Statins and Physical Activity in Older Men: The Osteoporotic Fractures in Men Study Public Deposited

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  • IMPORTANCE: Muscle pain, fatigue, and weakness are common adverse effects of statin medications and may decrease physical activity in older men. OBJECTIVE: Determine whether statin use is associated with physical activity, longitudinally and cross-sectionally. DESIGN, SETTING, AND PARTICIPANTS: Men participating in the Osteoporotic Fractures in Men Study, a multicenter prospective cohort study of community-living men age 65+, enrolled between March 2000-April 2002. EXPOSURE: Statin use as determined by an inventory of medications (taken within last 30 days). In cross-sectional analyses, statin use categories were: users and nonusers. In longitudinal analyses, categories were: prevalent users (baseline use and throughout study), new users (initiated use during the study) and nonusers (never used). MAIN OUTCOMES AND MEASURE: Self-reported physical activity at baseline and 2 follow-up visits using the Physical Activity Scale for the Elderly (PASE). At the third visit, an accelerometer measured metabolic equivalents (METs; kcal/kg/hr) and minutes of moderate activity (METs ≥3.0), vigorous activity (METs ≥6.0), and sedentary behavior (METs ≤1.5). RESULTS: At baseline, 989 men (24%) were users and 3,148 (76%) were nonusers. The adjusted difference in baseline PASE between users and nonusers was -5.8 points (95% CI, -10.9 to -0.7). A total of 3,039 men met the inclusion criteria for longitudinal analysis: 727 (24%) prevalent users, 845 (28%) new users, 1,467 (48%) nonusers. PASE declined by an average of 2.5 points/year (2.0-3.0) for nonusers and 2.8 points/year (2.1, 3.5) for prevalent users, a nonstatistical difference (0.3 point, -0.5-1). For new users, annual PASE score declined at a faster rate than nonusers (0.9 point difference; 0.1-1.7). 3,071 men had adequate accelerometry data, 1,542 (50%) were statin users. Statin users expended less METS (0.03 kcal/kg/hr less; 0.02-0.04); engaged in less moderate physical activity (5.4 fewer minutes/day; 1.9-8.8), less vigorous activity (0.6 fewer minutes/day; 0.1-1.1), and more sedentary behavior (7.6 greater minutes/day; 2.6-12.4). CONCLUSION AND RELEVANCE: Statin use was associated with modestly lower physical activity among community-living men, even after accounting for medical history and other potentially confounding factors. The clinical significance of these findings deserves further investigation.
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  • Lee, D. S. H., Markwardt, S., Goeres, L., Lee, C. G., Eckstrom, E., Williams, C., . . . Nielson, C. M. (2014). Statins and physical activity in older men: The osteoporotic fractures in men study. JAMA Internal Medicine, 174(8), 1263-1270. doi:10.1001/jamainternmed.2014.2266
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  • 174
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  • 8
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  • The Osteoporotic Fractures in Men Study is supported by National Institutes of Health (NIH) funding; the following institutes provide support: the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Institute on Aging (NIA), the National Center for Research Resources (NCRR), and NIH Roadmap for Medical Research under the following grant numbers: U01 AR45580, U01 AR45614, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, U01 AG027810, and UL1 RR024140. This analysis was funded by a grant from the Medical Research Foundation of Oregon.
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