Lifestyle factors and site-specific risk of hip fracture in community dwelling older women – a 13-year prospective population-based cohort study

Abstract

BackgroundSeveral risk factors are associated to hip fractures. It seems that different hip fracture types have different etiologies. In this study, we evaluated the lifestyle-related risk factors for cervical and trochanteric hip fractures in older women over a 13-year follow-up period.MethodsThe study design was a prospective, population-based study consisting of 1681 women (mean age 72 years). Seventy-three percent (n = 1222) participated in the baseline measurements, including medical history, leisure-time physical activity, smoking, and nutrition, along with body anthropometrics and functional mobility. Cox regression was used to identify the independent predictors of cervical and trochanteric hip fractures.ResultsDuring the follow-up, 49 cervical and 31 trochanteric fractures were recorded. The women with hip fractures were older, taller, and thinner than the women with no fractures (p < 0.05). Low functional mobility was an independent predictor of both cervical and trochanteric fractures (HR = 3.4, 95% CI 1.8-6.6, and HR = 5.3, 95% CI 2.5-11.4, respectively). Low baseline physical activity was associated with an increased risk of hip fracture, especially in the cervical region (HR = 2.5, 95% CI 1.3-4.9). A decrease in cervical fracture risk (p = 0.002) was observed with physically active individuals compared to their less active peers (categories: very low or low, moderate, and high). Moderate coffee consumption and hypertension decreased the risk of cervical fractures (HR = 0.4, 95% CI 0.2-0.8, for both), while smoking was a predisposing factor for trochanteric fractures (HR = 3.2, 95% CI 1.1-9.3).ConclusionsImpaired functional mobility, physical inactivity, and low body mass may increase the risk for hip fractures with different effects at the cervical and trochanteric levels.

Association Between Physical Activity and Risk of Fracture

“…Of these, a few studies were excluded because of their case‐control or cross‐sectional design or because data were missing. After the evaluation, we included 22 studies in the meta‐analysis . Observers reached good agreement on which studies should be included (Cohen's unweighted κ = 0.92).…”

“…There were 22 cohort studies with 1,235,768 participants and 14,843 fractures, including 8874 hip, 690 wrist, and 927 vertebral fractures. The cohorts were from different countries (nine studies from the United States, 10 from Europe, two from Asia, and one from Australia). Eleven studies recruited male and female participants, three recruited only men, and another eight recruited only women .…”

“…However, considering other lifestyle factors, a regular and appropriate amount of physical activity is advocated as an efficient means of preventing osteoporosis and subsequent probabilities of fracture. Several prospective cohort studies have verified that physical activity may contribute to the prevention of fracture through various means . However, the results of these studies are inconsistent …”

Association between low-frequency ultrasound and hip fractures - comparison with DXA-based BMD

“…In the current study low V LF remained a significant risk factor for hip fracture when included in the lifestyle-related risk factor model observed in our previous study with the same population [9]. However, the lifestyle-related risk factors were collected at baseline whereas QUS measurements were made at eight years from baseline.…”

Life style risk factors for femoral neck fracture in Dr. Sardjito General Hospital, Yogyakarta

“…In line with this findings, subjects who had poor self reported health had higher risk for fracture, 8 times higher than those who reported good health, and for times higher than those who reported moderate health, a clear doses dependent association. 14,15…”