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Mortality Risk among Older People Who Did Versus Did Not Sustain a Fracture : Baseline Prefracture Strength and Gait Speed as Predictors in a 15-Year Follow-Up

Year of publication

2020

Authors

Koivunen, Kaisa; Sillanpää, Elina; von Bonsdorff, Mikaela; Sakari, Ritva; Törmäkangas, Timo; Rantanen, Taina

Abstract

BACKGROUND: Physiological reserve, as indicated by muscle strength and gait speed, may be especially determinant of survival in people who are exposed to a health stressor. We studied whether the association between strength/speed and mortality risk would be stronger in the time period after a fracture compared to other time periods. METHODS: Participants were population-based sample of 157 men and 325 women aged 75 and 80 years at baseline. Maximal 10-meter gait speed and maximal isometric grip and knee extension strength were tested at the baseline before the fracture. Subsequent fracture incidence and mortality were followed up for 15 years. Cox regression analysis was used to estimate fracture time-stratified effects of gait speed and muscle strength on mortality risk in three states: 1) non-fracture state, 2) the first post-fracture year and 3) after the first post-fracture year until death/end of follow-up. RESULTS: During the follow-up, 20% of the men and 44% of the women sustained a fracture. In both sexes, lower gait speed and in women lower knee extension strength was associated with increased mortality risk in the non-fracture state. During the first post-fracture year, the mortality risk associated with slower gait and lower strength was increased and higher than in the non-fracture state. After the first post-fracture year, mortality risk associated with lower gait speed and muscle strength attenuated. CONCLUSIONS: Lower gait speed and muscle strength were more strongly associated with mortality risk after fracture than during non-fracture time, which may indicate decreased likelihood of recovery.
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Organizations and authors

University of Jyväskylä

Sillanpää Elina Orcid -palvelun logo

Koivunen Kaisa Orcid -palvelun logo

Bonsdorff von Mikaela Orcid -palvelun logo

Sakari-Rantala Ritva Orcid -palvelun logo

Rantanen Taina Orcid -palvelun logo

Törmäkangas Timo Orcid -palvelun logo

Publication type

Publication format

Article

Parent publication type

Journal

Article type

Original article

Audience

Scientific

Peer-reviewed

Peer-Reviewed

MINEDU's publication type classification code

A1 Journal article (refereed), original research

Publication channel information

Open access

Open access in the publisher’s service

No

Self-archived

Yes

Other information

Fields of science

Health care science; Public health care science, environmental and occupational health; Sport and fitness sciences

Keywords

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Publication country

United States

Internationality of the publisher

International

Language

English

International co-publication

No

Co-publication with a company

No

DOI

10.1093/gerona/glz251

The publication is included in the Ministry of Education and Culture’s Publication data collection

Yes