A prospective study of the effect of fracture on measured physical performance: Results from the MacArthur study - MAC

OBJECTIVE: To examine the impact of fractures on measured physical performa nce and to assess whether specific fractures have unique sequelae. SUBJECTS: 762 men and women, aged 70 to 79 at baseline, who were part of th e MacArthur Study of Successful Aging. DESIGN: A longitudinal case-cohort: those with prevalent fractures at basel ine were excluded; cases were persons with a medically diagnosed hip, arm, spine, or wrist fracture during the follow-up period (1988-1995). MEASURES: Eight physical performance tests: turning a circle, walking fast, chair stands, timed tap, tandem stand, grip strength, single leg stand, an d balance (average of single leg and tandem stands) measured at baseline an d follow-up. ANALYSIS: Two fracture groups were defined: (1) those with incident wrist f ractures (n = 7) and (2) those with a fracture of the hip, arm, or spine (c ombined fractures group, n = 16). Change in physical performance was analyz ed using crude, age-adjusted, and multiply-adjusted ANCOVA models. RESULTS: The combined fracture group demonstrated statistically significant (P <.05) declines seven of eight of the performance tests compared with in dividuals without fractures. In contrast, individuals with wrist fractures did not experience a statistically significant decline in any performance m easure compared with the no fracture group. CONCLUSIONS: Relative to those without fractures, individuals with a hip, a rm, or clinical spinal fracture show similar global declines in physical pe rformance, whereas those with wrist fracture demonstrate no physical perfor mance decrements.