Oral Virtual Presentation (Virtual only) ESA-SRB-ANZBMS 2021

Self-assessed limited mobility is associated with increased fracture risk in both women and men in the 45 and Up Study (#79)

Dana Bliuc 1 2 , Thach Tran 1 2 , Dunia Alarkawi 1 2 , Weiwen Chen 1 2 , Robert D Blank 1 , Fiona Blyth 3 , Lyn March 3 , Jackie R Center 1 2
  1. Osteoporosis and Bone Biology, Garvan Institute of Medical Research, Darlinghurst, NEW SOUTH WALES, Australia
  2. Faculty of Medicine, UNSW Australia, Sydney, NSW, Australia
  3. Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia

Measured poor physical performance is associated with increased fracture risk.  However, whether self-assessed limited mobility is associated with fracture is unknown.

This study aimed to determine the association between self-reported limited mobility and 5-year fracture risk.

45 and Up is a prospective population-based cohort study with questionnaire data linked to mortality and hospital records. A cohort of 122,233 women and 110,365 men with baseline questionnaire data on limited mobility at 1 km self-assessed as “Not at all,” “A little” and “A lot” was selected. Fracture events were ascertained from hospital records. Fracture risk was estimated using gender-specific Cox proportional hazards models adjusted for age, weight, falls, and prior fracture.

Approximately 22% of women and men reported limited mobility (12% - “A little” and 10% - “A lot”) at baseline. During the first 5 years of follow-up, 6867 women and 4155 men experienced a minimal trauma fracture. Individuals with fracture were older, had more comorbidities, falls and prior fractures and were more likely to report limited mobility. After multivariable adjustment, limited mobility was associated with ~32% to >2-fold greater fracture risk [“A little”: 1.32 (1.23 - 1.41), and 1.46 (1.34 - 1.59); “A lot”: 1.59 (1.49 - 1.71) and 2.02 (1.86 - 2.21), for women and men, respectively](Figure). Limited mobility was significantly associated with fracture risk at all sites. The magnitude of association for all degrees of limited mobility was highest for hip (HR 2.16 - 3.34) followed by vertebral (HR 1.56 - 2.21) and non-hip non-vertebral fracture (HR 1.20 - 1.71).

All degrees of self-reported limitation in mobility is associated with increased fracture risk over and above known fracture risk factors. This study suggests that this simple assessment may be a useful clinical tool to select candidates who would benefit from osteoporosis investigation.611f4194826f5-Figure+-+abstract+v3.jpg