Physical Functioning Among Women Aged 80 Years and Older With Previous Fracture

Carolyn J. Crandall, Michael J. LaMonte, Beverly M. Snively, Meryl S. LeBoff, Jane A. Cauley, Cora E. Lewis, Robert Wallace, Wenjun Li, Zhao Chen, John A. Robbins, Jean Wactawski-Wende

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

BACKGROUND: The oldest old are the fastest growing segment of the elderly population. Little is known regarding the associations of fracture history with physical functioning assessed after age 80.

METHODS: Among 33,386 women surviving to age 80 years (mean ± SD years 84.6 ± 3.4), we examined the relationship between history of incident fracture after entry into the Women's Health Initiative (follow-up 15.2 ± 1.3 years) and their physical functioning assessed using the RAND-36 instrument most proximal to 2012 end of follow-up.

RESULTS: Baseline mean (±SD) physical function score was 82 (± 18). After adjustment for demographic and medical characteristics, fracture at each site, including hip, upper limb, lower limb, and central body, was associated with significantly lower subsequent physical functioning (all p < .001). Hip, upper leg, spine, and pelvis fractures were particularly related with lower physical functioning scores, 11.7 (95% CI: 10.3, 13.1), 10.5 (8.8, 12.3), 9.8 (8.9, 10.8), and 8.7 (7.2, 10.2) units lower, respectively, compared with women without fracture (each p < .0001). Compared with women without central site fracture, women with central site fractures also had lower physical functioning scores (10.0 [9.3, 10.8] units lower]; p < .0001). In case-only analysis of fractures, older age, less than 1 year since fracture, one or more additional sites fractured, history of cardiovascular disease or cancer, higher body mass index, and no alcohol intake in the past 3 months also were independent predictors of lower physical functioning score (all p < .05).

CONCLUSIONS: Among women surviving to 80 years and older, prior fracture is associated with lower current physical functioning, regardless of anatomical site of fracture, independent of other major predictors of disability.

Original languageEnglish (US)
Pages (from-to)S31-S41
JournalThe journals of gerontology. Series A, Biological sciences and medical sciences
Volume71
DOIs
StatePublished - Mar 1 2016

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Hip
Women's Health
Pelvis
Upper Extremity
Lower Extremity
Leg
Spine
Body Mass Index
Cardiovascular Diseases
Alcohols
Demography
Population
Neoplasms

Keywords

  • Fracture
  • Frailty
  • Physical function

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology

Cite this

Crandall, C. J., LaMonte, M. J., Snively, B. M., LeBoff, M. S., Cauley, J. A., Lewis, C. E., ... Wactawski-Wende, J. (2016). Physical Functioning Among Women Aged 80 Years and Older With Previous Fracture. The journals of gerontology. Series A, Biological sciences and medical sciences, 71, S31-S41. https://doi.org/10.1093/gerona/glv060

Physical Functioning Among Women Aged 80 Years and Older With Previous Fracture. / Crandall, Carolyn J.; LaMonte, Michael J.; Snively, Beverly M.; LeBoff, Meryl S.; Cauley, Jane A.; Lewis, Cora E.; Wallace, Robert; Li, Wenjun; Chen, Zhao; Robbins, John A.; Wactawski-Wende, Jean.

In: The journals of gerontology. Series A, Biological sciences and medical sciences, Vol. 71, 01.03.2016, p. S31-S41.

Research output: Contribution to journalArticle

Crandall, CJ, LaMonte, MJ, Snively, BM, LeBoff, MS, Cauley, JA, Lewis, CE, Wallace, R, Li, W, Chen, Z, Robbins, JA & Wactawski-Wende, J 2016, 'Physical Functioning Among Women Aged 80 Years and Older With Previous Fracture', The journals of gerontology. Series A, Biological sciences and medical sciences, vol. 71, pp. S31-S41. https://doi.org/10.1093/gerona/glv060
Crandall, Carolyn J. ; LaMonte, Michael J. ; Snively, Beverly M. ; LeBoff, Meryl S. ; Cauley, Jane A. ; Lewis, Cora E. ; Wallace, Robert ; Li, Wenjun ; Chen, Zhao ; Robbins, John A. ; Wactawski-Wende, Jean. / Physical Functioning Among Women Aged 80 Years and Older With Previous Fracture. In: The journals of gerontology. Series A, Biological sciences and medical sciences. 2016 ; Vol. 71. pp. S31-S41.
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abstract = "BACKGROUND: The oldest old are the fastest growing segment of the elderly population. Little is known regarding the associations of fracture history with physical functioning assessed after age 80.METHODS: Among 33,386 women surviving to age 80 years (mean ± SD years 84.6 ± 3.4), we examined the relationship between history of incident fracture after entry into the Women's Health Initiative (follow-up 15.2 ± 1.3 years) and their physical functioning assessed using the RAND-36 instrument most proximal to 2012 end of follow-up.RESULTS: Baseline mean (±SD) physical function score was 82 (± 18). After adjustment for demographic and medical characteristics, fracture at each site, including hip, upper limb, lower limb, and central body, was associated with significantly lower subsequent physical functioning (all p < .001). Hip, upper leg, spine, and pelvis fractures were particularly related with lower physical functioning scores, 11.7 (95{\%} CI: 10.3, 13.1), 10.5 (8.8, 12.3), 9.8 (8.9, 10.8), and 8.7 (7.2, 10.2) units lower, respectively, compared with women without fracture (each p < .0001). Compared with women without central site fracture, women with central site fractures also had lower physical functioning scores (10.0 [9.3, 10.8] units lower]; p < .0001). In case-only analysis of fractures, older age, less than 1 year since fracture, one or more additional sites fractured, history of cardiovascular disease or cancer, higher body mass index, and no alcohol intake in the past 3 months also were independent predictors of lower physical functioning score (all p < .05).CONCLUSIONS: Among women surviving to 80 years and older, prior fracture is associated with lower current physical functioning, regardless of anatomical site of fracture, independent of other major predictors of disability.",
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AU - Lewis, Cora E.

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