Search tips
Search criteria 


Logo of jepicomhJournal of Epidemiology and Community HealthVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
J Epidemiol Community Health. 1993 December; 47(6): 441–443.
PMCID: PMC1059855

Physical inactivity is an independent risk factor for hip fracture in the elderly.


STUDY OBJECTIVE--To test the hypothesis that physical inactivity is an independent risk factor for hip fracture in the elderly. DESIGN--Population based, case-control study. SETTING--Metropolitan borough of Newcastle upon Tyne. PARTICIPANT--A total of 197 patients aged 50 years and over, resident in Newcastle, and admitted consecutively with a hip fracture, and 382 community controls, matched by age and sex, who had not suffered a hip fracture. MEASUREMENTS AND MAIN RESULTS--Validated methods were used to assess customary physical activity. Information on body build, cigarette smoking, and alcohol consumption was also obtained. Grip strength was measured. Physical inactivity was strongly associated with the risk of hip fracture in men and women. Subjects who did not regularly weight-bear, perform muscle-loading activities such as climbing stairs, and perform productive activities such as gardening, were all more than twice as likely to sustain a hip fracture, when compared with subjects at the higher end of the activity spectrum. These increases in risk remained after adjusting for body mass index, smoking, alcohol consumption, and dependence in daily living activities. CONCLUSIONS--Customary physical inactivity is an independent determinant of hip fracture in the elderly. Strategies to improve the day to day activity of elderly people require urgent exploration.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (626K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Cooper C, Barker DJ, Morris J, Briggs RS. Osteoporosis, falls, and age in fracture of the proximal femur. Br Med J (Clin Res Ed) 1987 Jul 4;295(6589):13–15. [PMC free article] [PubMed]
  • Smith EL, Raab DM. Osteoporosis and physical activity. Acta Med Scand Suppl. 1986;711:149–156. [PubMed]
  • Chow R, Harrison JE, Notarius C. Effect of two randomised exercise programmes on bone mass of healthy postmenopausal women. Br Med J (Clin Res Ed) 1987 Dec 5;295(6611):1441–1444. [PMC free article] [PubMed]
  • Cooper C, Barker DJ, Wickham C. Physical activity, muscle strength, and calcium intake in fracture of the proximal femur in Britain. BMJ. 1988 Dec 3;297(6661):1443–1446. [PMC free article] [PubMed]
  • Lau E, Donnan S, Barker DJ, Cooper C. Physical activity and calcium intake in fracture of the proximal femur in Hong Kong. BMJ. 1988 Dec 3;297(6661):1441–1443. [PMC free article] [PubMed]
  • Qureshi KN, Hodkinson HM. Evaluation of a ten-question mental test in the institutionalized elderly. Age Ageing. 1974 Aug;3(3):152–157. [PubMed]
  • Dallosso HM, Morgan K, Bassey EJ, Ebrahim SB, Fentem PH, Arie TH. Levels of customary physical activity among the old and the very old living at home. J Epidemiol Community Health. 1988 Jun;42(2):121–127. [PMC free article] [PubMed]
  • Cole TJ, Prentice A. Bone mineral measurements. BMJ. 1992 Nov 14;305(6863):1223–1224. [PMC free article] [PubMed]
  • ROTH M, HOPKINS B. Psychological test performance in patients over sixty. I. Senile psychosis and the affective disorders of old age. J Ment Sci. 1953 Jul;99(416):439–450. [PubMed]
  • Blessed G, Tomlinson BE, Roth M. The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry. 1968 Jul;114(512):797–811. [PubMed]
  • LaPorte RE, Montoye HJ, Caspersen CJ. Assessment of physical activity in epidemiologic research: problems and prospects. Public Health Rep. 1985 Mar-Apr;100(2):131–146. [PMC free article] [PubMed]
  • Smith EL, Gilligan C. Physical activity effects on bone metabolism. Calcif Tissue Int. 1991;49 (Suppl):S50–S54. [PubMed]
  • Wickham C, Cooper C, Margetts BM, Barker DJ. Muscle strength, activity, housing and the risk of falls in elderly people. Age Ageing. 1989 Jan;18(1):47–51. [PubMed]
  • Cooper C, Wickham C, Coggon D. Sedentary work in middle life and fracture of the proximal femur. Br J Ind Med. 1990 Jan;47(1):69–70. [PMC free article] [PubMed]
  • Boyce WJ, Vessey MP. Habitual physical inertia and other factors in relation to risk of fracture of the proximal femur. Age Ageing. 1988 Sep;17(5):319–327. [PubMed]
  • Lau EM, Cooper C, Wickham C, Donnan S, Barker DJ. Hip fracture in Hong Kong and Britain. Int J Epidemiol. 1990 Dec;19(4):1119–1121. [PubMed]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Group