MID-LIFE LEISURE-TIME PHYSICAL ACTIVITY IS ASSOCIATED WITH LOWER HIP FRACTURE RISK IN UK BIOBANK
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Leisure time physical activity (LTPA) in mid-life may have beneficial effects on risk factors for hip fracture in later life. Conversely, physical activity may increase fracture risk through risk of injury, and the optimal amount of physical activity for reducing hip fracture risk remains unclear. We explored the associations between volume and intensity of LTPA in mid-life, and subsequent risk of hip fracture ascertained from linked health data. This prospective observational study used middle aged adults aged 40-65 years from UK Biobank. LTPA volume (LTPAv) was derived from self-reported walking, moderate and vigorous activity at baseline (2006-2010). Cox proportional hazard and Fine-Gray sub-distribution models were used to estimate the association between activity and hip fracture, which was sex-stratified. From 324,284 participants with complete data 53% were female and mean age at baseline was 54.5 (SD 7.3). Across 16 years of follow-up there were 2,674 hip fractures. In terms of LTPA volume, the lowest risk of hip fracture occurred in quintile 3 for women (HR 0.78, 95% CI 0.67–0.91), and men (HR 0.74, 95% CI 0.60–0.90), relating to approximately one hour/day of leisure time physical activity. When activity intensities were examined separately, the lowest estimated hazards were observed for vigorous activity, at quintile 4 in women (HR 0.65, 95% CI 0.55–0.76) and quintile 3 in men (HR 0.64, 95% CI 0.52–0.79), corresponding to approximately 60–90 minutes of vigorous activity per week. In conclusion, moderately high volumes of mid-life physical activity, particularly vigorous activity, were related to lower risk of subsequent hip fracture, but these relationships appear to attenuate at higher volumes.
Lay Summary
It is not clear whether being active in mid-life, aged 40-65 years, reduces your risk of having a hip fracture in older age. We used data from 324,284 people from the UK Biobank, a long running health study, to understand this better. We found that people who were more active had a lower risk of hip fracture. Risk was lowest among people doing about an hour a day of leisure-time physical activity overall, but less benefit was observed with higher amounts. When we looked at different activity intensities, those doing about 60-90 minutes a week of more vigorous activities like running had the lowest risk. This suggests that both the amount and intensity of activity matters.
