The ability to walk one kilometer comfortably can help predict fracture risk, according to a recent study. The findings suggest that simply asking an individual about walking limitations could allow clinicians and others working with older adults to identify those in need of bone health screening and interventions that could prevent fractures from occurring.

The researchers examined data on nearly 267,000 adults aged 45 and older from the Sax Institute's 45 and Up Study, an ongoing research initiative that has been tracking health outcomes in adults in New South Wales for more than 15 years. Participants were asked if health issues limited their ability to walk various distances, with answer options of “not at all,” “a little,” or “a lot.” The group was then followed for five years to track fracture outcomes.

One in five adults reported some walking limitation at the beginning of the study. Those with more difficulty walking were significantly more likely to experience a fracture during follow-up. For example, women who said they were limited “a lot” in walking one kilometer had a 60% higher fracture risk than women with no limitation. For men, the increased risk was over 100%.

Approximately 60% of all fractures in the study were attributable to some level of walking limitation. The link remained strong even after accounting for other factors like age, falls, prior fractures, and weight, and the findings were consistent across different fracture sites like hips, vertebrae, arms, and legs.

Osteoporosis medications, lifestyle changes, and other interventions are available to improve bone strength and avoid first or repeat fractures. However, screening rates currently remain low, meaning many miss out on fracture-risk assessments. Finding easy but accurate ways to detect at-risk people is an important target for research. Meanwhile, the authors think this simple assessment could help identify more at-risk individuals who may benefit from screening or preventive treatment.

To read the full study, published in JAMA Network Open, click here