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Physical activity in middle-aged women and hip fracture risk: the UFO study

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Abstract

Summary

In a population-based case-control study, we demonstrate that middle-aged women who were active with walking or in different physical spare time activities were at lower risk of later sustaining a hip fracture compared to more sedentary women.

Introduction

In middle-aged women participating in the Umeå Fracture and Osteoporosis (UFO) study, we investigated whether physical activity is associated with a subsequent decreased risk of sustaining a hip fracture.

Methods

The UFO study is a nested case-control study investigating associations between bone markers, lifestyle, and osteoporotic fractures. We identified 81 female hip fracture cases that had reported lifestyle data before they sustained their fracture. Each case was compared with two female controls who were identified from the same cohort and matched for age and week of reporting data, yielding a total cohort of 237 subjects. Mean age at baseline was 57.2 ± 5.0 years, and mean age at fracture was 65.4 ± 6.4 years.

Results

Conditional logistic regression analysis with adjustments for height, weight, smoking, and menopausal status showed that subjects who were regularly active with walking or had a moderate or high frequency of physical spare time activities (i.e. berry/mushroom picking and snow shovelling) were at reduced risk of sustaining a hip fracture (OR 0.14; 95% CI; 0.05–0.53 for walking and OR 0.19; 95% CI; 0.08–0.46, OR 0.17, 95% CI; 0.05–0.64 for moderate and high frequency of spare time activities, respectively) compared to more sedentary women.

Conclusion

An active lifestyle in middle age seems to reduce the risk of future hip fracture. Possible mechanisms may include improved muscle strength, coordination, and balance resulting in a decreased risk of falling and perhaps also direct skeletal benefits.

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References

  1. Johnell O (1997) The socioeconomic burden of fractures: today and in the 21st century. Am J Med 103(2A):20S–25S, Discussion 25S–26S

    Article  CAS  PubMed  Google Scholar 

  2. Vestergaard P, Rejnmark L, Mosekilde L (2007) Increased mortality in patients with a hip fracture effect of pre-morbid conditions and post-fracture complications. Osteoporos Int 18(12):1583–1593

    Article  CAS  PubMed  Google Scholar 

  3. Jarvinen TL et al (2008) Shifting the focus in fracture prevention from osteoporosis to falls. BMJ 336(7636):124–126

    Article  PubMed  Google Scholar 

  4. Thorngren KG et al (2002) Epidemiology of femoral neck fractures. Injury 33(Suppl 3):C1–C7

    Article  PubMed  Google Scholar 

  5. Johnell O et al (1992) The apparent incidence of hip fracture in Europe: a study of national register sources. MEDOS Study Group. Osteoporos Int 2(6):298–302

    Article  CAS  PubMed  Google Scholar 

  6. Kannus P et al (1999) Hip fractures in Finland between 1970 and 1997 and predictions for the future. Lancet 353(9155):802–805

    Article  CAS  PubMed  Google Scholar 

  7. Melton LJ 3rd (1996) Epidemiology of hip fractures: implications of the exponential increase with age. Bone 18(3 Suppl):121S–125S

    Article  PubMed  Google Scholar 

  8. Kannus P et al (2006) Nationwide decline in incidence of hip fracture. J Bone Miner Res 21(12):1836–1838

    Article  PubMed  Google Scholar 

  9. Rogmark C et al (1999) Incidence of hip fractures in Malmo, Sweden, 1992–1995. A trend break. Acta Orthop Scand 70(1):19–22

    Article  CAS  PubMed  Google Scholar 

  10. Albrand G et al (2003) Independent predictors of all osteoporosis-related fractures in healthy postmenopausal women: the OFELY Study. Bone 32(1):78–85

    Article  CAS  PubMed  Google Scholar 

  11. Cummings SR et al (1995) Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med 332(12):767–773

    Article  CAS  PubMed  Google Scholar 

  12. Moayyeri A (2008) The association between physical activity and osteoporotic fractures: a review of the evidence and implications for future research. Ann Epidemiol 18(11):827–835

    Article  PubMed  Google Scholar 

  13. Hoidrup S et al (2001) Leisure-time physical activity levels and changes in relation to risk of hip fracture in men and women. Am J Epidemiol 154(1):60–68

    Article  CAS  PubMed  Google Scholar 

  14. Paganini-Hill A et al (1991) Exercise and other factors in the prevention of hip fracture: the Leisure World study. Epidemiology 2(1):16–25

    Article  CAS  PubMed  Google Scholar 

  15. Feskanich D, Willett W, Colditz G (2002) Walking and leisure-time activity and risk of hip fracture in postmenopausal women. JAMA 288(18):2300–2306

    Article  PubMed  Google Scholar 

  16. Michaelsson K et al (2007) Leisure physical activity and the risk of fracture in men. PLoS Med 4(6):e199

    Article  PubMed  Google Scholar 

  17. Karlsson MK, Nordqvist A, Karlsson C (2008) Physical activity, muscle function, falls and fractures. Food Nutr Res 52

  18. Hallmans G et al (2003) Cardiovascular disease and diabetes in the Northern Sweden Health and Disease Study Cohort—evaluation of risk factors and their interactions. Scand J Public Health Suppl 61:18–24

    Article  PubMed  Google Scholar 

  19. Bergstrom U et al (2008) Fracture mechanisms and fracture pattern in men and women aged 50 years and older: a study of a 12-year population-based injury register, Umea, Sweden. Osteoporos Int 19(9):1267–1273

