Is physical activity protective against hip fracture in frail older people?

Background: there is limited evidence of a protective effect of physical ac tivity in preventing hip fractures among older people living in institution s and in those aged 80 or over. Objective: to examine the relationship between physical activity and risk o f hip fracture in frail older people. Design: a case-control study. Setting: Auckland, New Zealand. Subjects: a random sample of individuals hospitalized with a fracture of th e femoral neck (n=911) and 910 randomly selected age- and sex-matched indiv iduals from the lists of a random sample of general practitioners. Methods: we sought information on physical activity and other potential ris k factors for hip fracture from cases and controls, using a standardized in terviewer-administered questionnaire. We conducted multivariate analyses, s eparately for those living in private homes and residential institutions. Results: increasing hours of physical activity per week protected against t he risk of hip fracture among individuals living in private homes, includin g those who are over 80. However, among individuals living in institutions, physical activity levels were extremely low (<15% participated in <greater than or equal to>2 h per week) and there was limited evidence of a protect ive effect. Conclusions: efforts to prevent hip fractures in individuals living in care homes and institutions should focus on passive interventions which are kno wn to be effective.