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

2 Citations (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

Bibliographical note

Acknowledgements We are grateful to all the participants who have been part of the project and to the many members of the study teams at the University of Cambridge who have enabled this research.
Funding This work was supported by funding from the Medical Research Council (Grant/Award Numbers: MR/N003284/1, MC- UU_12015/1.) and Cancer Research UK (Grant/Award Number: C864/A14136), with additional support from the Stroke Association, British Heart Foundation, Department of Health, Europe Against Cancer Programme Commission of the European Union, Food
Standards Agency, Research into Ageing, Academy of Medical Sciences and Wellcome Trust. Sarah Perrott received an institutional grant from the University of Aberdeen Academic Centre for Applied Clinical and Translational Research into Ageing (ACTRA). The role of this grant was to financially support a student researcher from November 2020 to January 2021.

Data Availability Statement

There are no linked research data sets for this paper. Data will be made available on request to the steering committee of EPIC-Norfolk.


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


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