Japan’s rapidly ageing population has brought the health and wellbeing of older adults into sharper focus, with preventing falls and fractures emerging as a major public health priority. Fragility fractures, which occur when weakened bones break after relatively minor falls or impacts, can significantly reduce mobility, independence, and quality of life. Identifying preventable risk factors is therefore essential to helping older adults remain healthy and active for longer.
While lifestyle habits and medication use are believed to influence the likelihood of falls and fractures, researchers say comprehensive evidence has been limited. Particular attention has been given to potentially modifiable factors such as polypharmacy—the use of multiple medications simultaneously—and unintentional weight loss, both of which are common among older adults. At the same time, the role of physical activity in preventing falls and fractures has remained uncertain, with previous studies producing conflicting findings.
To better understand these risks, a research team led by Dr. Masayoshi Iwamae from Osaka Metropolitan University’s Graduate School of Medicine conducted a cross-sectional study involving 4,967 community-dwelling adults aged 60 and older in Osaka Prefecture. Participants completed an online survey that collected information on demographic characteristics, fragility fractures and falls over the previous five years, medication use, unintended weight loss, and levels of physical activity.
The analysis identified several independent factors associated with fragility fractures. Women were more likely than men to experience these injuries, while polypharmacy, a previous history of falls, and unintentional weight loss were also linked to a higher risk of fracture. These findings suggest that multiple health-related factors can combine to increase vulnerability among older adults, highlighting the need for comprehensive assessments rather than focusing on a single risk factor.
When researchers examined falls specifically, they found a slightly different pattern. The use of sleeping medications, polypharmacy, and unintended weight loss were each independently associated with a greater likelihood of falling. In contrast, physical activity was not significantly associated with either falls or fragility fractures. Although exercise remains widely recommended for maintaining overall health, the findings suggest that physical activity alone may not be sufficient to reduce fracture or fall risk without addressing other underlying health issues.
According to Dr. Iwamae, the results underscore the importance of adopting broad prevention strategies that go beyond encouraging exercise alone. Optimising medication use to reduce unnecessary prescriptions and addressing nutritional problems that contribute to weight loss could play key roles in lowering the risk of falls and fractures among older adults. While physical activity should continue to be promoted because of its many benefits for overall health and quality of life, the study provides evidence that practical interventions targeting medication management and nutrition may be equally important in helping community-dwelling seniors maintain their independence and reduce their risk of serious injury.
More information: Masayoshi Iwamae et al, Lifestyle factors, including physical activity status, associated with fragility fractures and falls: a cross-sectional study, BMC Geriatrics. DOI: 10.1186/s12877-026-07344-7
Journal information: BMC Geriatrics Provided by Osaka Metropolitan University
