Purpose: Occupational activity plays a critical role in both the development and the prevention of fragility fractures, which are a major clinical concern in older adults as they profoundly affect quality of life and mortality. The present study therefore aimed to assess the impact of occupational activity on muscle strength, physical performance, and fracture risk among active workers, sedentary workers, and unemployed women.
Methods: Female patients with osteoporosis and at least one documented fragility fracture were enrolled. Inclusion criteria included a bone mineral density (BMD) T-score below −2.5 standard deviations and ongoing pharmacological treatment for osteoporosis. Patients with severe comorbidities were excluded. A comprehensive multidimensional assessment was conducted, including age, body mass index, smoking status, alcohol consumption, sun exposure, physical activity (assessed using the International Physical Activity Questionnaire), and physical performance (assessed using the Short Physical Performance Battery). Muscle strength was evaluated using handgrip dynamometry (handgrip strength), BMD by dual-energy X-ray absorptiometry, and fracture risk using the FRAX algorithm. Participants were categorized as employed or unemployed, and employed individuals were further classified as visual display terminal workers or physically active (PA) workers. Between-group differences in physical performance, physical activity, muscle strength, and fracture risk were analyzed.
Results: The study cohort included 100 women with a mean age of 66.9 ± 8.6 years. Of these, 63% were employed, and 87% had sustained fragility fractures, most commonly involving the vertebrae. The PA workers exhibited a 50.38% lower fracture risk compared with the unemployed participants (p < 0.001). The employed women demonstrated significantly higher physical performance and muscle strength than the unemployed women, with the PA subgroup showing the highest outcomes across all functional and strength measures, as well as the lowest fracture risk.
Conclusions: Occupational activity, particularly if physically demanding, may act as a protective factor against fragility fractures. However, differences between sedentary workers and unemployed women were not statistically significant. Further studies are warranted to clarify the relationship between sedentary work and fracture risk.
KEY WORDS: Fragility fractures, bone mineral density, osteoporosis, employment status, muscle strength.
