Open Access Open Badges Research article

Lifestyle factors and site-specific risk of hip fracture in community dwelling older women – a 13-year prospective population-based cohort study

Mikko Määttä12*, Erkki Terho3, Heikki Jokinen13, Pasi Pulkkinen1, Juha Korpelainen4, Jorma Heikkinen5, Sirkka Keinänen-Kiukaanniemi67, Timo Jämsä18 and Raija Korpelainen1367

Author Affiliations

1 Department of Medical Technology, University of Oulu, PO Box 5000, FI-90014, Oulu, Finland

2 Infotech Oulu, University of Oulu, PO Box 4500, FI-90014, Oulu, Finland

3 Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Kajaaninkatu 17, FI-90100, Oulu, Finland

4 Oulu University Hospital, Kajaanintie 50, FI-90029, Oulu, Finland

5 Osteoporosis Clinic, Oulu Deaconess Institute, Albertinkatu 16, FI-90100, Oulu, Finland

6 Institute of Health Sciences, University of Oulu, PO Box 5000, FI-90014, Oulu, Finland

7 Unit of General Practice, Oulu University Hospital, Kajaanintie 50, FI-90029, Oulu, Finland

8 Department of Diagnostic Radiology, Oulu University Hospital, Kajaanintie 50, FI-90029, Oulu, Finland

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BMC Musculoskeletal Disorders 2012, 13:173  doi:10.1186/1471-2474-13-173

Published: 14 September 2012



Several risk factors are associated to hip fractures. It seems that different hip fracture types have different etiologies. In this study, we evaluated the lifestyle-related risk factors for cervical and trochanteric hip fractures in older women over a 13-year follow-up period.


The study design was a prospective, population-based study consisting of 1681 women (mean age 72 years). Seventy-three percent (n = 1222) participated in the baseline measurements, including medical history, leisure-time physical activity, smoking, and nutrition, along with body anthropometrics and functional mobility. Cox regression was used to identify the independent predictors of cervical and trochanteric hip fractures.


During the follow-up, 49 cervical and 31 trochanteric fractures were recorded. The women with hip fractures were older, taller, and thinner than the women with no fractures (p < 0.05). Low functional mobility was an independent predictor of both cervical and trochanteric fractures (HR = 3.4, 95% CI 1.8-6.6, and HR = 5.3, 95% CI 2.5-11.4, respectively). Low baseline physical activity was associated with an increased risk of hip fracture, especially in the cervical region (HR = 2.5, 95% CI 1.3-4.9). A decrease in cervical fracture risk (p = 0.002) was observed with physically active individuals compared to their less active peers (categories: very low or low, moderate, and high). Moderate coffee consumption and hypertension decreased the risk of cervical fractures (HR = 0.4, 95% CI 0.2-0.8, for both), while smoking was a predisposing factor for trochanteric fractures (HR = 3.2, 95% CI 1.1-9.3).


Impaired functional mobility, physical inactivity, and low body mass may increase the risk for hip fractures with different effects at the cervical and trochanteric levels.

Fracture type; Cervical fracture; Trochanteric fracture; Mobility; Physical activity; Risk factors