{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T07:24:00Z","timestamp":1792567440651,"version":"4.5.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2024,2,10]],"date-time":"2024-02-10T00:00:00Z","timestamp":1707523200000},"content-version":"vor","delay-in-days":2035,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2018,8,29]],"date-time":"2018-08-29T00:00:00Z","timestamp":1535500800000},"content-version":"vor","delay-in-days":44,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["4050502589"],"award-info":[{"award-number":["4050502589"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["asbmr.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,12,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2003<\/jats:title>\n                  <jats:p>Measures of muscle mass, strength, and function predict risk of incident fractures, but it is not known whether this risk information is additive to that from FRAX (fracture risk assessment tool) probability. In the Osteoporotic Fractures in Men (MrOS) Study cohorts (Sweden, Hong Kong, United States), we investigated whether measures of physical performance\/appendicular lean mass (ALM) by DXA predicted incident fractures in older men, independently of FRAX probability. Baseline information included falls history, clinical risk factors for falls and fractures, femoral neck aBMD, and calculated FRAX probabilities. An extension of Poisson regression was used to investigate the relationship between time for five chair stands, walking speed over a 6\u2009m distance, grip strength, ALM adjusted for body size (ALM\/height2), FRAX probability (major osteoporotic fracture [MOF]) with or without femoral neck aBMD, available in a subset of n\u2009=\u20097531), and incident MOF (hip, clinical vertebral, wrist, or proximal humerus). Associations were adjusted for age and time since baseline, and are reported as hazard ratios (HRs) for first incident fracture per SD increment in predictor using meta-analysis. 5660 men in the United States (mean age 73.5 years), 2764 men in Sweden (75.4 years), and 1987 men in Hong Kong (72.4 years) were studied. Mean follow-up time was 8.7 to 10.9 years. Greater time for five chair stands was associated with greater risk of MOF (HR 1.26; 95% CI, 1.19 to 1.34), whereas greater walking speed (HR 0.85; 95% CI, 0.79 to 0.90), grip strength (HR 0.77; 95% CI, 0.72 to 0.82), and ALM\/height2 (HR 0.85; 95% CI, 0.80 to 0.90) were associated with lower risk of incident MOF. Associations remained largely similar after adjustment for FRAX, but associations between ALM\/height2 and MOF were weakened (HR 0.92; 95% CI, 0.85 to 0.99). Inclusion of femoral neck aBMD markedly attenuated the association between ALM\/height2 and MOF (HR 1.02; 95% CI, 0.96 to 1.10). Measures of physical performance predicted incident fractures independently of FRAX probability. Whilst the predictive value of ALM\/height2 was substantially reduced by inclusion of aBMD requires further study, these findings support the consideration of physical performance in fracture risk assessment. \u00a9 2018 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals Inc.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/jbmr.3556","type":"journal-article","created":{"date-parts":[[2018,7,16]],"date-time":"2018-07-16T14:19:42Z","timestamp":1531750782000},"page":"2150-2157","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":116,"title":["Measures of Physical Performance and Muscle Strength as Predictors of Fracture Risk Independent of FRAX, Falls, and aBMD: A Meta-Analysis of the Osteoporotic Fractures in Men (MrOS) Study"],"prefix":"10.1093","volume":"33","author":[{"given":"Nicholas C","family":"Harvey","sequence":"first","affiliation":[{"name":"National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southamptonand University Hospital Southampton NHS Foundation TrustSouthamptonUK"},{"name":"Medical Research Council (MRC) Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Od\u00e9n","sequence":"additional","affiliation":[{"name":"Centre for Metabolic Bone DiseasesUniversity of SheffieldSheffieldUK"},{"name":"Centre for Bone and Arthritis Research (CBAR)Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Orwoll","sequence":"additional","affiliation":[{"name":"Oregon Health & Science UniversityPortlandORUSA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodi","family":"Lapidus","sequence":"additional","affiliation":[{"name":"Department of Public Health and Preventive MedicineDivision of BiostatisticsOregon Health and Science UniversityPortlandORUSA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Kwok","sequence":"additional","affiliation":[{"name":"Department of Medicine & Therapeutics and School of Public HealthThe Chinese University of Hong KongHong KongThe People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus K","family":"Karlsson","sequence":"additional","affiliation":[{"name":"Clinical and Molecular Osteoporosis Research UnitLund University, Lund, Sweden; and Department of OrthopedicsSkane University HospitalMalm\u00f6Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn E","family":"Rosengren","sequence":"additional","affiliation":[{"name":"Clinical and Molecular Osteoporosis Research UnitLund University, Lund, Sweden; and Department of OrthopedicsSkane University HospitalMalm\u00f6Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Ribom","sequence":"additional","affiliation":[{"name":"Department of Surgical SciencesUniversity of UppsalaUppsalaSweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrus","family":"Cooper","sequence":"additional","affiliation":[{"name":"National Institute for Health Research (NIHR) Biomedical Research CentreUniversity of OxfordOxfordUK"},{"name":"National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southamptonand University Hospital Southampton NHS Foundation TrustSouthamptonUK"},{"name":"Medical Research Council (MRC) Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy M","family":"Cawthon","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and BiostatisticsUniversity of California\u2013San FranciscoSan FranciscoCAUSA"},{"name":"Research InstituteCalifornia Pacific Medical CenterSan FranciscoCAUSA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A","family":"Kanis","sequence":"additional","affiliation":[{"name":"Institute for Health and AgingCatholic University of AustraliaMelbourneAustralia"},{"name":"Centre for Metabolic Bone DiseasesUniversity of SheffieldSheffieldUK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claes","family":"Ohlsson","sequence":"additional","affiliation":[{"name":"Centre for Bone and Arthritis Research (CBAR)Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Mellstr\u00f6m","sequence":"additional","affiliation":[{"name":"Centre for Bone and Arthritis Research (CBAR)Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Johansson","sequence":"additional","affiliation":[{"name":"Institute for Health and AgingCatholic University of AustraliaMelbourneAustralia"},{"name":"Centre for Metabolic Bone DiseasesUniversity of SheffieldSheffieldUK"},{"name":"Centre for Bone and Arthritis Research (CBAR)Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"McCloskey","sequence":"additional","affiliation":[{"name":"Centre for Integrated Research in Musculoskeletal Ageing (CIMA)Mellanby Centre for Bone ResearchUniversity of SheffieldSheffieldUK"},{"name":"Centre for Metabolic Bone DiseasesUniversity of SheffieldSheffieldUK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,7,16]]},"reference":[{"issue":"Suppl 4","key":"2024021014305325900_jbmr3556-bib-0001","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1093\/ageing\/30.suppl_4.3","article-title":"Epidemiology of falls","volume":"30","author":"Masud","year":"2001","journal-title":"Age and ageing"},{"issue":"3","key":"2024021014305325900_jbmr3556-bib-0002","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.jocd.2011.05.010","article-title":"Official positions for FRAX(R) clinical regarding falls and frailty: can falls and frailty be used in FRAX(R)? 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