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Sports participation and fracture in older Australian men

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Abstract

Summary

Older men who participated in a sporting activity were less likely to sustain any fracture or major osteoporotic fracture over a 6-year follow-up period.

Purpose

Regular weight-bearing physical activity can reduce fracture risk through an increase in bone strength, as well as reducing falls risk by improving muscle strength and balance. In this study, we aimed to determine whether a specific type of physical activity, sports participation, reduces fracture risk in older Australian men.

Methods

Participation in sporting activities was documented for men aged 60 years and over enrolled in the Geelong Osteoporosis Study situated in south-eastern Australia. Fractures at any skeletal site (excluding skull, face, fingers and toes) and major osteoporotic fracture sites (MOF; wrist, proximal humerus, spine and hip) were ascertained through examination of radiological reports (median follow-up 6.63 years, IQR 5.58–7.29). Multivariable logistic regression was used to investigate the association between sports participation (either binary or continuous) and any fracture or MOF. Other clinical measures and lifestyle variables (such as comorbidity, falls and mobility) were included as potential confounders.

Results

During follow-up, 82 of 656 men (12.5%) sustained at least one fracture at any site and 58 sustained at least one MOF (8.8%). Of those who did and did not fracture (any site), 17 (20.7%) and 204 (35.5%) participated in at least one sporting activity. For MOF, the values were 11 (19.0%) and 210 (35.1%), respectively. Participation in any sporting activity was associated with a reduction in the likelihood of any fracture during follow-up (unadjusted: OR 0.47, 95%CI 0.27–0.83), which persisted after adjusting for other factors (adjusted: OR 0.52, 95%CI 0.29–0.91). The results for MOF were similar (unadjusted: OR 0.43, 0.22–0.85; adjusted 0.48, 0.24–0.95). When considering sports participation as a continuous variable, a trend was observed (adjusted: p = 0.051 and p = 0.059 for any and MOF, respectively). A sensitivity analysis showed similar results when excluding men who reported using a walking aid.

Conclusions

In this group of older men, participation in sporting activity was associated with a reduced risk of fracture during the subsequent follow-up period.

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Acknowledgements

The study was supported by the National Health and Medical Research Council (NHMRC) Australia (Projects 299831, 628582), the Geelong Regional Medical Foundation, Arthritis Foundation of Australia, Perpetual Trustees, and Amgen Europe (GmBH); however, the funding bodies played no part in the design or conduct of the study, the collection, management, analysis and interpretation of the data, nor in the preparation or review of the manuscript. SLB-O is supported by an NHMRC Career Development Fellowship (1107510). NKH is supported by an Australian Postgraduate Award. KLH-K is supported by an Alfred Deakin Postdoctoral Research Fellowship.

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Correspondence to Kara L. Holloway-Kew.

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Written informed consent was obtained from all participants and this study was approved by the Barwon Health Human Research Ethics Committee.

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Holloway-Kew, K.L., Moloney, D.J., Bucki-Smith, G. et al. Sports participation and fracture in older Australian men. Arch Osteoporos 13, 43 (2018). https://doi.org/10.1007/s11657-018-0459-z

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