Leisure time physical activity and risk of non-vertebral fracture in men and women aged 55 years and older: the Tromsø Study

Abstract

Although the positive association between physical activity and bone mineral density (BMD) is well established, few epidemiological studies have investigated the long-term associations between physical activity during adulthood and BMD later in life. The aim of this prospective, population-based study was to examine the association between leisure time physical activity in adulthood and areal BMD (aBMD) later in life. We examined 1,766 women and 1,451 men aged 20-54 years at baseline who were followed up 22 years later, as part of a population-based study in Norway. Leisure time physical activity was assessed by questionnaire at baseline and followup. aBMD was measured at the hip and forearm at follow-up, using X-ray absorptiometry. The association between aBMD and physical activity was analyzed using general linear models. We observed a positive linear trend in aBMD across physical activity levels in both women and men, after adjustments for baseline age, height, weight, and smoking status (P < 0.05). The relationship between aBMD and leisure time physical activity was consistent over different sites of the hip (total hip, femoral neck and trochanter area) and forearm (distal and ultradistal area).In a subsample of 2436 men and women under 70 years of age, those who where sedentary at both baseline and follow-up (6%) had lower aBMD than those who were moderately active or active at both baseline and follow-up (71%) (P ≤ 0.01). This study suggests that leisure time physical activity in adulthood is associated with higher aBMD and reduced risk of osteoporosis later in life.

Too Fit To Fracture: exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture

“…To address the question about the effect of exercise on pre-specified outcomes for individuals with osteoporosis, recent meta-analyses were identified [6][7][8][9]12]. Because sufficiently powered randomized controlled trials had not been conducted, a 2008 meta-analysis of observational studies and more recent observational studies examining the relationship between fractures and exercise were identified [13][14][15][16][17][18][19][20][21][22][23][24][25] via literature search of OVID, EMBASE, and CINAHL, performed by a librarian using search terms related to exercise, physical activity, and fractures. To address the question about the effect of exercise on pre-specified outcomes for individuals with a history of vertebral fracture, a Cochrane Collaboration systematic review that synthesized all randomized controlled trials of exercise in individuals with osteoporotic vertebral fractures was used [10].…”

“…The finding that higher physical activity may not reduce the risk of fractures other than hip fractures [20,22] or may be associated with an increased risk of wrist fractures has been reported in several studies [13,17]. Rikkonen et al [17] reported that being in the highest quintile of physical activity participation was associated with an increased risk of wrist fractures, with hazard ratio (HR) of 1.4 [95 % CI, 1.14-1.69], happening more often in winter.…”

Too Fit To Fracture: a consensus on future research priorities in osteoporosis and exercise

“…Exercise may have important effects on bone strength or fracture risk that are not measureable with BMD scans [4]. Populationbased studies or long-term follow-up studies of RCTs examining the effect of exercise with fracture as an outcome have point estimates that suggest potential fracture risk reduction, but they are subject to bias or are underpowered, and a few suggest that the risk of certain types of fracture may be slightly increased [3,[5][6][7][8][9][10][11][12][13][14][15]. There is good evidence that exercise can prevent falls in at-risk older adults [16,17], which could indirectly prevent fractures; some researchers suggest that fall prevention, and not changes in BMD, should be the therapeutic target [18].…”

Investigating the Outcomes of a Physical Activity Program offered to Older Adults in South Florida and Understanding the Correlates of Completion

“…Similar findings have been reported by other researchers (CDC, 2010(CDC, , 2011e, 2013; National Institute on Aging and the National Library of Medicine, 2012). Maintaining a healthy life style helps better management of diabetes mellitus, improves sleep quality, lowers risk of fractures, reduces chances of obesity, and lowers risk of cancers (CDC, 2010b(CDC, , 2011f, 2013Colberg et al, 2010;Michaëlsson et al, 2007;Morseth et al, 2012;National Cancer Institute, 2009;Yang, Ho, Chen, & Chien, 2012). In addition, physical activity has been found to alleviate the symptoms associated with inflammatory disorders of joints and associated conditions such as arthritis, gout, spondylitis, osteomyelitis and other inflammatory disorders of joints (CDC, 2010b(CDC, , 2011a(CDC, , 2013cShih, Hootman, Kruger, & Helmick, 2006;Stewart, 2005).…”

“…Balance and strength training exercises through full range of motions in older adults allow improving flexibility, gait, and restores balance, which decreases the likelihood and severity of falls and related complications including fractures CDC, 2010bCDC, , 2011f, 2013cMichaelsson et al, 2007;Morseth et al, 2012;Neid & Franklin, 2002a). Further, physical activity promotes circulation that allows reducing complications of immobility and sedentary behaviors in older adults such as heart disease, deep vein thrombosis, edema, hypertension, contractures, pressure sores, and severe constipation (CDC, 2010bConti, Russomanno, Corbi, & Filippelli, 2012;Neid & Franklin, 2002a;.…”