title: Motor speed and lower extremity strength as predictors of fall-related bone fractures in elderly individuals.
abstract: OBJECTIVE
  The purpose of this prospective population-based study was to examine the combined effects of motor speed and knee extension strength on risk of fall-related bone fractures in elderly individuals over a 10-year period.
  
  
  METHODS
  Participants were 307 men and women aged 75 or 80 years at baseline, who visited the research laboratory at the University of Jyväskylä, Finland. Multi-choice motor speed tests and maximal isometric knee extension strength tests were carried out at baseline. Information on fractures was collected from hospital and health center records. The presence of impairment was defined as a score in the lowest tertile of sex- and age-stratified distribution of results in each test.
  
  
  RESULTS
  During the 10-year period, 93 participants had at least one fracture. In Cox proportional hazards models for motor speed and knee extension strength, the risk of fracture was almost double in the lowest vs the highest tertile of each test score. For those in the poorest speed and strength tertiles compared with the best speed and strength tertiles, the relative risk of fracture adjusted for age, sex and bone mineral density was 4.69 (95% confidence interval 1.72-12.81).
  
  
  CONCLUSIONS
  Increased risk of fracture was observed for those with either slow motor speed or poor lower extremity strength; however, a combination of these impairments increased the fracture risk significantly when compared with those with no impairments. A co-impairment approach may prove useful in gaining better understanding of the risk of fall-related bone fractures and the development of effective interventions.
authors.affiliation: Faculty of Education, Mie University, Kurima-machiya 1577, Tsu, Mie 514-8507, Japan. rshige@edu.mie-u.ac.jp
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Shigematsu
authors.forename: Taina
authors.initials: T
authors.lastname: Rantanen
authors.forename: Päivi
authors.initials: P
authors.lastname: Saari
authors.forename: Ritva
authors.initials: R
authors.lastname: Sakari-Rantala
authors.forename: Markku
authors.initials: M
authors.lastname: Kauppinen
authors.forename: Sarianna
authors.initials: S
authors.lastname: Sipilä
authors.forename: Eino
authors.initials: E
authors.lastname: Heikkinen
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise / Q000502:physiology*; D005260:Female; D050723:Fractures, Bone / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D007719:Knee Joint / Q000502:physiology; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D053580:Muscle Strength / Q000502:physiology*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000502:physiology*; D012307:Risk Factors