Abstract
ObjectiveHip fracture incidence is increasing with rapid aging of the population and regular physical activity (RPA) is an important modifiable protective factor for fracture. However, the association between the risk of hip fractures and changes in RPA status in the general population remains unknown. Thus, we explore the association between the risk of hip fracture and changes in RPA status.MethodsWe studied 4,984,144 individuals without fractures within a year whose data were registered in the Korean National Health Insurance Service database. Baseline physical activity level was assessed using a standardized self-reported questionnaire during two consecutive national health screening surveys performed in Korea from 2009 to 2012. The risk of hip fracture between 2013 and 2016 according to change in RPA was prospectively analyzed. Participants were divided into those who were always inactive, became inactive, became active, and were always active.ResultsCompared to participants who were always inactive, those who became inactive exhibited a 0.12/1,000 person-years (PY) reduction in hip fracture incidence rate (IR) [aHR: 0.865; 95% confidence interval (CI): 0.824–0.908]. Participants who became active, and those who were always active, exhibited a 0.24/1,000 PY reduction in IR (aHR: 0.827; 95% CI: 0.787–0.870) and a 0.39/1,000 PY reduction in IR (aHR: 0.691; 95% CI: 0.646–0.740), respectively.ConclusionChanges in RPA status were associated with the risk of hip fracture; consistent RPA was related to the maximum benefit for risk reduction in the general population.
Highlights
A hip fracture is a serious fracture for which the risk increases with age
After multivariable adjustment (Model 5, adjusted for age, sex, smoking status, alcohol consumption, household income, BMI, diabetes, prior fracture and region), the regular physical activity (RPA) group exhibited a significantly reduced risk of hip fracture, compared to the non-RPA group (0.29/1,000 PY reduction in incidence rate (IR); adjusted hazard ratios (HRs) [aHR]: 0.795; 95% confidence interval (CI): 0.763–0.829)
We found that always active participants aged 65 years exhibited a much lower risk of hip fracture (HR: 0.63)
Summary
A hip fracture is a serious fracture for which the risk increases with age. Patients with hip fracture may be unable to engage in economic activity prior to recovery. It is important to prevent hip fractures by enhancing bone strength or reducing the risk of falls. Risk factors for hip fracture include a poor diet low in calcium, cigarette smoking, physical inactivity, poor housing, and heavy alcohol use [5]. Of these risk factors, physical inactivity is an important modifiable factor. The prevalence of physical inactivity is high; only 16% of individuals aged 65 years in the United States are physically active, as determined by questionnaires based on recognized aerobic and muscle-strengthening guidelines [6]. Fewer than one-third of European adults engage in at least 150 min of physical activity weekly [6]
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