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- Title
Trajectories of Lower Extremity Physical Performance: Effects on Fractures and Mortality in Older Women.
- Authors
Barbour, Kamil E.; Li-Yung Lui; McCulloch, Charles E.; Ensrud, Kristine E.; Cawthon, Peggy M.; Yaffe, Kristine; Barnes, Deborah E.; Fredman, Lisa; Newman, Anne B.; Cummings, Steven R.; Cauley, Jane A.; Lui, Li-Yung; Study of Osteoporotic Fractures
- Abstract
<bold>Background: </bold>Prior studies have only considered one measurement of physical performance in its relationship to fractures and mortality. A single measurement is susceptible to large within-person changes over time, and thus, may not capture the true association between physical performance and the outcomes of interest.<bold>Methods: </bold>Using data from the Study of Osteoporotic Fractures, we followed 7,015 women enrolled prior to age 80 years who had outcome information beyond this age. Trajectories of walking speed (m/s) and chair stand speed (stands/s) were estimated up to the last visit prior to age 80 years using mixed-effects linear regression. Physical performance at age 80 (PF_age80) was assessed at the last visit prior to age 80 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression and multivariate models adjusted for all other covariates.<bold>Results: </bold>Greatest walking speed decline and chair stand speed decline were both associated with higher risk of hip fracture (HR: 1.28; 95% CI: 1.03, 1.58 and HR: 1.26; 95% CI: 1.03, 1.54, respectively), but not nonspine fractures. Greatest walking speed decline and chair stand speed decline were both associated with a significant 29% (95% CI: 17-42%) and 27% (95% CI: 15-39%) increased risk of mortality, respectively.<bold>Conclusions: </bold>Greatest declines in walking speed and chair stand speed were both associated with an increased risk of hip fracture and mortality independent of PF_age80 and other important confounders. Both physical performance change and the single physical performance measurement should be considered in the etiology of hip fracture and mortality.
- Subjects
UNITED States; BONE fractures; CONFIDENCE intervals; META-analysis; PROPORTIONAL hazards models; REGRESSION analysis; GERIATRIC assessment; COMPARATIVE studies; HIP joint injuries; LEG; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; MORTALITY; RESEARCH; RESEARCH funding; SYMPTOMS; EVALUATION research; CONFOUNDING variables
- Publication
Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 2016, Vol 71, Issue 12, p1609
- ISSN
1079-5006
- Publication type
journal article
- DOI
10.1093/gerona/glw071