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JAMA Intern Med. 2014 Aug;174(8):1263-70. doi: 10.1001/jamainternmed.2014.2266.

Statins and physical activity in older men: the osteoporotic fractures in men study.

Author information

1
Department of Pharmacy Practice, Oregon State University/Oregon Health and Science University College of Pharmacy, Portland.
2
Research Service, Department of Veterans Affairs Medical Center, Portland, Oregon3Division of Endocrinology, Department of Medicine, Diabetes and Clinical Nutrition, Oregon Health and Science University School of Medicine, Portland.
3
Division of General Medicine and Geriatrics, Oregon Health and Science University School of Medicine, Portland.
4
Department of Public Health and Preventive Medicine, Oregon Health and Science University School of Medicine, Portland.
5
Division of Endocrinology, Department of Medicine, Diabetes and Clinical Nutrition, Oregon Health and Science University School of Medicine, Portland.
6
California Pacific Medical Center Research Institute, San Francisco.
7
Prevention Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California.
8
Department of Medicine, University of California, San Francisco.

Abstract

IMPORTANCE:

Muscle pain, fatigue, and weakness are common adverse effects of statin medications and may decrease physical activity in older men.

OBJECTIVE:

To 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 (N = 5994), a multicenter prospective cohort study of community-living men 65 years and older, enrolled between March 2000 and April 2002. Follow-up was conducted through 2009.

EXPOSURES:

Statin use as determined by an inventory of medications (taken within the last 30 days). In cross-sectional analyses (n = 4137), statin use categories were users and nonusers. In longitudinal analyses (n = 3039), categories were prevalent users (baseline use and throughout the study), new users (initiated use during the study), and nonusers (never used).

MAIN OUTCOMES AND MEASURES:

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 [kilocalories per kilogram per hour]) 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 3148 (76%) were nonusers. The adjusted difference in baseline PASE between users and nonusers was -5.8 points (95% CI, -10.9 to -0.7 points). A total of 3039 men met the inclusion criteria for longitudinal analysis: 727 (24%) prevalent users, 845 (28%) new users, and 1467 (48%) nonusers. PASE score declined by a mean (95% CI) of 2.5 (2.0 to 3.0) points per year for nonusers and 2.8 (2.1 to 3.5) points per year for prevalent users, a nonstatistical difference (0.3 [-0.5 to 1.0] points). For new users, annual PASE score declined at a faster rate than nonusers (difference of 0.9 [95% CI, 0.1 to 1.7] points). A total of 3071 men had adequate accelerometry data, 1542 (50%) were statin users. Statin users expended less METs (0.03 [95% CI, 0.02-0.04] METs less) and engaged in less moderate physical activity (5.4 [95% CI, 1.9-8.8] fewer minutes per day), less vigorous activity (0.6 [95% CI, 0.1-1.1] fewer minutes per day), and more sedentary behavior (7.6 [95% CI, 2.6-12.4] greater minutes per day).

CONCLUSIONS 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.

Comment in

PMID:
24911216
PMCID:
PMC4346343
DOI:
10.1001/jamainternmed.2014.2266
[Indexed for MEDLINE]
Free PMC Article
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