Impact of mild and moderate/severe vertebral fractures on physical activity: a prospective study of older women in the UK

• Published in: Osteoporosis international 2019-01, Vol.30 (1), p.155-166
• Main Authors: Al-Sari, U.A., Tobias, J.H., Clark, E.M.
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon - methods; Activities of Daily Living; Aged; Aged, 80 and over; Dual energy X-ray absorptiometry; Endocrinology; Exercise; Exercise - physiology; Female; Follow-Up Studies; Fractures; Health risk assessment; Humans; Medicine; Medicine & Public Health; Middle Aged; Older people; Original Article; Orthopedics; Osteoporotic Fractures - diagnostic imaging; Osteoporotic Fractures - physiopathology; Osteoporotic Fractures - rehabilitation; Physical activity; Prospective Studies; Radiography; Rheumatology; Self Report; Severity of Illness Index; Spinal Fractures - diagnostic imaging; Spinal Fractures - physiopathology; Spinal Fractures - rehabilitation; Vertebrae; Walking - physiology
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-018-4692-5

Summary Little is known about the long-term impact of vertebral fractures on physical activity. There is also uncertainty over the clinical significance of mild vertebral fracture. We showed that women with moderate/severe but not mild vertebral fracture do less walking duration and housework than those without fracture after 5.4 years of follow-up. Introduction Little is known about the long-term impact of vertebral fractures on physical activities. There is also uncertainty over the clinical significance of mild fracture. Therefore, the aim of this study was to evaluate the prospective association between vertebral fracture and future physical activity. Methods This is a 5-year prospective study of a mixed community and secondary care cohort of women aged > 50 from the UK. Vertebral fractures were identified at baseline on radiographs or DXA-based Vertebral Fracture Assessment by a Quantitative Morphometric approach and defined as moderate/severe (≥ 25% height decrease) or mild (20–24.9% height decrease). Physical activity data were collected 5.4 years later by self-completion questionnaires. Multivariable logistic regression was used to determine the association between presence of fracture and various physical activities while adjusting for potential confounders. Results Two hundred eighty-six women without, 58 with mild, and 69 with moderate/severe fracture were recruited. Those with mild and moderate/severe fracture were older than women without fracture and had more concomitant diseases at baseline. At 5.4 years follow-up, women with moderate/severe fracture self-reported shorter walking duration compared to those without fracture, even after adjusting for potential confounders (OR 2.96, 95%CI 1.11–7.88, P  = 0.030). No independent association was seen between the presence of mild fractures and reduced physical activity at follow-up. Conclusion This is the first study of older women from the UK that explored the prospective association between vertebral fracture and physical activity duration. Moderate/severe fractures were associated with reduced walking duration. Mild fractures had no impact on future physical ability.