Physical activity and the risk of hip fracture in the elderly: a prospective cohort study

Ylva Trolle Lagerros,Rino Bellocco,Karl Michaëlsson,Hans-Olov Adami,Weimin Ye,Essi Hantikainen

doi:10.1007/s10654-017-0312-5

Abstract

Physical activity has been inversely associated with the risk of hip fracture, however, few studies have been conducted on the contributions from different domains of physical activity. This study was performed to investigate the association between daily household activities, leisure time physical activity, work-related physical activity and total physical activity during a 24-h period, and the risk of hip fracture. In the Swedish National March Cohort we followed 23,881 men and women aged of 50 and over from 1997 until 2010. Information on domain-specific physical activity was collected at baseline using a questionnaire. We fitted separate multivariable adjusted Cox proportional hazard models to each domain to obtain hazard ratios (HRs) with 95% confidence intervals (CIs). Each model was mutually adjusted for the other domains of physical activity. During a mean follow-up period of 12.2 years we identified 824 incidents of hip fracture. Subjects who spent less than 1 h per week engaged in daily household activities had an 85% higher risk of hip fracture than subjects spending ≥6 h per week carrying out daily household activities (HR 1.85; 95% CI 1.01–3.38). Subjects engaged in leisure time physical activities for >3.1 MET-h/day had a 24% lower risk of hip fracture (HR 0.76; 95% CI 0.59–0.98) than subjects spending <1.1 MET-h/day performing such activities. No association was found between hip fracture and work-related or total physical activity. We conclude that daily household activities and leisure time physical activity may independently decrease the risk of hip fracture in those aged 50 and over.

Highlights

Hip fracture is a major cause of hospitalization, impaired functional status and premature death among older adults
An inverse association has been found between physical activity and the risk of hip fracture in several observational cohort studies focusing on exercise and leisure time physical activity [14,15,16]
Subjects who were active more than, or equal to 6 h per week had a lower BMI, smoked to a lesser degree, had a higher dietary calcium intake, a higher consumption of vitamin and mineral supplements, were more likely to be retired, and spent more time engaged in leisure time physical activities

Summary

Introduction

Hip fracture is a major cause of hospitalization, impaired functional status and premature death among older adults. An increasing proportion of the population has a sedentary lifestyle [2], which may lead to an increase in the incidence of hip fracture [3]. An inverse association has been found between physical activity and the risk of hip fracture in several observational cohort studies focusing on exercise and leisure time physical activity [14,15,16]. The relative contributions of different domains of physical activity, i.e., daily household activities, leisure time physical activity, workrelated physical activity and total physical activity, to the reduction in the risk of hip fracture have not been widely studied. We investigated the possible associations between these different domains of physical activity and the risk of hip fracture in a large prospective study, with a more comprehensive assessment of physical activity than in most previous epidemiological studies

Subjects and methods

Results

Discussion

Compliance with ethical standards