Impact of mild and moderate/severe vertebral fractures on physical activity: a prospective study of older women in the UK
- 215 Downloads
Little is known about the long-term impact of vertebral fractures on physical activity. There is also uncertainty over the clinical significance of mild vertebral fracture. We showed that women with moderate/severe but not mild vertebral fracture do less walking duration and housework than those without fracture after 5.4 years of follow-up.
Little is known about the long-term impact of vertebral fractures on physical activities. There is also uncertainty over the clinical significance of mild fracture. Therefore, the aim of this study was to evaluate the prospective association between vertebral fracture and future physical activity.
This is a 5-year prospective study of a mixed community and secondary care cohort of women aged > 50 from the UK. Vertebral fractures were identified at baseline on radiographs or DXA-based Vertebral Fracture Assessment by a Quantitative Morphometric approach and defined as moderate/severe (≥ 25% height decrease) or mild (20–24.9% height decrease). Physical activity data were collected 5.4 years later by self-completion questionnaires. Multivariable logistic regression was used to determine the association between presence of fracture and various physical activities while adjusting for potential confounders.
Two hundred eighty-six women without, 58 with mild, and 69 with moderate/severe fracture were recruited. Those with mild and moderate/severe fracture were older than women without fracture and had more concomitant diseases at baseline. At 5.4 years follow-up, women with moderate/severe fracture self-reported shorter walking duration compared to those without fracture, even after adjusting for potential confounders (OR 2.96, 95%CI 1.11–7.88, P = 0.030). No independent association was seen between the presence of mild fractures and reduced physical activity at follow-up.
This is the first study of older women from the UK that explored the prospective association between vertebral fracture and physical activity duration. Moderate/severe fractures were associated with reduced walking duration. Mild fractures had no impact on future physical ability.
KeywordsEpidemiology Physical activity Postmenopausal women Vertebral fracture
We thank all the research participants for their cooperation in this work.
Data collection and analysed data: UA. Contributed to writing of manuscript: UA and EC. Read and approved final manuscript: all authors.
The project was funded by an unrestricted education grant from Republic of Iraq Ministry of Higher Education and Scientific Research (MOHESR).
Compliance with ethical standards
Conflicts of interest
- 11.Silverman SL, Minshall ME, Shen W, Harper KD, Xie S, on behalf of the Health-Related Quality of Life Subgroup of the Multiple Outcomes of Raloxifene Evaluation Study (2001) The relationship of health-related quality of life to prevalent and incident vertebral fractures in postmenopausal women with osteoporosis: results from the Multiple Outcomes of Raloxifene Evaluation Study. Arthritis Rheum 44(11):2611–2619PubMedCrossRefGoogle Scholar
- 16.Clark EM, Gould V, Morrison L, Ades AE, Dieppe P, Tobias JH (2012) Randomized controlled trial of a primary care-based screening program to identify older women with prevalent osteoporotic vertebral fractures: Cohort for Skeletal Health in Bristol and Avon (COSHIBA). J Bone Miner Res 27(3):664–671PubMedCrossRefGoogle Scholar
- 17.Rosenkranz RR, Kolt GS, Berentson-Shaw J (2013) A review of enablers and barriers to physical activity participation among older people of New Zealand and international populations. Int Sports Med J 14:294–312Google Scholar
- 24.Samelson EJ, Christiansen BA, Demissie S, Broe KE, Zhou Y, Meng CA, Yu W, Cheng X, O’Donnell CJ, Hoffmann U, Genant HK, Kiel DP, Bouxsein ML (2011) Reliability of vertebral fracture assessment using multidetector CT lateral scout views: the Framingham Osteoporosis Study. Osteoporos Int 22(4):1123–1131PubMedCrossRefGoogle Scholar
- 25.Cawthon PM, Haslam J, Fullman R, Peters KW, Black D, Ensrud KE, Cummings SR, Orwoll ES, Barrett-Connor E, Marshall L, Steiger P, Schousboe JT, Osteoporotic Fractures in Men (MrOS) Research Group (2014) Methods and reliability of radiographic vertebral fracture detection in older men: the osteoporotic fractures in men study. Bone 67:152–155PubMedPubMedCentralCrossRefGoogle Scholar
- 26.Fleiss JL (1981) Statistical methods for rates and proportions, 2nd edn. Wiley, New York ISBN 0-471-26370-2Google Scholar
- 28.Jefferis BJ, Sartini C, Ash S, Lennon LT, Wannamethee SG, Whincup PH (2016) Validity of questionnaire-based assessment of sedentary behaviour and physical activity in a population-based cohort of older men; comparisons with objectively measured physical activity data. Int J Behav Nutr Phys Act 13:14PubMedPubMedCentralCrossRefGoogle Scholar
- 29.Elhakeem A, Hannam K, Deere KC, Hartley A, Clark EM, Moss C, Edwards MH, Dennison E, Gaysin T, Kuh D, Wong A, Cooper C, Cooper R, Tobias JH (2018) Physical activity producing low, but not medium or higher, vertical impacts is inversely related to BMI in older adults: findings from a multicohort study. J Gerontol A Biol Sci Med Sci 73(5):643–651PubMedCrossRefGoogle Scholar
- 34.Salaffi F, Cimmino MA, Malavolta N, Carotti M, di Matteo L, Scendoni P, Grassi W, Italian Multicentre Osteoporotic Fracture Study Group (2007) The burden of prevalent fractures on health-related quality of life in postmenopausal women with osteoporosis: the IMOF study. J Rheumatol 34(7):1551–1560PubMedGoogle Scholar
- 38.Nevitt MC, Cummings SR, Stone KL, Palermo L, Black DM, Bauer DC, Genant HK, Hochberg MC, Ensrud KE, Hillier TA, Cauley JA (2005) Risk factors for a first-incident radiographic vertebral fracture in women > or = 65 years of age: the study of osteoporotic fractures. J Bone Miner Res 20(1):131–140PubMedCrossRefGoogle Scholar
- 43.Suzuki N, Ogikubo O, Hansson T (2009) The prognosis for pain, disability, activities of daily living and quality of life after an acute osteoporotic vertebral body fracture: its relation to fracture level, type of fracture and grade of fracture deformation. Eur Spine J 18(1):77–88PubMedCrossRefGoogle Scholar