Hip to bone care

ISABEL Lavin's flat in a warden-assisted housing development in Haxby sparkles like a new pin. "I do everything," she says proudly, serving me coffee in an elegant china cup. "I do all the cleaning and cooking myself. I like to keep busy." At 83, she's as bright and energetic as a bird, constantly on the move, fussing around to make sure my coffee is just so. She's astonishingly fit and active for her age.

"I do Yoga twice a week, and exercises every day," she says, with a lilting Spanish accent. "When I was 54 years of age, I had a slipped disc in my back. My GP told me to keep on with my exercises. Now, if I don't do my exercises, I feel very tired."

Mrs Lavin has lived alone since her husband, Manuel, died three years ago at the age of 93. They had been married for 62 years. "I was 16 years old when I met him and he was my only love," she says. Her eyes shine. "He was very very handsome and unique."

She misses him, desperately. And, while she remains immensely house-proud and active, now he has gone she admits she is nervous - scared of injuring herself in a way which would affect her ability to be independent.

"My poor husband broke his hip," she says. "He was swimming and he fell down. He was 87. He was not desperate because he had me. But if I broke my hip now, I would feel desperate. I'm scared to break anything."

It's a common fear among many elderly people - and not without reason. The older we get, the more fragile our bones become. That's especially so for women who, because of hormonal changes caused by menopause, are at much greater risk of developing the brittle bone condition osteoporosis in later life.

It means a simple fall can lead to a broken arm or hip, a lengthy stay in hospital - and even having to give up that much-prized independence and go into care.

"A lot of elderly women are very proud and they obviously love their independence," says Ruth Hildreth, a state-registered nurse who has been seconded to York University to implement a study looking at the effect of calcium supplements in strengthening bones in older women.

"As you get older, your risk of falling becomes greater, because of many factors, such as eyesight, medication you're taking, other illness or physical impairment.

"Your bone density also gets less, which means that your bones become weaker, so that if you do fall, you're more likely to break something - and if you do break something, it can be quite serious.

"The result of a hip fracture, for example, could be long-term physical impairment, lost confidence or mobility, and even not being able to go back into your own home. Even just an arm fracture can actually impair them so much that they cannot look after themselves."

That's why the new clinical trial Ruth is involved with is such good news.

With the help of a £144,000 grant from the NHS Executive, York University hopes over the next two years to look at the effect of increasing doses of calcium and vitamin D on up to 3,500 women like Isabel Lavin - women aged over 70 who live alone in their own homes.

Dr David Torgerson of the university's Department of Health Studies, who is leading the trial, says it has long been known that if you don't get enough calcium, that's bad for the health of your bones.

What the new study is looking at is whether increasing the levels of calcium taken by older women to double the present recommended daily allowance of 500mg will further reduce the risk of broken bones.

So far 300 women in Yorkshire have been recruited - with a further 3,200 to be enrolled from throughout the country.

The women taking part are divided into two groups: one of which is given a daily dosage of calcium and vitamin D (which helps the body to absorb calcium) and the other of which is given normal care by their GP.

At the end of the study, the two groups will be compared to see if there is a significant difference in the number who suffered broken bones.

If there is, and the extra calcium has been shown to help, it could lead to an easy and effective method of helping women like Mrs Lavin avoid the trauma of broken bones.

The study also allows Ruth Hildreth, who meets the women taking part in the trial and monitors their progress, to give useful information on diet and on how to minimise the risk of a fall.

It could be something as simple as making sure rugs aren't folded or doubled up so they don't pose a tripping risk, or ensuring furniture is placed so it is not going to cause a fall.

If the study means more women like Mrs Lavin can continue to enjoy their independence for longer, it has to be a good thing, Ruth says. Mrs Lavin obviously agrees. "They are lovely, nurses," she says, sitting on the settee in her neat little home. "But I wouldn't like it in hospital."

Women are referred to the trial by their GP. Dr Torgerson is looking for more GP practices to take part in the study. For more information contact Jill Porthouse at the university on 01904 434126.