Changes in physical activity and risk of fracture: a Korean nationwide population-based cohort study

Sangsoo Han,Kyungdo Han,Hyunwoong Lim,Sungwoo Choi,Hae-Dong Jang,Bongmo Koo,Jae-Young Hong,Gi Deok Kim,Kyung Dae Min

doi:10.1038/s41598-020-73495-1

Abstract

Physical activity (PA) is one of the most important modifiable factors associated with fracture risk. However, the association between interval changes in PA and the risk of fracture remains unknown. We investigated the risk of fracture development according to interval changes in PA in middle aged and older individuals. In this nationwide cohort study of adults aged ≥ 40 years, more than 4.9 million individuals without fractures within the last year who underwent two consecutive national health screenings in Korea from 2009 to 2012 were identified. The risk of fracture between 2013 and 2016 according to interval changes in regular PA was prospectively analyzed. Compared to individuals with a continuous lack of PA, those with a decrease in PA (0.41/1000 person-years (PY) decrease in incidence rate (IR); adjusted hazard ratio (aHR) 0.975; 95% confidence interval (CI) 0.964–0.987), increase in PA (1.8/1000 PY decrease in IR; aHR 0.948; 95% CI 0.937–0.959), and continuous PA (3.58/1000 PY decrease in IR; aHR 0.888; 95% CI 0.875–0.901) had a significantly reduced risk of fracture. Interval changes in regular PA were associated with risk of fracture. Individuals who engaged in continuous regular PA exhibited the maximum protective benefit against fracture.

Highlights

Physical activity (PA) is one of the most important modifiable factors associated with fracture risk
More than half of patients with hip fractures are unable to return to their pre-fracture states, and the mortality rate rises to 33% within 1 year of fracture[3,4,5]
The incidence of fracture was highest in the continuous lack of PA group, which included participants who did not consistently exercise

Summary

Introduction

Physical activity (PA) is one of the most important modifiable factors associated with fracture risk. The association between interval changes in PA and the risk of fracture remains unknown. We investigated the risk of fracture development according to interval changes in PA in middle aged and older individuals. In this nationwide cohort study of adults aged ≥ 40 years, more than 4.9 million individuals without fractures within the last year who underwent two consecutive national health screenings in Korea from 2009 to 2012 were identified. Physical activity (PA) is one of the most important modifiable factors associated with fracture risk, along with alcohol intake and smoking[6]. The secondary aim was to identify differences in fracture incidence according to PA in different sex, age, and previous fracture history subgroups

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Conclusion