Lifestyle factors and site-specific risk of hip fracture in community dwelling older women – a 13-year prospective population-based cohort study

• Main Authors: Määttä Mikko, Terho Erkki, Jokinen Heikki, Pulkkinen Pasi, Korpelainen Juha, Heikkinen Jorma, Keinänen-Kiukaanniemi Sirkka, Jämsä Timo, Korpelainen Raija
• Format: Article
• Language: English
• Published: BMC 2012-09-01
• Series: BMC Musculoskeletal Disorders
• Subjects: Fracture type; Cervical fracture; Trochanteric fracture; Mobility; Physical activity; Risk factors
• Online Access: http://www.biomedcentral.com/1471-2474/13/173

<p>Abstract</p> <p>Background</p> <p>Several risk factors are associated to hip fractures. It seems that different hip fracture types have different etiologies. In this study, we evaluated the lifestyle-related risk factors for cervical and trochanteric hip fractures in older women over a 13-year follow-up period.</p> <p>Methods</p> <p>The study design was a prospective, population-based study consisting of 1681 women (mean age 72 years). Seventy-three percent (n = 1222) participated in the baseline measurements, including medical history, leisure-time physical activity, smoking, and nutrition, along with body anthropometrics and functional mobility. Cox regression was used to identify the independent predictors of cervical and trochanteric hip fractures.</p> <p>Results</p> <p>During the follow-up, 49 cervical and 31 trochanteric fractures were recorded. The women with hip fractures were older, taller, and thinner than the women with no fractures (p < 0.05). Low functional mobility was an independent predictor of both cervical and trochanteric fractures (HR = 3.4, 95% CI 1.8-6.6, and HR = 5.3, 95% CI 2.5-11.4, respectively). Low baseline physical activity was associated with an increased risk of hip fracture, especially in the cervical region (HR = 2.5, 95% CI 1.3-4.9). A decrease in cervical fracture risk (p = 0.002) was observed with physically active individuals compared to their less active peers (categories: very low or low, moderate, and high). Moderate coffee consumption and hypertension decreased the risk of cervical fractures (HR = 0.4, 95% CI 0.2-0.8, for both), while smoking was a predisposing factor for trochanteric fractures (HR = 3.2, 95% CI 1.1-9.3).</p> <p>Conclusions</p> <p>Impaired functional mobility, physical inactivity, and low body mass may increase the risk for hip fractures with different effects at the cervical and trochanteric levels.</p>