title: Recent decline in heavy outdoor work activity predicts occurrence of fractures among the home-dwelling elderly.
abstract: The contribution of reduced physical activity of a defined duration to the risk of fall-related fractures and serious soft tissue injuries is not known. We conducted a prospective population-based study among the home-dwelling elderly to examine the association between a recent decline in physical activity and the occurrence of fall-related fractures and soft tissue injuries. The study population consisted of representative sample of home-dwelling older adults who conducted heavy outdoor work activity at least once a week at baseline (n = 284; 136 men, 148 women) and among whom in 93 persons (33%) heavy outdoor work activity was found to have declined during the 2 1/2 years follow-up. Fall-related fractures (n = 24) and serious soft tissue injuries (n = 49) were recorded from the time of the follow-up examination until the end of a further follow-up period lasting 3 1/2 years on average. A decline in heavy outdoor work activity did not predict the occurrence of soft tissue injuries (Mantel-Cox 0.795, p = 0.373), but a greater proportion of those with a decline (n = 14, 15%) than of others (n = 10, 5%) suffered fractures (Mantel-Cox 10.231, p = 0.001). Other risk factors for fractures were female sex (p = 0.03), slow choice reaction time (p = 0.02) and dependency as regards at least one basic activity of daily living (p = 0.01). According to the Cox proportional hazard model, the adjusted hazard ratio of fracture as regards a decline in heavy outdoor work activity was 2.7 (95% CI 1.14-6.62). A recent decline in heavy outdoor work activity predicts the occurrence of fractures, but not the occurrence of serious soft tissue injuries. Early recognition of a decline in physical activity may help in prevention of fractures among the elderly.
authors.affiliation: Department of Public Health Science and General Practice, University of Oulu, Oulu University Hospital, Finland. Mika.Herala@Oulu.fi
authors.forename: M
authors.initials: M
authors.lastname: Herala
authors.forename: S L
authors.initials: SL
authors.lastname: Kivelä
authors.forename: R
authors.initials: R
authors.lastname: Honkanen
authors.forename: K
authors.initials: K
authors.lastname: Koski
authors.forename: P
authors.initials: P
authors.lastname: Laippala
authors.forename: H
authors.initials: H
authors.lastname: Luukinen
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008019:Life Style; D008297:Male; D005082:Physical Exertion; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D017695:Soft Tissue Injuries / Q000453:epidemiology