Calcified Tissue International

, Volume 94, Issue 5, pp 522–530 | Cite as

Gender-Specific Associations Between Physical Functioning, Bone Quality, and Fracture Risk in Older People

  • Regula Furrer
  • Natasja M. van Schoor
  • Arnold de Haan
  • Paul Lips
  • Renate T. de JonghEmail author
Original Research


The aim of this study was to investigate which parameters of physical functioning are associated with bone quality and fracture risk and whether gender-specific differences exist within these associations. We studied 1,486 participants of the Longitudinal Aging Study Amsterdam. As measures of physical functioning, handgrip strength, physical performance, and level of physical activity were assessed. To assess bone quality, broadband ultrasound attenuation (BUA) and speed of sound (SOS) were measured at baseline using quantitative ultrasound and bone mineral density (BMD) at baseline and after 3 years by dual-energy X-ray absorptiometry. In addition, fracture incidence over 6 years was assessed. After adjustment for confounders (age, serum 25[OH]D, smoking, and body weight), in men, physical performance was positively related to BUA, SOS, and BMD cross-sectionally and to BMD longitudinally. Using Cox proportional hazards model, in men higher handgrip strength and physical performance were associated with reduced fracture risk after adjustment for confounders (hazard ratio [HR] 0.96, 95 % confidence interval [CI] 0.92–0.99, and HR 0.89, 95 % CI 0.80–0.98, respectively). In women, a moderate level of physical activity was related to reduced fracture risk (HR 0.57, 95 % CI 0.33–0.99). In conclusion, in men, higher handgrip strength and physical performance are related to higher bone quality and reduced fracture risk, whereas in women, a moderate to high level of physical activity is associated with reduced fracture risk. These measurements may contribute to the identification of individuals at high fracture risk. Both the causality of and explanations for gender-specific differences in these relationships remain subject to further studies.


Osteoporosis Fracture Risk factor Handgrip strength Physical performance Physical activity 



The Longitudinal Aging Study Amsterdam is largely supported by a Grant from the Netherlands Ministry of Health Welfare and Sports, Directorate of Nursing Care and Older Persons.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Regula Furrer
    • 1
  • Natasja M. van Schoor
    • 2
  • Arnold de Haan
    • 1
  • Paul Lips
    • 3
  • Renate T. de Jongh
    • 3
    Email author
  1. 1.Faculty of Human Movement Sciences, MOVE Research Institute AmsterdamVU University AmsterdamAmsterdamThe Netherlands
  2. 2.Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care ResearchVU University Medical Center AmsterdamAmsterdamThe Netherlands
  3. 3.Department of Internal Medicine and Endocrinology, MOVE Research Institute AmsterdamVU University Medical Center AmsterdamAmsterdamThe Netherlands

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