Background: there is limited evidence of a protective effect of physical ac
tivity in preventing hip fractures among older people living in institution
s and in those aged 80 or over.
Objective: to examine the relationship between physical activity and risk o
f hip fracture in frail older people.
Design: a case-control study.
Setting: Auckland, New Zealand.
Subjects: a random sample of individuals hospitalized with a fracture of th
e femoral neck (n=911) and 910 randomly selected age- and sex-matched indiv
iduals from the lists of a random sample of general practitioners.
Methods: we sought information on physical activity and other potential ris
k factors for hip fracture from cases and controls, using a standardized in
terviewer-administered questionnaire. We conducted multivariate analyses, s
eparately for those living in private homes and residential institutions.
Results: increasing hours of physical activity per week protected against t
he risk of hip fracture among individuals living in private homes, includin
g those who are over 80. However, among individuals living in institutions,
physical activity levels were extremely low (<15% participated in <greater
than or equal to>2 h per week) and there was limited evidence of a protect
Conclusions: efforts to prevent hip fractures in individuals living in care
homes and institutions should focus on passive interventions which are kno
wn to be effective.