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. 2024 Sep 1;79(9):glae186.
doi: 10.1093/gerona/glae186.

Frailty Status, Sedentary Behaviors, and Risk of Incident Bone Fractures

Jian Zhou  1   2 , Rui Tang  1 , Xuan Wang  1 , Hao Ma  1 , Xiang Li  1 , Yoriko Heianza  1 , Lu Qi  1   3
Affiliations

Frailty Status, Sedentary Behaviors, and Risk of Incident Bone Fractures

Jian Zhou et al. J Gerontol A Biol Sci Med Sci. .

Abstract

Background: The associations of physical pre-frailty and frailty with bone fractures and the modified effect of sedentary lifestyle remain uncertain. This study was performed to explore the association of physical pre-frailty and frailty with risk of incident bone fractures, and test the modification effects of sedentary lifestyle and other risk factors.

Methods: This cohort study included 413 630 participants without bone fractures at baseline in the UK Biobank study between 2006 and 2010 and followed up to 2021. The mean age of the participants was 56.5 years. A total of 224 351 (54.2%) enrolled participants were female and 376 053 (90.9%) included participants were White. Three Cox regression models were constructed to analyze the association of pre-frailty and frailty with total fractures, hip fractures, vertebrae fractures, and other fractures.

Results: As compared with the physical nonfrailty group, the multivariate-adjusted hazard ratios were 1.17 (95% confidence interval [CI]: 1.14-1.21) and 1.63 (95% CI: 1.53-1.74) for the physical pre-frailty group and frailty group, respectively (p-trend < .001). In addition, we found that sedentary behavior time significantly accentuated the associations of physical pre-frailty and frailty with total fractures (p-interaction <.001), hip fractures (p-interaction = .013), and other fractures (p-interaction <.001).

Conclusions: Our results indicate that physical pre-frailty and frailty are related to higher risks of bone fractures; such association was more pronounced among those with longer sedentary behavior time.

Keywords: Bone fractures; Physical frailty; Sedentary behavior time.

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Conflict of interest statement

None.

Figures

Figure 1.
Figure 1.
Dose–response associations of physical frailty index with risk of bone fractures. Model 3 with penalized splines adjusted for age (years), sex (male or female), ethnic background (White or others), Townsend deprivation index (continuous), household income (<£18 000, £18 000–£30 999, £31 000–£51 999, £52 000–£100 000, or >£100 000), body mass index (continuous), standing height (continuous), smoking status (never, previous or current smoking), alcohol intake (<1, 1–2, >2 times/week), healthy diet score (<3 or ≥3), sedentary behavior time (continuous), heel bone mineral density T-score (continuous), falls history (with or without), vitamin D supplementation (yes or no), calcium supplementation (yes or no), serum vitamin D (continuous), and serum calcium (continuous).
Figure 2.
Figure 2.
Association of physical frailty status with risk of fractures stratified by sedentary behavior time via Model 3 adjusted for age (years), sex (male or female), ethnic background (White or others), Townsend deprivation index (continuous), household income (<£18 000, £18 000–£30 999, £31 000–£51 999, £52 000–£100 000, or >£100 000), body mass index (continuous), standing height (continuous), smoking status (never, previous or current smoking), alcohol intake (<1, 1–2, >2 times/week), healthy diet score (<3 or ≥3), sedentary behavior time (continuous), heel bone mineral density T-score (continuous), falls history (with or without), vitamin D supplementation (yes or no), calcium supplementation (yes or no), serum vitamin D (continuous), and serum calcium (continuous).
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