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Objective Measures of Physical Activity, Fractures and Falls: The Osteoporotic Fractures in Men Study
Author(s) -
Cauley Jane A.,
Harrison Stephanie L.,
Cawthon Peggy M.,
Ensrud Kristine E.,
Danielson Michelle E.,
Orwoll Eric,
Mackey Dawn C.
Publication year - 2013
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12326
Subject(s) - medicine , physical activity , physical therapy , poison control , injury prevention , osteoporosis , falls in older adults , human factors and ergonomics , gerontology , occupational safety and health , suicide prevention , physical medicine and rehabilitation , medical emergency , pathology
Objectives To determine the association between objectively measured physical activity ( PA ), fractures, and falls. Design Longitudinal cohort study. Setting Six U . S . clinical sites. Participants Two thousand seven hundred thirty‐one men with a mean age of 79. Measurements Total and active energy expenditure ( EE ) and minutes per day spent in sedentary and moderate intensity activities were measured for at least 5 days. Energy expended at a metabolic equivalent of greater than three was termed active EE . Incident nonspine fractures and falls were identified every 4 months. Results Seven hundred fifty‐nine (28.2%) men fell at least once over 12 months of follow‐up; 186 (6.8%) experienced one or more fractures over an average follow‐up of 3.5 ± 0.9 years. The association between PA and falling varied according to age ( P interaction = .02). Men younger than 80 with the lowest active EE had a lower risk of falling than men with the highest active EE (relative risk ( RR ) = 0.75; P trend = .08), whereas men aged 80 and older with the lowest active EE had a higher risk of falling than men with the highest active EE ( RR = 1.43, P trend = .09). In multivariate models including health status, men in the lowest quintile of active EE had a significantly higher risk of fracture (hazard ratio ( HR ) = 1.82, 95% confidence interval ( CI ) = 1.10–3.00, P trend = .04) than men in highest quintile. Men with <33 min/d of moderate activity had a 70% greater risk of fracture ( HR = 1.70, 95% CI = 1.03–2.80). Conclusion Age modifies the association between PA and falling. Interventions aimed at obtaining more than 30 minutes of moderate PA per day may reduce fractures, extending PA guidelines to the oldest old, the fastest‐growing proportion of those aged 65 and older.