Evidence map›Paper›PMID 40332499›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025

Association between walking and hip fracture in women aged 65 and older: 20-year follow-up from the study of osteoporotic fractures.

Enwu Liu, Ryan Yan Liu, John Moraros, Eugene V McCloskey, Nicholas C Harvey, Mattias Lorentzon, Helena Johansson, John A Kanis

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In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Roles of skeletal muscle-derived exosomes in osteoporosis.Journal of translational medicine · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Enwu LiuCollege of Medicine and Public Health, Flinders University, Adelaide, Australia. Enwu.liu@flinders.edu.au.ORCID http://orcid.org/0000-0003-2580-3523
Ryan Yan LiuCollege of Medicine and Public Health, Flinders University, Adelaide, Australia.ORCID http://orcid.org/0009-0001-9095-1349
John MorarosSchool of Science, Suzhou Municipal Key Lab of AI4Health, Xi'an Jiaotong-Liverpool University, Suzhou, China.
Eugene V McCloskeyDivision of Clinical Medicine, School of Medicine & Population Health, Versus Arthritis Centre for Integrated Research in Musculoskeletal Ageing, University of Sheffield, Sheffield, UK.ORCID http://orcid.org/0000-0003-0177-8140
Nicholas C HarveyMRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.ORCID http://orcid.org/0000-0002-8194-2512
Mattias LorentzonDepartment of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Osteoporosis Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID http://orcid.org/0000-0003-0749-1431
Helena JohanssonDepartment of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Osteoporosis Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
John A KanisCentre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.ORCID http://orcid.org/0000-0002-3129-4326

Funding

Study of Osteoporotic FracturesR01AG005407 · NIA · UNIVERSITY OF CALIFORNIA SAN FRANCISCO · PI CUMMINGS, STEVEN RON, YAFFE, KRISTINE · 1986 to 2016
$23.2M
Study of Osteoporotic FracturesR01AG005394 · NIA · UNIVERSITY OF MINNESOTA TWIN CITIES · PI ENSRUD, KRISTINE · 1986 to 2015
$6.1M
STUDY OF OSTEOPOROTIC FRACTURES: VERTEBRAL FRACTURESR01AR035583 · NIAMS · KAISER FOUNDATION RESEARCH INSTITUTE · PI HILLIER, TERESA A · 1986 to 2005
$3.2M
Study of Osteoporotic FracturesR01AR035582 · NIAMS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CAULEY, JANE · 1986 to 2005
$2.4M
Study of Osteoporotic FracturesR01AR035584 · NIAMS · UNIVERSITY OF MARYLAND BALTIMORE · PI HOCHBERG, MARC C. · 1986 to 2005
$2.1M
NIAMS NIH HHS R01 AR035582NIAMS NIH HHS R01 AR035583NIAMS NIH HHS R01 AR035584NIA NIH HHS R01 AG005394NIA NIH HHS R01 AG005407
6 · The paper itself

Abstract

Hip fractures in elderly women pose significant healthcare challenges. Promoting walking for exercise as a cost-effective intervention may help reduce the risk of fractures in this population. PURPOSE: This study aimed to examine the relationship between walking and hip fracture risk among women aged 65 years and older.

methodsA 20-year prospective study (1986-2006) included 9704 women from the Study of Osteoporotic Fractures (SOF) in the USA. Participants were followed biennially, and walking exposure was assessed by the number of city blocks walked for exercise, routine activity, and total blocks walked daily. Cox regression models with time-varying covariates assessed associations, with competing risks addressed using Fine and Gray models. Penalized splines were used to explore dose-response relationships.

resultsIn total, 1419 hip fractures were identified through the study period. The mean and median follow-up times for hip fractures or censoring were 15.0 and 15.8 years in the walking for exercise group, vs. 13.2 and 13.7 years in the not walking for exercise group. The hip fracture incidence rate was 10.0 cases per 1000 person-years (py) in the walking for exercise group compared to 10.9 per 1000 py in the not walking for exercise group. All-cause mortality was 37.1 per 1000 py in the walking for exercise group compared to 46.4 per 1000 py in the not walking for exercise group. Adjusted models showed that walking for exercise significantly reduced hip fracture risk (HR, 0.864; 95% CI, 0.762-0.980; P = 0.0230), with each additional block walked for exercise reducing risk (HR per block, 0.986; 95% CI, 0.978-0.995; P = 0.0022). Walking for routine activities showed no significant association. Spline analysis indicated walking 16 blocks (≈3200 steps) daily significantly lowered hip fracture risk.

conclusionWalking for exercise is linked to a reduced risk of hip fractures in elderly women. Walking the equivalent of 16 blocks or more (> 3200 steps) per day might be an effective way to reduce the risk of hip fractures in this vulnerable population.

Indexed as

Hip FracturesOsteoporotic FracturesWalkingAgedAged, 80 and overFemaleFollow-Up StudiesHumansIncidenceProspective StudiesRisk AssessmentRisk FactorsUnited StatesElderly womenHip fractureOsteoporotic fractures

Identifiers

PMID40332499
PMCPMC12208960

What Socratic holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.