A1 Journal article (refereed)
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 (2020)

Koivunen, K., Sillanpää, E., von Bonsdorff, M., Sakari, R., Törmäkangas, T., & Rantanen, T. (2020). 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. Journals of Gerontology Series A : Biological Sciences and Medical Sciences, 75(10), 1996-2002. https://doi.org/10.1093/gerona/glz251

JYU authors or editors

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

Publication details

All authors or editors: Koivunen, Kaisa; Sillanpää, Elina; von Bonsdorff, Mikaela; Sakari, Ritva; Törmäkangas, Timo; Rantanen, Taina

Journal or series: Journals of Gerontology Series A : Biological Sciences and Medical Sciences

ISSN: 1079-5006

eISSN: 1758-535X

Publication year: 2020

Volume: 75

Issue number: 10

Pages range: 1996-2002

Publisher: Oxford University Press; The Gerontological Society of America

Publication country: United States

Publication language: English

DOI: https://doi.org/10.1093/gerona/glz251

Publication open access: Not open

Publication channel open access:

Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/66116

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.

Keywords: epidemiology; mortality; older people; elderly; bone fractures; physical functioning

Free keywords: adverse events; epidemiology; fracture; health stressors; physical function

Fields of science: