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

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.

Metadata

Item Type:	Article
Authors/Creators:	Larsson, B.A.M. Johansson, L. Mellström, D. Johansson, H. Axelsson, K.F. Harvey, N. Vandenput, L. McCloskey, E. https://orcid.org/0000-0003-0177-8140 Liu, E. Sundh, D. Kanis, J.A. Lorentzon, M.
Copyright, Publisher and Additional Information:	© 2021 The Author(s). This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.
Keywords:	Clinical risk factors and bone mineral density; Epidemiology; Fracture risk; Osteoporosis; The one leg standing test
Dates:	Published: January 2022 Published (online): 8 September 2021 Accepted: 15 June 2021
Institution:	The University of Sheffield
Academic Units:	The University of Sheffield > Sheffield Teaching Hospitals
Depositing User:	Symplectic Sheffield
Date Deposited:	24 Feb 2022 12:56
Last Modified:	25 Feb 2022 08:55
Status:	Published
Publisher:	Springer Nature
Refereed:	Yes
Identification Number:	10.1007/s00198-021-06039-6
Open Archives Initiative ID (OAI ID):	oai:eprints.whiterose.ac.uk:183912

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

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