Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California, 1100 Glendon Ave. Suite 850 - Room 858, Los Angeles, 90024, USA.
Fred Hutchinson Cancer Research Center, Seattle, USA.
Osteoporos Int. 2024 Jun;35(6):1029-1040. doi: 10.1007/s00198-024-07050-3. Epub 2024 Mar 9.
Long-term physical functioning trajectories following distal forearm fracture are unknown. We found that women with versus those without distal forearm fracture were more likely to experience a 5-year decline in physical functioning, independent of initial physical functioning level. This association was most evident among women 80 years and older.
Physical functioning trajectory following lower arm or wrist fracture is not well understood.
This study is to evaluate physical functioning trajectory before vs. after lower arm or wrist fracture, stratified by age.
We performed a nested case-control study of prospective data from the Women's Health Initiative Study (n = 2097 cases with lower arm or wrist fracture, 20,970 controls). Self-reported fractures and the physical functioning subscale of the RAND 36-item Short-Form Health Survey were assessed annually. We examined three physical functioning trajectory groups: stable, improving, and declining.
Mean (SD) number of physical functioning measurements was 5.2 (1.5) for cases and 5.0 (1.4) for controls. Declining physical functioning was observed among 20.4% of cases and 16.0% of controls. Compared to women without lower arm or wrist fracture, women with lower arm or wrist fracture were 33% more likely to experience declining physical functioning (adjusted odds ratio [aOR] 1.33 95% confidence interval [CI] 1.19-1.49, reference group stable or improving physical functioning trajectory). Associations varied by age: age ≥ 80 years aOR 1.56 (95% CI 1.29-1.88); age 70-79 years aOR 1.29 (95% CI 1.09-1.52); age < 70 years aOR 1.15 (95% CI 0.86-1.53) (p = 0.06). Associations between lower arm or wrist fracture and odds of declining physical functioning did not vary by baseline physical functioning or physical activity level.
Women with lower arm or wrist fracture, particularly those aged 80 and older, were more likely to experience declines in physical functioning than women without such fractures, independent of baseline physical functioning level.
评估年龄分层下前臂或腕部骨折前后的身体功能轨迹。
我们对妇女健康倡议研究（n=2097 例前臂或腕部骨折病例，20970 例对照）前瞻性数据进行了嵌套病例对照研究。每年评估自述骨折和 RAND 36 项简短健康调查身体功能子量表。我们检查了 3 种身体功能轨迹组：稳定、改善和下降。
病例的平均（SD）身体功能测量次数为 5.2（1.5），对照为 5.0（1.4）。20.4%的病例和 16.0%的对照出现身体功能下降。与无前臂或腕部骨折的女性相比，有前臂或腕部骨折的女性出现身体功能下降的可能性高 33%（调整后的优势比[OR] 1.33，95%置信区间[CI] 1.19-1.49，参考组为稳定或改善的身体功能轨迹）。关联因年龄而异：年龄≥80 岁 OR 1.56（95%CI 1.29-1.88）；70-79 岁 OR 1.29（95%CI 1.09-1.52）；年龄＜70 岁 OR 1.15（95%CI 0.86-1.53）（p=0.06）。前臂或腕部骨折与身体功能下降几率之间的关联与基线身体功能或身体活动水平无关。
与无此类骨折的女性相比，特别是 80 岁及以上的女性，前臂或腕部骨折的女性更有可能出现身体功能下降，而与基线身体功能水平无关。
