Background There have been few studies of physical impairment following nonspine fractures.
Objectives To examine this issue among 705 Japanese women in Hawaii.
Methods Only new fractures that had occurred during 13 years of follow up were considered; 121 women had 1, and 26 women had 2 or more new nonviolent, nonspine fractures. Activities of daily living (ADLs) and measures of physical performance (PP) were measured at the end of follow up. Associations with new nonspine fractures were evaluated using logistic regression analysis adjusted for age, height, body mass index, prior vertebral fractures, and prior nonspine fractures.
Results Women with new fractures had significantly greater difficulty with 10 out of 13 ADLs, with odds ratios of 1.6 to 2.9. The associations tended to be stronger for fractures within the prior 5 years; only 2 ADLs were significantly associated with fractures that had occurred more than 5 years earlier. For most ADLs, associations with hip, rib, and upper arm fractures were generally stronger (odd ratios >2.3) than for wrist, foot, or lower leg fractures (odds ratios < 2.0). Overall, nonspine fractures were significantly associated with 25% slower walking speed and longer time to complete the chair stand test, but not with other PP measures. However, hip fractures were associated with lower performance on 5 out of 6 PPs.
Conclusion We conclude that nonspine fractures may be associated with increased physical impairment for up to 5 years later, and that the severity appears to vary by fracture location.