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Rest-activity patterns and falls and fractures in older men

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Abstract

Summary

Dysregulated rest-activity rhythm (RAR) patterns have been associated with several health conditions in older adults. This study showed that later acrophase was associated with a modestly greater risk of falls but not fractures in elderly men. Associations between dysregulated RAR patterns and osteoporosis risk warrant further investigation.

Purpose

The purpose of this study was to investigate the relationship between rest-activity rhythm (RAR) patterns and risk of falls/fractures in older men. We hypothesized that dysregulated RAR would be associated with incident falls/fractures.

Methods

We used wrist-worn actigraphy to measure RAR over 4.8 ± 0.8 24-h periods in men (≥67 years) enrolled in the multicenter Outcomes of Sleep Disorders in Men (MrOS Sleep) Study (n = 3001). Men were contacted every 4 months to report occurrence of falls/fractures. RAR parameters included amplitude (difference between peak and nadir activity in counts/minute), mesor (activity counts/minute), acrophase (time of day of peak activity), and pseudo-F statistic (rhythm robustness) and were evaluated as continuous variables with associations reported per SD increase/decrease in models adjusted for confounders. Logistic regression was used to estimate the likelihood (odds ratio, OR) of recurrent falls in the year after the visit. Proportional hazards models were used to estimate the risk (hazard ratio, HR) of fractures.

Results

One year after the visit, 417 men (14%) had recurrent (≥2) falls. Later acrophase (OR 1.18, 95% CI 1.06–1.32) was associated with a modestly greater likelihood of falls. In 8.6 years (SD 2.6 years) of >97% complete follow-up, 256 men (8.53%) had a major osteoporotic fracture, 85 (2.8%) had a clinical spine fracture, and 110 (3.7%) had a hip fracture. No consistent, significant associations were observed between RAR patterns and fractures.

Conclusions

Later acrophase was associated with a modestly greater risk of falls; this association did not translate into a higher fracture risk in this cohort of elderly men.

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Acknowledgements

The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Institute on Aging (NIA), the National Center for Research Resources (NCRR), and NIH Roadmap for Medical Research under the following grant numbers: U01 AR45580, U01 AR45614, U01 AR45632, AR45647, AR45654, AR45583, AG18197, AG027810, and TR000128. The National Heart, Lung, and Blood Institute (NHLBI) provides funding for the MrOS Sleep ancillary study “Outcomes of Sleep Disorders in Older Men” under the following grant numbers: HL071194, HL070848, HL070847, HL070842, HL070841, HL070837, HL070838, and R01 HL070839. Additional funding was provided by NIH/NIAMS grant P50 AR063043.

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Authors and Affiliations

  1. Center for Musculoskeletal Health and Department of Internal Medicine, University of California, Davis Medical Center, 4625 2nd Avenue, Suite 2000, Sacramento, CA, 95817, USA

    Tara S. Rogers & Nancy E. Lane

  2. California Pacific Medical Center Research Institute, San Francisco, CA, USA

    Terri L. Blackwell, Greg Tranah, Katie L. Stone, Steven R. Cummings & Peggy M Cawthon

  3. Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA

    Eric S. Orwoll

  4. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    Jane A. Cauley

  5. Departments of Psychiatry and Medicine, University of California, San Diego, La Jolla, CA, USA

    Sonia Ancoli-Israel

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  1. Tara S. Rogers
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  2. Terri L. Blackwell
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  3. Nancy E. Lane
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  4. Greg Tranah
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  5. Eric S. Orwoll
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  6. Jane A. Cauley
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  7. Sonia Ancoli-Israel
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  8. Katie L. Stone
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  9. Steven R. Cummings
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  10. Peggy M Cawthon
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Corresponding author

Correspondence to Tara S. Rogers.

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Ethical approval

All procedures performed in the MrOS study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board at each clinic site, and all participants provided written informed consent. For this type of retrospective analysis, additional formal consent was not required.

Disclosures

Dr. Ancoli-Israel consults for Marck, Easai, Jansen, Pfizer.

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Rogers, T.S., Blackwell, T.L., Lane, N.E. et al. Rest-activity patterns and falls and fractures in older men. Osteoporos Int 28, 1313–1322 (2017). https://doi.org/10.1007/s00198-016-3874-2

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