Gender- and age-group-specific associations between physical performance and bone mineral density, falls, and osteoporotic fractures in Koreans: the Chungju Metabolic Disease Cohort study

Abstract

Several factors increase the risk of fragility fracture, including low bone mineral density, falls, and poor physical performance. The associations among these factors have been investigated; however, most of the subjects of previous studies were either elderly men or elderly women, and the associations were controversial. The aim of this study was to evaluate the associations between physical performance and bone mineral density, and the history of falls and fractures, stratified by gender and age group. We analyzed 5368 subjects who were aged 50 years or older, including 1288 younger men (younger than 70 years), 1615 younger women (younger than 70 years), 1087 older men (70 years or older), and 1378 older women (70 years or older). We used the one-leg standing time (OLST) for assessing static balance and the timed up-and-go test (TUGT) for assessing dynamic balance. The subjects in the worst performance quartile for the OLST were more likely to have osteoporosis than those in the best performance quartile. Additionally, women who had experienced a fracture during the past 2 years were 1.68 times more likely to be in the worst performance quartile for the OLST than women without a previous fracture. Although the TUGT time was not associated with either the incidence of osteoporosis or the fracture history, the odds ratios for falling were 1.51 and 1.28 as the TUGT time increased by one standard deviation in younger men and younger women, respectively. The findings of the present study show that the OLST was associated with the incidence of osteoporosis and previous fracture and that the TUGT time was associated with the incidence of falling.

A systematic review of one-legged balance performance and falls risk in community-dwelling adults

“…Our database searches identified a total of 4,310 unique records. After the two-stage screening and additional papers identified via the reference list search, a total of 55 papers are included in the review (Andresen et al, 2006;Ansai et al, 2016;Arai et al, 2020;Beauchet et al, 2010;Bergland and Wyller, 2004;Blain et al, 2021;Bongue et al, 2011;Briggs et al, 1989;Buatois et al, 2006;Buatois et al, 2010;Cho and Kamen, 1998;Choy et al, 2008;Choy et al, 2007;Crenshaw et al, 2020;de Rekeneire et al, 2003;Delbaere et al, 2010;Depasquale and Toscano, 2009;Ek et al, 2019a;Ek et al, 2019b;El-Sobkey, 2011;Eto and Miyauchi, 2018;Gerdhem et al, 2005;Hasegawa et al, 2019;Hashidate et al, 2011;Heitmann et al, 1989;Ikegami et al, 2019;Jalali et al, 2015;Kwan et al, 2011;Lim et al, 2016;Lin et al, 2004b;MacRae et al, 1992;Mahoney et al, 2019;Moreira et al, 2017;Muir et al, 2010;Mulasso et al, 2017;Nevitt et al, 1989;Niam and Wee, 1999;Park et al, 2020;Porto et al, 2020;Rossat et al, 2010;…”

“…country, sex). For example, only five papers considered sex differences in their analyses (Blain et al, 2021;Ek et al, 2019a;Ek et al, 2019b;Lim et al, 2016;Vellas et al, 1998), despite conceivable sex differences indicated by better one-legged balance in men and greater prevalence of falls in women (Blodgett et al, 2020a;Cooper et al, 2011;Overstall et al, 1977;Peeters et al, 2018;Springer et al, 2007). Similarly, all but one study (Lim et al, 2016) examined associations across the full age range of their sample.…”

“…For example, only five papers considered sex differences in their analyses (Blain et al, 2021;Ek et al, 2019a;Ek et al, 2019b;Lim et al, 2016;Vellas et al, 1998), despite conceivable sex differences indicated by better one-legged balance in men and greater prevalence of falls in women (Blodgett et al, 2020a;Cooper et al, 2011;Overstall et al, 1977;Peeters et al, 2018;Springer et al, 2007). Similarly, all but one study (Lim et al, 2016) examined associations across the full age range of their sample. Although stratification of the standardised mean difference meta-analysis by mean age of sample (<75, ≥ 75 years) suggested that associations were stronger in younger adults, there remained substantial heterogeneity in the age range of each sample.…”

Prevalence of osteoporosis and incidence of related fractures in developed economies in the Asia Pacific region: a systematic review

“…Wider age group estimates largely ranged between 20 and 45% for women aged 40 + and 50 + [ 80 – 84 ]. Most estimates for men suggested a prevalence of 15% or lower [ 80 , 85 – 87 ], although some ranged from 20% to more than 40% for men aged 70 + [ 75 , 77 , 88 ]. The vast majority of fragility fracture incidence data suggested site-specific and combined rates below 500 per 100,000 person-years [ 37 , 38 , 89 – 91 ], although numerous estimates between 500 and 1000 per 100,000 and even higher were also found, especially for individuals aged 80 + [ 92 – 97 ].…”

Physical capability, physical activity, and their association with femoral bone mineral density in adults aged 40 years and older: The Tromsø study 2015–2016

“…The ability to stand on one leg over time is a predictor of hip fracture risk [25,26], and several studies have indicated that one-leg stance tests are associated with BMD [21][22][23]. Other physical capability tests, such as the Short Physical Performance Battery (SPPB) and Timed Up and Go (TUG), are often performed when assessing older people's physical capability, to measure the severity of sarcopenia [7] and to evaluate risk of falling [27][28][29]. However, few studies have investigated the association between these tests and BMD.…”