The relationship between BPAQ-derived physical activity and bone density of middle-aged and older men

Abstract

Summary

The bone-specific physical activity questionnaire (BPAQ) accounts for activities that affect bone but has not been used in studies with older adults. Relationships exist between the BPAQ-derived physical activity and bone density in healthy middle-aged and older men but not men with prostate cancer. Disease-related treatments detrimental to bone should be considered when administering the BPAQ.

Introduction

The bone-specific physical activity questionnaire (BPAQ) was developed to account for bone-specific loading. In this retrospective study, we examined the relationship between BPAQ-derived physical activity and bone mineral density (BMD) in middle-aged and older men with and without prostate cancer.

Methods

Two groups, 36 healthy men and 69 men with prostate cancer receiving androgen suppression therapy (AST), completed the BPAQ and had whole body, total hip, femoral (FN) and lumbar spine BMD assessed by dual-energy X-ray absorptiometry.

Results

Past (pBPAQ), current (cBPAQ) and total BPAQ (tBPAQ) scores for the healthy men were related to FN BMD (pBPAQ r = 0.36, p = 0.030; cBPAQ r _s = 0.35, p = 0.034; tBPAQ r = 0.41, p = 0.014), and pBPAQ and tBPAQ were related to total hip (r _s = 0.35, p = 0.035 and r _s = 0.36, p = 0.029, respectively) and whole body BMD (r _s = 0.44, p = 0.007 and r _s = 0.45, p = 0.006, respectively). In men with prostate cancer, the BPAQ was not significantly associated with BMD. In stepwise regression analyses, body mass and tBPAQ predicted 30 % of the variance in total hip BMD (p = 0.003), cBPAQ predicted 14 % of the variance in FN BMD (p = 0.002), and body mass, age and tBPAQ predicted 47 % of the variance in whole body BMD (p < 0.001) in healthy men. In men with prostate cancer, the BPAQ was not an independent predictor of BMD.

Conclusions

Although BPAQ-derived estimates of physical activity are related to bone status in healthy middle-aged and older men, the adverse effect of AST on bone appears to obscure this relationship in men with prostate cancer.

Appendix 1

Algorithms used to analyze BPAQ responses

Current BPAQ (cBPAQ) algorithm:

$$ \mathrm{cBPAQ} = \left[ R + 0.2 R\left( n - 1\right)\right] \times a $$

where:

R :

effective load stimulus (derived from ground reaction force testing)

N :

frequency of participation (per week)

A :

age weighting factor

(age weightings <10 years = 1.2; 10–15 years = 1.5; 15–35 years = 1.1; >35 years = 1.0)

Past BPAQ (pBPAQ) algorithm:

$$ \mathrm{pBPAQ} = R \times y \times a $$

where:

R :

effective load stimulus (derived from ground reaction force testing)

Y :

years of participation

A :

age weighting factor

(age weightings <15 years = 0.25; >15 years 0.10)