Physical Activity Across Adulthood and Bone Health in Later Life: The 1946 British Birth Cohort

Leisure time physical activity (LTPA) is widely recommended for the prevention of osteoporosis and fractures in older populations. However, whether the beneficial effects of LTPA on bone accumulate across life and are maintained even after reduction or cessation of regular PA in later life is unknown. We aimed to examine whether LTPA across adulthood was cumulatively associated with volumetric and areal bone mineral density (vBMD, aBMD) at age 60‐64 and whether associations were mediated by lean mass. Up to 1498 participants from the Medical Research Council National Survey of Health and Development were included in analyses. LTPA was self‐reported at ages 36, 43, 53 and 60‐64, and responses summed to generate a cumulative score (range:0 (inactive at all 4 ages) to 8 (most active at all 4 ages)). Total and trabecular vBMD were measured at the distal radius using peripheral quantitative computed tomography and aBMD at the total hip and lumbar spine (L1‐L4) using dual‐energy X‐ray absorptiometry. Linear regression was used to test associations of the cumulative LTPA score with each bone outcome. After adjustment for height and weight, a 1‐unit increase in LTPA score [95% CI] in men was associated with differences of: 1.55% [0.78%,2.31%] in radial trabecular vBMD; 0.83% [0.41%,1.25%] in total hip aBMD and; 0.97% [0.44%,1.49%] in spine aBMD. Among women, positive associations were seen for radial trabecular vBMD and total hip aBMD but only among those of greater weight (LTPA x weight interaction p≤ 0.01). In men, there was evidence to suggest that lean mass index may partly mediate these associations.

These findings suggest that there are cumulative benefits of LTPA across adulthood on BMD in early old age, especially among men. The finding of weaker associations among women suggests that promotion of specifıc types of LTPA may be needed to benefit bone health in women.