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Assessment method [4]
379361
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Timepoint [4]
379361
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At baseline and follow-up 2
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Secondary outcome [5]
379362
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Beliefs about osteoporosis will be determined using the Osteoporosis Health Belief Scale questionnaire
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Assessment method [5]
379362
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Timepoint [5]
379362
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At baseline and follow-up 2
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Secondary outcome [6]
379363
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Differences in hand grip strength will be determined using a Jamar hand dynamometer
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Assessment method [6]
379363
0
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Timepoint [6]
379363
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At baseline, follow-up 1 and 2
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Secondary outcome [7]
379364
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Differences in physical activity will be determined using the International Physical Activity Questionnaire (IPAQ) - Short Form
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Assessment method [7]
379364
0
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Timepoint [7]
379364
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At baseline, follow-up 1 and 2
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Secondary outcome [8]
379365
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Differences in physical function will be determined by the Short Physical Performance Battery (SPPB)
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Assessment method [8]
379365
0
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Timepoint [8]
379365
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At baseline, follow-up 1 and 2
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Secondary outcome [9]
379366
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Assessment of an individuals "usual" dietary intake over a period of 12 months will be assessed using a food frequency questionnaire (FFQ) from the Victorian Cancer Council (DQES)
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Assessment method [9]
379366
0
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Timepoint [9]
379366
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At baseline, follow-up 1 and 2
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Secondary outcome [10]
379367
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Differences in blood pressure (SBP/DBP), pulse and ankle brachial index (ABI) will be determined using the OMRON. This is a composite secondary outcome.
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Assessment method [10]
379367
0
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Timepoint [10]
379367
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At baseline, follow-up 1 and 2
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Secondary outcome [11]
379368
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Indicators of kidney function from blood tests include: urea (U), electrolytes (E), creatinine (Cr), estimated glomerular filtration rate (eGFR), calcium, phosphate and magnesium.
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Assessment method [11]
379368
0
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Timepoint [11]
379368
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At baseline and follow-up 2
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Secondary outcome [12]
379755
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Indicators of diabetes from blood tests include: glycated haemoglobin (HbA1c), fasting blood glucose
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Assessment method [12]
379755
0
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Timepoint [12]
379755
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At baseline and follow-up 2
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Secondary outcome [13]
379756
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Indicators of cardiovascular function from blood tests include: high-density lipoproteins (HDL), low-density lipoproteins (LDL), very low-density lipoproteins (VLDL), triglycerides, total cholesterol
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Assessment method [13]
379756
0
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Timepoint [13]
379756
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At baseline and follow-up 2
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Secondary outcome [14]
379757
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Indicators of liver function from blood tests include: liver function tests (LFT) and c-reactive protein (CRP)
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Assessment method [14]
379757
0
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Timepoint [14]
379757
0
At baseline and follow-up 2
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Secondary outcome [15]
379758
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Vitamin D status will be determined from serum to measure 25(OH)D
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Assessment method [15]
379758
0
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Timepoint [15]
379758
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At baseline and follow-up 2
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Eligibility
Key inclusion criteria
Inclusion criteria for eligibility includes the participant:
- To identify as Aboriginal or Torres Strait Islander
- Aged 35 years and over
- Body weight less than 160 kg (maximum rating of imaging machines)
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Minimum age
35
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
The exclusion criteria include:
- Pregnant women
- Lactating women
- Breastfeeding in the last 6 months
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
The sample size of 298 participants was calculated to produce a two-sided 95% confidence interval with a width of 0.04, a 20% precision (based on the DXA site with the worst precision, i.e. femoral neck), to detect a within-individual change of 2% per year (i.e. a rate that has been documented in other populations) and a 20% loss-to-follow-up. In the other DXA skeletal sites and HRpQCT regions, which can be measured with more precision, smaller rates of change will be detectable with this number of participants. The rates of bone loss will differ between men and women and may alter with age; the greatest bone loss in non-Indigenous Australians occurs in women in the first 5-10 years after menopause. Therefore, the sample size has been determined to allow investigation of bone loss in men and women separately.
The time interval of 12-15 months between scans has been selected to assess bone loss within an individual over ~3 years (baseline, follow-up 1 and follow-up 2), as the magnitude of bone loss in Aboriginal and Torres Strait Islander adults is unknown; this will ensure the age of osteoporosis (bone fragility) and sarcopenia (decreased muscle mass and function) onset is not missed.
