Physical Performance and Risk of Hip Fractures in Older Men

Research Institute, California Pacific Medical Center, San Francisco, California 94107-1762, USA.
Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research (Impact Factor: 6.83). 07/2008; 23(7):1037-44. DOI: 10.1359/jbmr.080227
Source: PubMed


The aim of these analyses was to describe the association between physical performance and risk of hip fractures in older men. Performance on five physical function exams (leg power, grip strength, usual walking pace, narrow walk balance test, and five repeated chair stands) was assessed in 5902 men >or=65 yr of age. Performance (time to complete or strength) was analyzed as quartiles, with an additional category for unable to complete the measure, in proportional hazards models. Follow-up averaged 5.3 yr; 77 incident hip fractures were confirmed by physician review of radiology reports. Poor physical performance was associated with an increased risk of hip fracture. In particular, repeated chair stand performance was strongly related to hip fracture risk. Men unable to complete this exam were much more likely to experience a hip fracture than men in the fastest quartile of this test (multivariate hazard ratio [MHR]: 8.15; 95% CI: 2.65, 25.03). Men with the worst performance (weakest/slowest quartile or unable) on at least three exams had an increased risk of hip fracture compared with men with higher functioning (MHR: 3.14, 95% CI: 1.46, 6.73). Nearly two thirds of the hip fractures (N = 49, 64%) occurred in men with poor performance on at least three exams. Poor physical function is independently associated with an increased risk of hip fracture in older men. The repeated chair stands exam should be considered in clinical settings for evaluation of hip fracture risk. Concurrent poor performance on multiple physical function exams is associated with an increased risk of hip fractures.

Download full-text


Available from: Robin L Fullman, Sep 30, 2015
20 Reads
  • Source
    • "Osteoporosis is a metabolic disorder which is characterized by deterioration of bone tissue and loss of bone mass with a consequent increased risk of fracture. It is due to decreased activities of osteoblasts and increased activities of osteoclasts [1]. In both sexes, estrogens and testosterones play a vital role in the pathophysiology of osteoporosis. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Oxidative stress and free radicals have been implicated in the pathogenesis of osteoporosis. Therefore, antioxidant compounds have the potential to be used in the prevention and treatment of the disease. In this study, we investigated the effects of virgin coconut oil (VCO) on bone microarchitecture in a postmenopausal osteoporosis rat model. VCO is a different form of coconut oil as it is rich with antioxidants. Three-month-old female rats were randomly grouped into baseline, sham-operated, ovariectomized control (Ovx), and ovariectomized rats fed with 8% VCO in their diet for six weeks (Ovx+VCO). Bone histomorphometry of the right femora was carried out at the end of the study. Rats supplemented with VCO had a significantly greater bone volume and trabecular number while trabecular separation was lower than the Ovx group. In conclusion, VCO was effective in maintaining bone structure and preventing bone loss in estrogen-deficient rat model.
    Evidence-based Complementary and Alternative Medicine 09/2012; 2012(3):237236. DOI:10.1155/2012/237236 · 1.88 Impact Factor
  • Source
    • "The side effects of such treatment include osteoporosis, [4,5] increased fracture risk, [6-8] poorer quality of life with decline in physical function, [9,10] fatigue, decline in muscle mass, increased fat mass, weight gain, [11,12] reduced psychosocial and cognitive functions [13,14]. Osteoporosis and physical function decline are of particular concern as these are factors that are closely related to risks of falls and fractures in older men [15-18]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Androgen deprivation therapy (ADT) is the mainstay therapy for men with prostate cancer. However, there are musculoskeletal side effects from ADT that increase the risk for osteoporosis and fracture, and can compromise the quality of life of these individuals. The objectives of this study are to determine the efficacy of a home-based walking exercise program in promoting bone health, physical function and quality of life in men with prostate cancer receiving ADT. A 12-month prospective, single-blinded, randomized controlled trial will be conducted to compare the Exercise Group with the Control Group. Sixty men with prostate cancer who will be starting ADT will be recruited and randomly assigned to one of the two groups: the Exercise Group will receive instructions in setting up an individualized 12-month home-based walking exercise program, while the Control Group will receive standard medical advice from the attending physician. A number of outcome measures will be used to assess bone health, physical function, and health-related quality of life. At baseline and 12 months, bone health will be assessed using dual-energy X-ray absorptiometry. At baseline and every 3 months up to 12 months, physical function will be evaluated using the Functional Assessment of Chronic Illness Therapy - Fatigue Scale, Activities-specific Balance Confidence Scale, Short Physical Performance Battery, and Six-Minute Walk Test; and health-related quality of life will be assessed using the Functional Assessment of Cancer Therapy Prostate Module and the Medical Outcomes Study 12-item Short Form Health Survey Version 2. A mixed multiple analysis of variance will be used to analyze the data. Musculoskeletal health management remains a challenge in men with prostate cancer receiving ADT. This study addresses this issue by designing a simple and accessible home-based walking exercise program that will potentially have significant impact on reducing the risk of fracture, promoting physical function, and ultimately improving the health-related quality of life in men with prostate cancer receiving ADT. NCT00834392.
    BMC Cancer 03/2012; 12(1):103. DOI:10.1186/1471-2407-12-103 · 3.36 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: About one in three osteoporotic fractures occur in men, and the consequences of fractures are more severe in men. However, only too few men at high risk of fracture are detected and treated. There is no consensus definition of osteoporosis in men based on bone mineral density (BMD), and therapeutic decisions should be based on absolute fracture risk as estimated from age, BMD, fracture history, and additional clinical risk factors. In men, secondary osteoporosis deserves particular attention. Genetically determined alterations of bone mass acquisition during growth are involved in idiopathic osteoporosis in the young, whereas senile osteoporosis involves progressive bone loss throughout adult life. Estradiol appears to be the predominant sex steroid involved in regulation of bone maturation and metabolism. The evidence base for the long-term efficacy and safety of therapies for osteoporosis in men, including the bone-active agents (i.e. bisphosphonates and teriparatide), is limited, so that they should be applied with discernment based on clinical judgement and careful estimation of fracture risk.
    Best Practice & Research: Clinical Endocrinology & Metabolism 11/2008; 22(5):787-812. DOI:10.1016/j.beem.2008.09.005 · 4.60 Impact Factor
Show more