Reducing sedentary behavior may lower clinical fracture risk for older men
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Key takeaways:
- Older men who spent more time engaging in sedentary behavior had a higher risk for sustaining a fracture.
- Increased physical activity was tied to lower odds for recurrent falls.
The risk for clinical fractures is higher for older men who spend a higher proportion of their day performing sedentary behavior rather than physical activity or sleeping, according to new findings.
In a longitudinal analysis of data from the Osteoporotic Fractures in Men study published in the Journal of Bone and Mineral Research, researchers found older men who spend a higher percentage of their day engaged in physical activity relative to sedentary behavior are less likely to have recurrent falls, and the risk for any clinical fracture is lower for adults spending a higher percentage of time sleeping or performing physical activity vs. sedentary behavior.
“Older adults are told to get sufficient sleep and exercise regularly, but guidelines lack detail about an optimal 24-hour day that includes both activities,” Lauren S. Roe, PhD, MS, aging T32 predoctoral fellow in the department of epidemiology at the University of Pittsburgh School of Public Health, told Healio. “Clinically, these results can inform 24-hour guidelines that clinicians can provide to patients who are at risk for falls and fractures. Interventions focusing on the 24-hour day to ensure sufficient sleep and focus on displacing sedentary behavior with physical activity may be beneficial.”
Researchers obtained data from 2,910 men aged 65 years and older who enrolled in the 2000-2001 Osteoporotic Fractures in Men study. Participants wore an accelerometer for 7 consecutive days after a follow-up visit in 2007-2009. Activity measured as more than 1.5 metabolic equivalents of task (METs) was considered physical activity, whereas all other nonsleeping activity was defined as sedentary behavior. Falls and incident fractures were self-reported in questionnaires administered three times per year. Falls were assessed over 4 years of follow-up, fractures were examined over 10 years and major osteoporotic fractures were followed for 9.5 years.
Of the participants, 35.2% reported they were a recurrent faller, with two or more falls in any year of follow-up. Any clinical fracture was reported by 22.9% of men, and 12.7% of men reported sustaining a major osteoporotic fracture. Participants spent a mean of 62.2% of their day in sedentary behavior, 28.5% of the day sleeping and 9.3% of the day engaging in physical activity.
In a model adjusted for covariates, men who spent a higher percentage of time in physical activity relative to sedentary behavior were less likely to have a recurrent fall (adjusted OR = 0.87; 95% CI, 0.76-0.99). At 4 years of follow-up, the probability of being a recurrent faller was 16.4% for the full study group. That probability was higher for men in the lowest quartile of physical activity at 18.1%.
In an adjusted model, men who spent more time in sleep relative to physical activity and sedentary behavior (HR = 0.74; 95% CI, 0.54-0.99) and those who spent more time in physical activity relative to sedentary behavior (HR = 0.8; 95% CI, 0.64-0.99) had a lower risk for any clinical fracture. Conversely, spending a higher proportion of time in sedentary behavior relative to physical activity and sleep was tied to a higher risk for any clinical fracture (HR = 1.42; 95% CI, 1.05-1.92).
“The opposing association between the proportion of physical activity with falls and fractures and the proportion of sedentary behavior with falls and fractures stood out to me because it provides evidence towards more tailored exercise interventions,” Roe told Healio. “This result could be used by investigators to design interventions that specifically increase physical activity at the expense of sedentary behavior, not sleep.”
In fully adjusted models, there were no significant associations between proportion of time in physical activity, sedentary behavior or sleep and risk for major osteoporotic fractures. The researchers wrote that the lack of associations may be due to a low number of major osteoporotic fractures reported in the study.
Roe said future research should assess different interventions that may benefit older adults. She added a similar study should also be conducted in older women.
For more information:
Lauren S. Roe, PhD, MS, can be reached at lauren.s.roe@pitt.edu.
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Roe LS, et al. J Bone Miner Res. 2024;doi:10.1093/jbmr/zjae160.
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