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

• Published in: Osteoporosis international 2022-01, Vol.33 (1), p.185-194
• Main Authors: Larsson, B.A.M., Johansson, L., Mellström, D., Johansson, H., Axelsson, K.F., Harvey, N., Vandenput, L., McCloskey, E., Liu, E., Sundh, D., Kanis, J.A., Lorentzon, M.
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon; adults; Aged; Aged, 80 and over; balance; Bone Density; Bone mineral density; Clinical risk factors and bone mineral density; Dual energy X-ray absorptiometry; elderly women; Endocrinology; Endocrinology & Metabolism; Epidemiology; falls; Female; Fracture; Fractures; functional status; health; Health risks; Health Sciences; Hip Fractures; hip-fracture; Humans; Hälsovetenskaper; Leg; Medicine; Medicine & Public Health; mortality; Older people; Original; Original Article; Orthopedics; Osteoporosis; osteoporotic fractures; Osteoporotic Fractures - epidemiology; Osteoporotic Fractures - etiology; population; Population studies; Rheumatology; risk; Risk Factors; The one leg standing test
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-021-06039-6

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 (