Initially, repeated measures ANOVA will compare changes in bone and muscle parameters. Multivariable regression analyses will be performed to determine whether these associations are independent of potential confounders including age, sex, co-morbidities, physical activity and social demographics. For all analyses, a p-value of <0.05 or 95% confidence interval not including the null point will be considered statistically significant. All data will be analysed using STATA.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
23/03/2020
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Actual
17/12/2020
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Date of last participant enrolment
Anticipated
31/12/2023
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Actual
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Date of last data collection
Anticipated
31/12/2025
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Actual
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Sample size
Target
298
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Accrual to date
5
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
15723
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Monash Medical Centre - Clayton campus - Clayton
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Recruitment postcode(s) [1]
29144
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3168 - Clayton
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Recruitment postcode(s) [2]
29145
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3175 - Dandenong
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Recruitment postcode(s) [3]
29146
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3177 - Doveton
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Recruitment postcode(s) [4]
29147
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3199 - Frankston
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Recruitment postcode(s) [5]
29148
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3000 - Melbourne
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Recruitment postcode(s) [6]
29149
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3800 - Monash University
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Recruitment postcode(s) [7]
29150
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3065 - Fitzroy
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Recruitment postcode(s) [8]
29151
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3056 - Brunswick
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Recruitment postcode(s) [9]
29152
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3066 - Collingwood
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Funding & Sponsors
Funding source category [1]
304727
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Charities/Societies/Foundations
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Name [1]
304727
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Osteoporosis Australia & Australian and New Zealand Bone and Mineral Society
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Address [1]
304727
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Postal Address: PO Box 550 Broadway NSW 2007
Street Address: C2.11, Level 2 22 - 36 Mountain Street, Ultimo NSW 2007
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Country [1]
304727
0
Australia
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Funding source category [2]
304834
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Commercial sector/Industry
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Name [2]
304834
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Amgen
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Address [2]
304834
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Extramural Research Alliances (ERA)
Amgen Inc.
One Amgen Center Drive
Thousand Oaks, CA 91320
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Country [2]
304834
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United States of America
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Primary sponsor type
University
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Name
Monash University
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Address
Department of Medicine
School of Clinical Sciences at Monash Health
MHTP Translational Research Facility
Monash Medical Centre
246 Clayton Road
Clayton VIC 3168, Australia
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Country
Australia
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Secondary sponsor category [1]
305166
0
None
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Name [1]
305166
0
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Address [1]
305166
0
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Country [1]
305166
0
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Other collaborator category [1]
281152
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Other
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Name [1]
281152
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Bunurong Health Service at Dandenong & District Aborigines Co-Operative Limited
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Address [1]
281152
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3 Carroll Ave, Dandenong VIC 3175
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Country [1]
281152
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
305152
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Monash Health HREC
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Ethics committee address [1]
305152
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Research Support Services Monash Health Level 2, I Block Monash Medical Centre 246 Clayton Road Clayton Victoria 3168
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Ethics committee country [1]
305152
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Australia
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Date submitted for ethics approval [1]
305152
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24/05/2019
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Approval date [1]
305152
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09/08/2019
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Ethics approval number [1]
305152
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RES-19-0000374A
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Summary
Brief summary
There is a need to identify WHY fall and fracture risk is increased among Aboriginal and Torres Strait Islander (Indigenous) Australians. Indigenous Australians have a substantially greater fracture risk: Indigenous men are 50% and women are 26%, more likely to experience a hip fracture vs non-Indigenous Australians. Hip fractures occur at a much younger age in Indigenous vs non-Indigenous Australians (men:65 vs 81yrs; women:74 vs 83yrs). Fall-related injuries in Indigenous Australians increased by an average of 10%/year, while the average increase in non-Indigenous Australians was 4.3%/year. Findings from this study will identify why falls and minimal trauma fractures are higher among Indigenous adults. Data collected will enable us to determine the age of osteoporosis (bone fragility) and sarcopenia (decreased muscle function) onset, whether these are different to non-Indigenous Australians, and the best “window” for osteoporosis and sarcopenia screening and prevention strategies. Currently, there is no reference database for DXA-derived areal bone mineral density (aBMD) in Indigenous Australians, which may result in underestimation of fracture risk in this population. Data collected will be compiled into a reference database for Indigenous Australians as a starting point to collect data from Indigenous Australians in other geographic regions, with the aim of improving fracture risk prediction. Together, these data will enable health care professionals to improve screening, diagnosis and treatment of osteoporosis.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
99414
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Dr Ayse Zengin
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Address
99414
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Department of Medicine
School of Clinical Sciences at Monash Health
Monash University
Level 5/Block E
Monash Medical Centre
246 Clayton Road
Clayton VIC 3168
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Country
99414
0
Australia
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Phone
99414
0
+61 3 8572 2918
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Fax
99414
0
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Email
99414
0
[email protected]
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Contact person for public queries
Name
99415
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Ayse Zengin
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Address
99415
0
Department of Medicine
School of Clinical Sciences at Monash Health
Monash University
Level 5/Block E
Monash Medical Centre
246 Clayton Road
Clayton VIC 3168
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Country
99415
0
Australia
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Phone
99415
0
+61 3 8572 2918
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Fax
99415
0
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Email
99415
0
[email protected]
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Contact person for scientific queries
Name
99416
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Ayse Zengin
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Address
99416
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Department of Medicine
School of Clinical Sciences at Monash Health
Monash University
Level 5/Block E
Monash Medical Centre
246 Clayton Road
Clayton VIC 3168
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Country
99416
0
Australia
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Phone
99416
0
+61 3 8572 2918
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Fax
99416
0
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Email
99416
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Individual patient data will not be available to share.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
6687
Ethical approval
[email protected]
379089-(Uploaded-31-01-2020-14-55-07)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF