TY - JOUR
T1 - Muscle Strength and Physical Performance Are Associated With Risk of Postfracture Mortality But Not Subsequent Fracture in Men
AU - Alajlouni, Dima A.
AU - Bliuc, Dana
AU - Tran, Thach S.
AU - Blank, Robert D.
AU - Cawthon, Peggy M.
AU - Ensrud, Kristine E.
AU - Lane, Nancy E.
AU - Orwoll, Eric S.
AU - Cauley, Jane A.
AU - Center, Jacqueline R.
N1 - Funding Information:
The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding through the National Institute on Aging (NIA) and the National Center for Advancing Translational Sciences (NCATS) under grant numbers R01 AG066671 and UL1 TR000128. JC is the recipient of an Australian Medical Research Futures Fund (MRFF) grant 1137462. DA is the recipient of an Australian Government Research Training Program (RTP) Scholarship. The funding bodies of this study had no role in the design of the study, data collection, analysis, results interpretation, writing the manuscript, or the decision to submit the manuscript for publication. All authors had full access to all the data in the study and had final responsibility for the decision to submit for publication. Authors’ roles: Conceptualization and design: DAA, JRC, DB, TST, and RB. Acquisition of data: PMC, KE, NL, JAC, and ESO. Data analysis: DAA, DB, and TST. Interpretation of results: DAA, DB, TST, JRC, and RB. Drafting the manuscript: DAA. Reviewing and editing: JRC, DB, TST, RB, PMC, KE, NL, JAC, and ESO. Approving the final version: JRC, DB, TST, RB, PMC, KE, NL, JAC, and ESO. Funding acquisition: PMC, ESO, KE, NL, JAC, and JRC. Supervision: JRC, DB, and TST. Open access publishing facilitated by University of New South Wales, as part of the Wiley - University of New South Wales agreement via the Council of Australian University Librarians.
Funding Information:
The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding through the National Institute on Aging (NIA) and the National Center for Advancing Translational Sciences (NCATS) under grant numbers R01 AG066671 and UL1 TR000128. JC is the recipient of an Australian Medical Research Futures Fund (MRFF) grant 1137462. DA is the recipient of an Australian Government Research Training Program (RTP) Scholarship. The funding bodies of this study had no role in the design of the study, data collection, analysis, results interpretation, writing the manuscript, or the decision to submit the manuscript for publication. All authors had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Publisher Copyright:
© 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
PY - 2022/8
Y1 - 2022/8
N2 - Muscle strength and physical performance are associated with incident fractures and mortality. However, their role in the risk of subsequent fracture and postfracture mortality is not clear. We assessed the association between muscle strength (grip strength) and performance (gait speed and chair stands time) and the risk of subsequent fracture and mortality in 830 men with low-trauma index fracture, who participated in the Osteoporotic Fractures in Men (MrOS) USA Study and had their index measurements assessed within 5 years prior to the index fracture. The annual decline in muscle strength and performance following index fracture, estimated using linear mixed-effects regression, was also examined in relation to mortality. The associations were assessed using Cox proportional hazards models adjusted for age, femoral neck bone mineral density (FN BMD), prior fractures, falls, body mass index (BMI), index fracture site, lifestyle factors, and comorbidities. Over a median follow-up of 3.7 (interquartile range [IQR], 1.3–8.1) years from index fracture to subsequent fracture, 201 (24%) men had a subsequent fracture and over 5.1 (IQR, 1.8–9.6) years to death, and 536 (65%) men died. Index measurements were not associated with subsequent fracture (hazard ratios [HRs] ranging from 0.97 to 1.07). However, they were associated with postfracture mortality. HR (95% confidence interval [CI]) per 1 standard deviation (1-SD) decrement in grip strength: HR 1.12 (95% CI, 1.01–1.25) and gait speed: HR 1.14 (95% CI, 1.02–1.27), and 1-SD increment in chair stands time: HR 1.08 (95% CI, 0.97–1.21). Greater annual declines in these measurements were associated with higher mortality risk, independent of the index values and other covariates. HR (95% CI) per 1-SD annual decrement in change in grip strength: HR 1.15 (95% CI, 1.01–1.33) and in gait speed: HR 1.38 (95% CI, 1.13–1.68), and 1-SD annual increment in chair stands time: HR 1.28 (95% CI, 1.07–1.54). Men who were unable to complete one or multiple tests had greater risk of postfracture mortality (24%–109%) compared to those performed all tests. It remains to be seen whether improvement in these modifiable factors can reduce postfracture mortality.
AB - Muscle strength and physical performance are associated with incident fractures and mortality. However, their role in the risk of subsequent fracture and postfracture mortality is not clear. We assessed the association between muscle strength (grip strength) and performance (gait speed and chair stands time) and the risk of subsequent fracture and mortality in 830 men with low-trauma index fracture, who participated in the Osteoporotic Fractures in Men (MrOS) USA Study and had their index measurements assessed within 5 years prior to the index fracture. The annual decline in muscle strength and performance following index fracture, estimated using linear mixed-effects regression, was also examined in relation to mortality. The associations were assessed using Cox proportional hazards models adjusted for age, femoral neck bone mineral density (FN BMD), prior fractures, falls, body mass index (BMI), index fracture site, lifestyle factors, and comorbidities. Over a median follow-up of 3.7 (interquartile range [IQR], 1.3–8.1) years from index fracture to subsequent fracture, 201 (24%) men had a subsequent fracture and over 5.1 (IQR, 1.8–9.6) years to death, and 536 (65%) men died. Index measurements were not associated with subsequent fracture (hazard ratios [HRs] ranging from 0.97 to 1.07). However, they were associated with postfracture mortality. HR (95% confidence interval [CI]) per 1 standard deviation (1-SD) decrement in grip strength: HR 1.12 (95% CI, 1.01–1.25) and gait speed: HR 1.14 (95% CI, 1.02–1.27), and 1-SD increment in chair stands time: HR 1.08 (95% CI, 0.97–1.21). Greater annual declines in these measurements were associated with higher mortality risk, independent of the index values and other covariates. HR (95% CI) per 1-SD annual decrement in change in grip strength: HR 1.15 (95% CI, 1.01–1.33) and in gait speed: HR 1.38 (95% CI, 1.13–1.68), and 1-SD annual increment in chair stands time: HR 1.28 (95% CI, 1.07–1.54). Men who were unable to complete one or multiple tests had greater risk of postfracture mortality (24%–109%) compared to those performed all tests. It remains to be seen whether improvement in these modifiable factors can reduce postfracture mortality.
KW - AGING
KW - FRACTURE PREVENTION
KW - FRACTURE RISK ASSESSMENT SCREENING
KW - GENERAL POPULATION STUDIES
KW - MUSCLE STRENGTH
KW - PHYSICAL PERFORMANCE
KW - POST-FRACTURE MORTALITY
KW - SARCOPENIA
KW - SUBSEQUENT FRACTURE
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U2 - 10.1002/jbmr.4619
DO - 10.1002/jbmr.4619
M3 - Article
C2 - 35689796
AN - SCOPUS:85133454587
SN - 0884-0431
VL - 37
SP - 1571
EP - 1579
JO - Journal of Bone and Mineral Research
JF - Journal of Bone and Mineral Research
IS - 8
ER -