The Relation Between Previous Fractures and Physical Performance in Elderly Women

Abstract

Gerdhem P, Ringsberg KA, Åkesson K. The relation between previous fractures and physical performance in elderly women. Objective To examine the association between previous fracture and different aspects of physical performance. Design Population-based retrospective study. Setting Orthopaedic research department. Participants Randomly selected women (N=1044), all 75 years old and participants of the Malmö Osteoporosis Prospective Risk Assessment study. Interventions Not applicable. Main Outcome Measures Type of and time since any previous fracture event were compared with results of tests on physical performance function (Romberg test, computerized sway test, gait speed, questionnaire) at the age of 75. Results Women with no previous fractures (n=505) had a better median Romberg balance of 94 seconds (interquartile range [IQR], 75–118s) than women with 1, 2, or 3 or more fractures, who had a median balance of 88 seconds (IQR, 71–111s), 85 seconds (IQR, 68–107s), and 81 seconds (IQR, 65–109s), respectively (Kruskal-Wallis analysis of variance, P=.002). Balance was inferior in women who had sustained a previous fracture between the ages of 65 and 75 years compared with women with no previous fractures or fractures before the age of 65 years. Gait speed and questions on tendency to fall followed the same pattern. The computerized sway test could not differ between women with and without previous fractures. Conclusions Poor physical performance is associated with previous fractures. Inferior physical performance may exist up to 10 years after a fracture.