{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T14:51:20Z","timestamp":1766760680836},"reference-count":47,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>The relationship between self-reported walking limitation, a proxy of muscle function, and fracture risk has not been investigated.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine the association between a self-reported walking limitation of 1000 m or less and 5-year risk of fracture.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This prospective cohort study compared individuals with various degrees of walking ability limitation at 1000 m (a little limitation and a lot of limitation) and those without limitation (no limitation) accounting for age, falls, prior fractures, and weight. Participants from the ongoing population-based Sax Institute 45 and Up Study were followed from recruitment (2005-2008) for 5 years (2010-2013). Data analysis was conducted from July 2020 to September 2023.<\/jats:p><\/jats:sec>Exposure<\/jats:title>Self-reported walking limitation.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Incident fracture and site-specific fractures (hip, vertebral, and nonhip nonvertebral [NHNV] fractures).<\/jats:p><\/jats:sec>Results<\/jats:title>Among the 266\u202f912 participants enrolled in the 45 and Up Study, 238\u202f969 were included, with 126\u202f015 (53%) women (mean [SD] age, 63 [11] years) and 112\u202f954 (47%) men (mean [SD] age, 61 [11] years). Approximately 20% reported a degree of limitation in walking 1000 m or less at baseline (39\u202f324 women [24%]; 23\u202f191 men [21%]). During a mean (SD) follow-up of 4.1 (0.8) years, 7190 women and 4267 men experienced an incident fracture. Compared with participants who reported no walking limitations, a little limitation and a lot of limitation were associated with higher risk of fracture (a little limitation among women: hazard ratio [HR], 1.32; 95% CI, 1.23-1.41; a little limitation among men: HR, 1.46; 95% CI, 1.34-1.60; a lot of limitation among women: HR, 1.60; 95% CI, 1.49-1.71; a lot of limitation among men: HR, 2.03; 95% CI, 1.86-2.22). Approximately 60% of fractures were attributable to walking limitation. The association was significant for hip, vertebral, and NHNV fracture and ranged between a 21% increase to a greater than 219% increase.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study of 238\u202f969 participants, self-reported walking limitations were associated with increased risk of fracture. These findings suggest that walking ability should be sought by clinicians to identify high-risk candidates for further assessment.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.52675","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T16:03:59Z","timestamp":1706025839000},"page":"e2352675","source":"Crossref","is-referenced-by-count":3,"title":["Patient Self-Assessment of Walking Ability and Fracture Risk in Older Australian Adults"],"prefix":"10.1001","volume":"7","author":[{"given":"Dana","family":"Bliuc","sequence":"first","affiliation":[{"name":"Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia"},{"name":"School of Population Health, Faculty of Medicine and Health, UNSW, Sydney, New South Wales, Australia"},{"name":"UNSW Ageing Future Institute, Sydney, New South Wales, 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