Lifestyle factors, including physical activity status, associated with fragility fractures and falls: a cross-sectional study

Fragility fractures, which frequently occur following falls, represent a growing concern in aging populations, severely affecting health-related quality of life (HRQOL) and increasing mortality. Although physical activity is generally beneficial for health, it may also increase the risk of falls and, consequently, fragility fractures. The present cross-sectional study was aimed at comprehensively analyzing factors, including physical activity status as a key variable of interest, associated with fragility fractures and falls. An online survey was conducted among 4,967 community-dwelling older adults in Osaka, Japan. Data on a 5-year history of fragility fractures, falls within the past year, demographics, use of sleeping pills, polypharmacy (i.e., use of multiple medications), unintentional weight loss, and physical activity were collected. Physical activity levels were assessed using the International Physical Activity Questionnaire–Short Form (IPAQ-SF). Binary logistic regression analyses were conducted to identify factors associated with fragility fractures and falls. The EuroQol 5-Dimension 5-Level (EQ-5D-5 L) was used to compare HRQOL between participants with and without a history of fragility fractures and falls. Fragility fractures within the past 5 years were reported by 7.3% of participants and were independently associated with female sex (odds ratio [OR] = 1.68, p < 0.001), polypharmacy (OR = 1.57, p = 0.001), fall history (OR = 2.63, p < 0.001), and unintentional weight loss (OR = 1.37, p = 0.031). Falls within the past year were experienced by 20.6% of participants and were independently associated with sleeping pill use (OR = 1.53, p < 0.001), polypharmacy (OR = 1.342, p < 0.001), and unintentional weight loss (OR = 1.86, p < 0.001). Moderate physical activity was not related to fragility fractures (OR = 1.03, p = 0.840) or falls (OR = 0.90, p = 0.144). In the HRQOL assessment, EQ-5D-5 L index scores were significantly lower among participants with a history of fragility fractures and falls than among those without such a history. This study identified several key modifiable factors associated with fragility fractures and falls, demonstrating that physical activity was not independently associated with either outcome. Addressing these modifiable factors may help improve HRQOL in older populations.