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Later age at onset of independent walking is associated with lower bone strength at fracture-prone sites in older men

Later age at onset of independent walking is associated with lower bone strength at fracture-prone sites in older men
Later age at onset of independent walking is associated with lower bone strength at fracture-prone sites in older men
Later age at onset of independent walking is associated with lower leg bone strength in childhood and adolescence. However, it is unknown whether these associations persist into older age or whether they are evident at axial (central) or upper limb sites. Therefore, we examined walking age obtained at age 2 years and bone outcomes obtained by dual‐energy X‐ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) scans at ages 60 to 64 years in a nationally representative cohort study of British people, the MRC National Survey of Health and Development. It was hypothesized that later walking age would be associated with lower bone strength at all sites. Later independent walking age was associated with lower height‐adjusted hip (standardized regression coefficients with 95% confidence interval [CI] –0.179 [–0.251 to –0.107]), spine (–0.157 [–0.232 to –0.082]), and distal radius (–0.159 [–0.245 to –0.073]) bone mineral content (BMC, indicating bone compressive strength) in men (all p < 0.001). Adjustment for covariates partially attenuated these associations, primarily because of lower lean mass and adolescent sporting ability in later walkers. These associations were also evident for a number of hip geometric parameters (including cross‐sectional moment of inertia [CSMI], indicating bone bending/torsional strength) assessed by hip structural analysis (HSA) from DXA scans. Similar height‐adjusted associations were also observed in women for several hip, spine, and upper limb outcomes, although adjustment for fat or lean mass led to complete attenuation for most outcomes, with the exception of femoral shaft CSMI and spine bone area (BA). In conclusion, later independent walking age appears to have a lifelong association with bone strength across multiple skeletal sites in men. These effects may result from direct effects of early life loading on bone growth and mediation by adult body composition. Results suggest that late walking age may represent a novel risk factor for subsequent low bone strength. Existing interventions effective in hastening walking age may have positive effects on bone across life.
0884-0431
1209-1217
Ireland, A.
ed532b35-bd37-4dc1-af85-90dc13e6296d
Rittweger, J.
762358f9-7486-499d-864d-3237239a1b28
Adams, J.E.
a33a47cb-53dd-4f17-aebd-9dfff2485f97
Ward, K.A.
39bd4db1-c948-4e32-930e-7bec8deb54c7
Kuh, D.
6c5d95a4-433d-4895-bd95-86a7d5fe76a5
Cooper, R.
6cd7b578-a1fa-4511-bc7d-9addc4baf372
Ireland, A.
ed532b35-bd37-4dc1-af85-90dc13e6296d
Rittweger, J.
762358f9-7486-499d-864d-3237239a1b28
Adams, J.E.
a33a47cb-53dd-4f17-aebd-9dfff2485f97
Ward, K.A.
39bd4db1-c948-4e32-930e-7bec8deb54c7
Kuh, D.
6c5d95a4-433d-4895-bd95-86a7d5fe76a5
Cooper, R.
6cd7b578-a1fa-4511-bc7d-9addc4baf372

Ireland, A., Rittweger, J., Adams, J.E., Ward, K.A., Kuh, D. and Cooper, R. (2017) Later age at onset of independent walking is associated with lower bone strength at fracture-prone sites in older men. Journal of Bone and Mineral Research, 32 (6), 1209-1217. (doi:10.1002/jbmr.3099).

Record type: Article

Abstract

Later age at onset of independent walking is associated with lower leg bone strength in childhood and adolescence. However, it is unknown whether these associations persist into older age or whether they are evident at axial (central) or upper limb sites. Therefore, we examined walking age obtained at age 2 years and bone outcomes obtained by dual‐energy X‐ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) scans at ages 60 to 64 years in a nationally representative cohort study of British people, the MRC National Survey of Health and Development. It was hypothesized that later walking age would be associated with lower bone strength at all sites. Later independent walking age was associated with lower height‐adjusted hip (standardized regression coefficients with 95% confidence interval [CI] –0.179 [–0.251 to –0.107]), spine (–0.157 [–0.232 to –0.082]), and distal radius (–0.159 [–0.245 to –0.073]) bone mineral content (BMC, indicating bone compressive strength) in men (all p < 0.001). Adjustment for covariates partially attenuated these associations, primarily because of lower lean mass and adolescent sporting ability in later walkers. These associations were also evident for a number of hip geometric parameters (including cross‐sectional moment of inertia [CSMI], indicating bone bending/torsional strength) assessed by hip structural analysis (HSA) from DXA scans. Similar height‐adjusted associations were also observed in women for several hip, spine, and upper limb outcomes, although adjustment for fat or lean mass led to complete attenuation for most outcomes, with the exception of femoral shaft CSMI and spine bone area (BA). In conclusion, later independent walking age appears to have a lifelong association with bone strength across multiple skeletal sites in men. These effects may result from direct effects of early life loading on bone growth and mediation by adult body composition. Results suggest that late walking age may represent a novel risk factor for subsequent low bone strength. Existing interventions effective in hastening walking age may have positive effects on bone across life.

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Accepted/In Press date: 27 January 2017
e-pub ahead of print date: 9 February 2017
Published date: June 2017
Organisations: MRC Life-Course Epidemiology Unit

Identifiers

Local EPrints ID: 405334
URI: http://eprints.soton.ac.uk/id/eprint/405334
ISSN: 0884-0431
PURE UUID: c383400b-e033-4980-953c-7c0cb2ebf4e3
ORCID for K.A. Ward: ORCID iD orcid.org/0000-0001-7034-6750

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Date deposited: 02 Feb 2017 16:48
Last modified: 22 Nov 2021 05:07

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Contributors

Author: A. Ireland
Author: J. Rittweger
Author: J.E. Adams
Author: K.A. Ward ORCID iD
Author: D. Kuh
Author: R. Cooper

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