title: Lifestyle factors and site-specific risk of hip fracture in community dwelling older women--a 13-year prospective population-based cohort study.
abstract: BACKGROUND
  Several risk factors are associated to hip fractures. It seems that different hip fracture types have different etiologies. In this study, we evaluated the lifestyle-related risk factors for cervical and trochanteric hip fractures in older women over a 13-year follow-up period.
  
  
  METHODS
  The study design was a prospective, population-based study consisting of 1681 women (mean age 72 years). Seventy-three percent (n = 1222) participated in the baseline measurements, including medical history, leisure-time physical activity, smoking, and nutrition, along with body anthropometrics and functional mobility. Cox regression was used to identify the independent predictors of cervical and trochanteric hip fractures.
  
  
  RESULTS
  During the follow-up, 49 cervical and 31 trochanteric fractures were recorded. The women with hip fractures were older, taller, and thinner than the women with no fractures (p < 0.05). Low functional mobility was an independent predictor of both cervical and trochanteric fractures (HR = 3.4, 95% CI 1.8-6.6, and HR = 5.3, 95% CI 2.5-11.4, respectively). Low baseline physical activity was associated with an increased risk of hip fracture, especially in the cervical region (HR = 2.5, 95% CI 1.3-4.9). A decrease in cervical fracture risk (p = 0.002) was observed with physically active individuals compared to their less active peers (categories: very low or low, moderate, and high). Moderate coffee consumption and hypertension decreased the risk of cervical fractures (HR = 0.4, 95% CI 0.2-0.8, for both), while smoking was a predisposing factor for trochanteric fractures (HR = 3.2, 95% CI 1.1-9.3).
  
  
  CONCLUSIONS
  Impaired functional mobility, physical inactivity, and low body mass may increase the risk for hip fractures with different effects at the cervical and trochanteric levels.
authors.affiliation: Department of Medical Technology, University of Oulu, PO Box 5000, FI-90014, Oulu, Finland. mikko.j.maatta@oulu.fi
authors.forename: Mikko
authors.initials: M
authors.lastname: Määttä
authors.forename: Erkki
authors.initials: E
authors.lastname: Terho
authors.forename: Heikki
authors.initials: H
authors.lastname: Jokinen
authors.forename: Pasi
authors.initials: P
authors.lastname: Pulkkinen
authors.forename: Juha
authors.initials: J
authors.lastname: Korpelainen
authors.forename: Jorma
authors.initials: J
authors.lastname: Heikkinen
authors.forename: Sirkka
authors.initials: S
authors.lastname: Keinänen-Kiukaanniemi
authors.forename: Timo
authors.initials: T
authors.lastname: Jämsä
authors.forename: Raija
authors.initials: R
authors.lastname: Korpelainen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006620:Hip Fractures / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008019:Life Style; D051346:Mobility Limitation; D009043:Motor Activity / Q000502:physiology*; D011159:Population Surveillance / Q000379:methods*; D011446:Prospective Studies; D012307:Risk Factors