New research finds 1 in 5 people struggle to make it a half-mile pain free
DARLINGHURST, Australia — Can you walk a kilometer pain-free? For many Americans, the first question might be, how far is a kilometer? Whether you use the metric system or not, a new study finds that a person’s ability to comfortably walk one kilometer — or just over half a mile (0.6 miles) — can go a long way toward predicting future bone fracture risk.
Scientists at the Garvan Institute of Medical Research say asking patients about walking limitations is an easy and straightforward way for doctors and clinicians to identify individuals in need of further bone health screenings and interventions intended to stop fractures before they occur.
“We’ve discovered that trouble walking even short distances appears closely tied to higher fracture risk over the following five years,” says the study’s lead author, Professor Jacqueline Center, Head of Garvan’s Clinical Studies and Epidemiology Lab, in a media release. “Just a few simple questions about how far someone can walk could give doctors an early warning sign to check bone health.”
This project features data encompassing close to 267,000 adults 45 and older originally collected by the Sax Institute’s 45 and Up Study, a major ongoing research initiative tracking health outcomes among Australian adults for over 15 years. All participants answered questions regarding any health issues limiting their ability to walk various distances, and the possible answer options were: “not at all,” “a little,” or “a lot.” Then, researchers tracked everyone for five years to assess fracture outcomes.
Study authors uncovered that as many as one in five adults reported dealing with some walking limitation at the start of the study. Importantly, participants with more difficulty walking were significantly more likely to experience a fracture during the follow-up period. For instance, women who reported “a lot” of limitations in walking one kilometer had a 60-percent higher fracture risk than other women reporting no limitations. Among men, the increased risk was over 100 percent.
“We saw a clear ‘dose-response’ pattern, where greater walking limitation meant higher fracture risk. This suggests a direct relationship between low walking ability and weaker bones,” explains first author of the study Dr. Dana Bliuc, Senior Research Officer at Garvan.
Researchers revealed that roughly 60 percent of all studied fractures are attributable to some form or level of walking limitation. This link remained quite strong even after researchers accounted for other factors, including age, falls, prior fractures, and weight. Results also stayed consistent across different fracture sites like the hips, vertebrae, arms, and legs.
“In this generally healthy community-based population, we still found one in five people had trouble walking a kilometer,” Prof. Center comments. “We think this simple assessment could help identify many more at-risk individuals who may benefit from bone density screening or preventative treatment.”
Osteoporosis medications, lifestyle changes, and a number of additional interventions can already help people improve their bone strength and avoid first or repeat fractures. However, screening rates are currently quite low. That means many people miss out on fracture risk assessments. Finding easy yet still accurate ways of detecting at-risk people is a key target among researchers.
“Fracture risk assessment generally relies on a bone density test, which many people have not had when seeing their doctor,” Prof.Center adds. “Asking about walking ability takes just seconds and could be a free, non-invasive way to tell if someone needs their bones checked.”
Study authors point out that walking limitations can have other causes beyond weak bones (heart disease, arthritis). However, trouble walking even short distances appears closely related to fracture risk on an entirely independent level.
“We hope these findings will encourage clinicians to consider walking ability as a red flag for possible bone health issues. For patients, if you can’t walk a full kilometer comfortably, it may be wise to ask your doctor about getting your bones checked,” Dr. Bliuc concludes.
The study is published in JAMA Network Open.