    Article  CAS  PubMed  Google Scholar 

  20. Gregg EW et al (1998) Physical activity and osteoporotic fracture risk in older women. Study of Osteoporotic Fractures Research Group. Ann Intern Med 129(2):81–88

    CAS  PubMed  Google Scholar 

  21. Joakimsen RM, Magnus JH, Fonnebo V (1997) Physical activity and predisposition for hip fractures: a review. Osteoporos Int 7(6):503–513

    Article  CAS  PubMed  Google Scholar 

  22. Bergström U (2009) Fragility fractures in fragile people, in Department of Surgical and Perioperative Sciences Orthopaedics. Umeå University, Umeå

    Google Scholar 

  23. Martyn-St James M, Carroll S (2008) Meta-analysis of walking for preservation of bone mineral density in postmenopausal women. Bone 43(3):521–531

    Article  PubMed  Google Scholar 

  24. Uusi-Rasi K et al (2006) Long-term recreational gymnastics provides a clear benefit in age-related functional decline and bone loss. A prospective 6-year study. Osteoporos Int 17(8):1154–1164

    Article  CAS  PubMed  Google Scholar 

  25. Englund U et al (2005) A 1-year combined weight-bearing training program is beneficial for bone mineral density and neuromuscular function in older women. Osteoporos Int 16(9):1117–1123

    Article  PubMed  Google Scholar 

  26. Dargent-Molina P et al (1996) Fall-related factors and risk of hip fracture: the EPIDOS prospective study. Lancet 348(9021):145–149

    Article  CAS  PubMed  Google Scholar 

  27. McNeil CJ et al (2009) Geometry of a weight-bearing and non-weight-bearing bone in the legs of young, old, and very old men. Calcif Tissue Int 85(1):22–30

    Article  CAS  PubMed  Google Scholar 

  28. Kallman DA, Plato CC, Tobin JD (1990) The role of muscle loss in the age-related decline of grip strength: cross-sectional and longitudinal perspectives. J Gerontol 45(3):M82–M88

    CAS  PubMed  Google Scholar 

  29. Kamel HK (2003) Sarcopenia and aging. Nutr Rev 61(5 Pt 1):157–167

    Article  PubMed  Google Scholar 

  30. Province MA et al (1995) The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials. Frailty and injuries: cooperative studies of intervention techniques. JAMA 273(17):1341–1347

    Article  CAS  PubMed  Google Scholar 

  31. Lord SR et al (1996) The effects of a community exercise program on fracture risk factors in older women. Osteoporos Int 6(5):361–367

    Article  CAS  PubMed  Google Scholar 

  32. Opotowsky AR, Su BW, Bilezikian JP (2003) Height and lower extremity length as predictors of hip fracture: results of the NHANES I epidemiologic follow-up study. J Bone Miner Res 18(9):1674–1681

    Article  PubMed  Google Scholar 

  33. Hemenway D, Feskanich D, Colditz GA (1995) Body height and hip fracture: a cohort study of 90, 000 women. Int J Epidemiol 24(4):783–786

    Article  CAS  PubMed  Google Scholar 

  34. Gunnes M et al (1996) The relationship between anthropometric measurements and fractures in women. Bone 19(4):407–413

    Article  CAS  PubMed  Google Scholar 

  35. Ulusoy H et al (2008) A new value of proximal femur geometry to evaluate hip fracture risk: true moment arm. Hip Int 18(2):101–107

    CAS  PubMed  Google Scholar 

  36. Kaptoge S et al (2003) Hip section modulus, a measure of bending resistance, is more strongly related to reported physical activity than BMD. Osteoporos Int 14(11):941–949

    Article  CAS  PubMed  Google Scholar 

  37. Holmberg AH et al (2005) Risk factors for hip fractures in a middle-aged population: a study of 33, 000 men and women. Osteoporos Int 16(12):2185–2194

    Article  PubMed  Google Scholar 

  38. Kanis JA et al (2005) Smoking and fracture risk: a meta-analysis. Osteoporos Int 16(2):155–162

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank Hubert Sjödin and Åsa Ågren for skilful data processing. The study is funded by the Swedish Research Council (K2006-72X-20155013), Swedish Sports Research Council (87/06, 169/07), Swedish Society of Medicine, Medical Faculty of Umeå, and by project grants from the Erik and Anne-Marie Detlof Foundation and the J C Kempe Foundation. The funding bodies had no role in the design or conduct of the study.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden

    U. Englund, P. Nordström & G. Bucht

  2. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

    J. Nilsson & G. Hallmans

  3. Department of Surgical and Perioperative Science, Umeå University, Umeå, Sweden

    U. Björnstig & O. Svensson

  4. Department of Pharmacology and Clinical Neuroscience, Umeå University, SE-901 87, Umeå, Sweden

    U. Pettersson

Authors
  1. U. Englund
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  2. P. Nordström
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  3. J. Nilsson
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  4. G. Bucht
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  5. U. Björnstig
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  6. G. Hallmans
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  7. O. Svensson
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  8. U. Pettersson
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Corresponding author

Correspondence to U. Pettersson.

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Englund, U., Nordström, P., Nilsson, J. et al. Physical activity in middle-aged women and hip fracture risk: the UFO study. Osteoporos Int 22, 499–505 (2011). https://doi.org/10.1007/s00198-010-1234-1

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  • DOI: https://doi.org/10.1007/s00198-010-1234-1

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