PHYSICAL-ACTIVITY, FUNCTIONAL LIMITATIONS, AND THE RISK OF FALL-RELATED FRACTURES IN COMMUNITY-DWELLING ELDERLY

This case-control study examines the association of vigorous and mild physical activity with fall-related fractures in a community-dwelling population age 65 and older in South Florida. Vigorous physical activi ty was defined as exercising doing heavy housecleaning, or other hard labor three or more times per week in the month prior to the index dat e; mild physical activity was defined as the number of hours per day s ubjects reported spending on their feet. A case was any subject who su stained a fall-related fracture (ICD-9CM-800 through ICD-9CM-829) over a 21-month Period (n = 471). Controls were a 10% random sample select ed from the Health Care Financing Administration Medicare files (n = 7 12). The presence of any limitation in activities of daily living (ADL ) significantly modified the effect of vigorous physical activity. Phy sically active subjects with no limitations (ADL = 0) were less likely to sustain a fall-related fracture than were inactive subjects, with an adjusted odds ratio (aOR) of 0.6, (0.5-0.8 95% CI), and active subj ects with any limitation (ADL greater than or equal to 1) had an aOR o f 3.2 (1.1-9.8 95% CI). Limiting this analysis to 159 hip fracture cas es produced similar results. Mild physical activity was not associated with fracture. These results suggest that vigorous physical activity is associated with a lower fracture risk among elderly persons who hav e no limitations in ADL and with a higher risk among those with any li mitations. (C) 1997 by Elsevier Science, Inc.