Association of physical activity and hip fracture in chinese middle-aged and older adults: a prospective cohort study
1Department of Orthopedics, Tianjin Fifth Central Hospital (Peking University Binhai Hospital), Tianjin, People's Republic of China.
Background:
To investigate the associations between various patterns of physical activity (PA) and risk of hip fracture in Chinese middle-aged and older adults.
Methods:
Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020. PA levels, including moderate-to-vigorous (MVPA), vigorous (VPA), moderate (MPA), low (LPA), and total physical activity (TPA), were assessed using the International Physical Activity Questionnaire. Cox proportional hazard models were used to estimate hazard ratios (HRs), and a restricted cubic spline analyzed the dose-response relationship between TPA and hip fracture.
Results:
Among 6,193 participants (mean age 59.3; 54.0% female), 264 hip fractures occurred during follow-up. Meeting WHO-recommended MVPA levels ≥150 min/week) was not associated with reduced risk (HR 1.04, 95% CI 0.80-1.35). Similarly, no significant associations were observed for VPA (≥75 min/week), MPA (≥150 min/week), LPA (≥300 min/week), or TPA (≥600 MET-min/week). Dose-response analysis also showed no association between total PA and hip fracture.
Conclusion:
This study does not support the WHO recommendation of ≥ 150 min/week of MVPA for reducing hip fracture risk in this demographic. As PA was self-reported and largely work-related, future research should investigate leisure-time and objectively-measured PA.
