Self-reported physical functional health predicts future bone mineral density in EPIC-Norfolk cohort

Sarah Perrott, Kathryn Martin, Victoria Keevil, Nicholas J. Wareham, Kay Tee Khaw, Phyo Kyaw Myint* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Self-reported physical functional health may predict bone mineral density (BMD) and thus provide a method to identify people at risk of low BMD. In this study, the association between the 36-item short-form questionnaire (SF-36) physical component summary (PCS) score and future BMD in participants aged 40-79 years enrolled in the European Prospective Investigation of Cancer-Norfolk study was investigated.

Methods Associations between a participant’s SF-36 PCS score, measured 18 months after baseline health check, and broadband ultrasound attenuation (BUA – a measure of BMD), measured 2-5 years after baseline, were examined using sex-specific linear and logistic regression analyses adjusting for age, BMI, medical co-morbidities, lifestyle and socioeconomic factors.

Data from 10,203 participants, mean (standard deviation (SD)) age 61.5 (8.9) years (57.4% women) were analysed from 1993-2000. For every five points lower PCS score in men and women, there was approximately a 0.5 dB/MHz lower mean BUA. In women, a PCS score of less than one standard deviation (1SD) below the sex-specific mean was associated with having a low BUA (< 1SD
below sex-specific mean) and very low BUA (< 2.5SD below the sex specific mean); odds ratio (OR) (95% confidence interval) 1.53 (1.24, 1.88) and 8.28 (2.67, 25.69), respectively. The relationship was lesser so in men; corresponding OR (95%CI) were 1.34 (0.91, 1.98) and 2.57 (0.72, 9.20), respectively.

Self-reported physical functioning predicts BMD in an apparently healthy population, particularly in women. This could potentially provide an inexpensive, simple screening tool to identify individuals at risk of osteoporosis.
Original languageEnglish
Article number25
Number of pages9
JournalArchives of Osteoporosis
Issue number1
Early online date28 Jan 2022
Publication statusPublished - 28 Jan 2022


  • physical functioning
  • bone mineral density
  • older adults
  • SF-36


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