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Physical Performance and Risk of Hip Fractures in Older Men
Authors:Peggy Mannen Cawthon  Robin L Fullman  Lynn Marshall  Dawn C Mackey  Howard A Fink  Jane A Cauley  Steven R Cummings  Eric S Orwoll  Kristine E Ensrud
Affiliation:1. Research Institute, California Pacific Medical Center, San Francisco, California, USA;2. Oregon Health and Science University, Portland, Oregon, USA;3. Center for Chronic Disease Outcomes Research, VA Medical Center, Minneapolis, Minnesota, USA;4. Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA;5. Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA;6. University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Abstract:
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 ≥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.
Keywords:epidemiology  hip fracture  strength  physical performance  walking
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