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The relationship between objectively assessed physical activity and bone health in older adults differs by sex and is mediated by lean mass

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Abstract

Summary

Relationships between objectively assessed free-living physical activity (PA) and changes in bone health over time are poorly understood in older adults. This study suggests these relationships are sex-specific and that body composition may influence the mechanical loading benefits of PA.

Introduction

To investigate associations of objectively assessed PA and bone health in community-dwelling older adults.

Methods

This secondary analysis of a subset of the Tasmanian Older Adult Cohort study included participants with PA assessed utilising ActiGraph GT1M accelerometers over 7 days (N = 209 participants, 53% female; mean ± SD age 64.5 ± 7.2 years). Steps/day and PA intensity were estimated via established thresholds. Bone mineral content (BMC) was acquired at the total hip, lumbar spine, legs and whole body by DXA at baseline and approximately 2.2 years later. Relationships between PA and BMC were assessed by multivariable linear regression analyses adjusted for age, smoking status, height and total lean mass.

Results

Men with above-median total hip BMC completed significantly less steps per day, but there was no significant difference in PA intensity compared with those with below-median BMC. There were no significant differences in PA in women stratified by median BMC. In women, steps/day were positively associated with leg BMC (B = 0.178; P = 0.017), and sedentary behaviour was negatively associated with leg BMC (− 0.165; 0.016) at baseline. After adjustment for confounders including lean mass and height, higher sedentary behaviour at baseline was associated with declines in femoral neck BMC (− 0.286; 0.011) but also with increases in pelvic BMC (0.246; 0.030) in men and increases in total hip BMC (0.215; 0.032) in women, over 2.2 years. No other significant longitudinal associations were observed after adjustment for body composition.

Conclusions

Associations of accelerometer-determined sedentary behaviour and PA with bone health in older adults differ by sex and anatomical site and are mediated by body composition.

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Acknowledgements

We gratefully acknowledge the efforts of the TASOAC participants and staff, particularly study coordinator Catrina Boon. DS, GJ and DA wish to acknowledge fellowship support from the National Health and Medical Research Council of Australia. LBM was supported by an Australian Postgraduate Award.

Funding

This work was supported by the National Health and Medical Research Council of Australia, Arthritis Foundation of Australia, Tasmanian Community Fund, and University of Tasmania Institutional Research Grants Scheme.

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Authors and Affiliations

  1. School of Clinical Sciences at Monash Health, Department of Medicine, Monash Medical Centre, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia

    L. B. McMillan, P. Ebeling & D. Scott

  2. Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia

    D. Aitken, G. Jones & D. Scott

  3. Australian Institute of Musculoskeletal Science (AIMSS), Melbourne Medical School (Western Campus), Sunshine Hospital, The University of Melbourne, St Albans, Melbourne, VIC, 3021, Australia

    P. Ebeling & D. Scott

Authors
  1. L. B. McMillan
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  2. D. Aitken
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  3. P. Ebeling
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  4. G. Jones
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  5. D. Scott
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Corresponding author

Correspondence to L. B. McMillan.

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Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all participants.

Additional information

Graeme Jones and David Scott are joint senior authors.

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McMillan, L.B., Aitken, D., Ebeling, P. et al. The relationship between objectively assessed physical activity and bone health in older adults differs by sex and is mediated by lean mass. Osteoporos Int 29, 1379–1388 (2018). https://doi.org/10.1007/s00198-018-4446-4

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  • DOI: https://doi.org/10.1007/s00198-018-4446-4

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