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One leg standing time predicts fracture risk in older women independent of clinical risk factors and BMD

One leg standing time predicts fracture risk in older women independent of clinical risk factors and BMD
One leg standing time predicts fracture risk in older women independent of clinical risk factors and BMD

Summary: In women of ages 75–80 years, a low one leg standing time (OLST) was associated with an increased risk of incident fractures, independently of bone mineral density and clinical risk factors. OLST contributed substantially to fracture probability, indicating that the test should be considered when evaluating fracture risk in older women. Introduction: Physical function and risk of falls are important risk factors for fracture. A few previous studies have suggested that a one leg standing time (OLST) less than 10 s predicts fracture risk, but the impact of OLST, in addition to known clinical risk factors, for fracture probability is unknown. The aim of this study was to determine the independent contribution of OLST to fracture probability in older women. Methods: The Sahlgrenska University Hospital Prospective Evaluation of Risk of Bone Fractures (SUPERB) is a prospective population-based study of 3028 women 75–80 years old, recruited from the greater Gothenburg area in Sweden. At baseline, information on risk factors was collected using questionnaires, bone mineral density was measured with dual-energy X-ray absorptiometry (DXA), and OLST was performed. Results: During a median follow-up of 3.6 years (IQR 1.5 years), X-ray-verified incident fractures were identified using health records. OLST was available in 2405 women. OLST less than 10 s was associated with an increased risk for incident hip fracture (Hazard Ratio (HR) 3.02, 95% Confidence Interval (CI) [1.49–6.10]), major osteoporotic fracture (HR 95% CI 1.76 [1.34–1.46]), and nonvertebral fracture (HR 95% CI 1.61 [1.26–2.05]) in Cox regression analyses adjusted for age, height, and weight. Depending on BMD, the 4-year fracture probability increased by a factor of 1.3 to 1.5 in a 75-year-old woman with a low OLST (<10 s). Conclusion: A low OLST has a substantial impact on fracture probability and should be considered when evaluating fracture risk in older women.

Clinical risk factors and bone mineral density, Epidemiology, Fracture risk, Osteoporosis, The one leg standing test
0937-941X
Larsson, Berit A.M.
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Johansson, Lisa
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Mellstrom, D.
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Johansson, Helena
04f12338-4dd1-437b-b9bc-e0884130c215
Axelsson, Kristian F.
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Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Vandenput, Lisbeth
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McCloskey, E.
5211de37-303a-42f8-b24b-00c475264f78
Liu, E.
63b60e12-5d42-4f66-ba55-24da69557b35
Sundh, Daniel
7d3b2334-29a5-45b4-ae79-d3d8307719b5
Kanis, J A.
55c6bd2c-d653-48de-b4b9-29fe280fb00f
Lorentzon, M.
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Larsson, Berit A.M.
6cd2e1cf-94f0-4668-914d-64c9f7b773cc
Johansson, Lisa
54820beb-ecca-43fd-9208-283c2fef0f3d
Mellstrom, D.
43d24c2f-97e4-423a-acec-6a13b3d477d9
Johansson, Helena
04f12338-4dd1-437b-b9bc-e0884130c215
Axelsson, Kristian F.
1b319953-04ae-4f73-b221-dd56fd312993
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Vandenput, Lisbeth
51275083-bd2d-4d28-9b3b-f07c4d55aeb8
McCloskey, E.
5211de37-303a-42f8-b24b-00c475264f78
Liu, E.
63b60e12-5d42-4f66-ba55-24da69557b35
Sundh, Daniel
7d3b2334-29a5-45b4-ae79-d3d8307719b5
Kanis, J A.
55c6bd2c-d653-48de-b4b9-29fe280fb00f
Lorentzon, M.
11692e10-5916-4bb5-86c5-3ff9ccd77af6

Larsson, Berit A.M., Johansson, Lisa, Mellstrom, D., Johansson, Helena, Axelsson, Kristian F., Harvey, Nicholas, Vandenput, Lisbeth, McCloskey, E., Liu, E., Sundh, Daniel, Kanis, J A. and Lorentzon, M. (2021) One leg standing time predicts fracture risk in older women independent of clinical risk factors and BMD. Osteoporosis International. (doi:10.1007/s00198-021-06039-6).

Record type: Article

Abstract

Summary: In women of ages 75–80 years, a low one leg standing time (OLST) was associated with an increased risk of incident fractures, independently of bone mineral density and clinical risk factors. OLST contributed substantially to fracture probability, indicating that the test should be considered when evaluating fracture risk in older women. Introduction: Physical function and risk of falls are important risk factors for fracture. A few previous studies have suggested that a one leg standing time (OLST) less than 10 s predicts fracture risk, but the impact of OLST, in addition to known clinical risk factors, for fracture probability is unknown. The aim of this study was to determine the independent contribution of OLST to fracture probability in older women. Methods: The Sahlgrenska University Hospital Prospective Evaluation of Risk of Bone Fractures (SUPERB) is a prospective population-based study of 3028 women 75–80 years old, recruited from the greater Gothenburg area in Sweden. At baseline, information on risk factors was collected using questionnaires, bone mineral density was measured with dual-energy X-ray absorptiometry (DXA), and OLST was performed. Results: During a median follow-up of 3.6 years (IQR 1.5 years), X-ray-verified incident fractures were identified using health records. OLST was available in 2405 women. OLST less than 10 s was associated with an increased risk for incident hip fracture (Hazard Ratio (HR) 3.02, 95% Confidence Interval (CI) [1.49–6.10]), major osteoporotic fracture (HR 95% CI 1.76 [1.34–1.46]), and nonvertebral fracture (HR 95% CI 1.61 [1.26–2.05]) in Cox regression analyses adjusted for age, height, and weight. Depending on BMD, the 4-year fracture probability increased by a factor of 1.3 to 1.5 in a 75-year-old woman with a low OLST (<10 s). Conclusion: A low OLST has a substantial impact on fracture probability and should be considered when evaluating fracture risk in older women.

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Accepted/In Press date: 15 June 2021
e-pub ahead of print date: 8 September 2021
Published date: 8 September 2021
Additional Information: Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
Keywords: Clinical risk factors and bone mineral density, Epidemiology, Fracture risk, Osteoporosis, The one leg standing test

Identifiers

Local EPrints ID: 452006
URI: http://eprints.soton.ac.uk/id/eprint/452006
ISSN: 0937-941X
PURE UUID: ad66fa65-9ff3-4f50-bc2a-f3b31148971e
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

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Date deposited: 08 Nov 2021 17:32
Last modified: 17 Mar 2024 02:58

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Contributors

Author: Berit A.M. Larsson
Author: Lisa Johansson
Author: D. Mellstrom
Author: Helena Johansson
Author: Kristian F. Axelsson
Author: Nicholas Harvey ORCID iD
Author: Lisbeth Vandenput
Author: E. McCloskey
Author: E. Liu
Author: Daniel Sundh
Author: J A. Kanis
Author: M. Lorentzon

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