Association between kinesiophobia and bone mineral density in hospitalized older adults with osteoporosis: a cross-sectional study

Objective To examine the association between kinesiophobia (fear of movement) and lumbar spine Bone mineral density (BMD) among hospitalized older adults with osteoporosis. Methods This cross-sectional study included 246 hospitalized adults aged 60 years or older with osteoporosis who were admitted to orthopedic wards at the Affiliated Hospital of Chengdu University between August and October 2025. Kinesiophobia was assessed using the 17-item Tampa Scale for Kinesiophobia (TSK-17), with scores ≥37 indicating the presence of kinesiophobia. The primary outcome, volumetric trabecular bone mineral density (BMD), was measured at the lumbar spine (L1–L4) using quantitative computed tomography (QCT). Spearman correlation and multivariable linear regression analyses were performed to evaluate factors associated with BMD. Results Among 246 participants (53 men,193 women),186 (75.6%) exhibited kinesiophobia. CT-measured BMD was significantly lower in participants with kinesiophobia (p < 0.001). Kinesiophobia showed a moderate negative correlation with BMD (ρ = –0.286, p < 0.001), while age demonstrated a strong negative correlation (ρ = –0.443, p < 0.001), and BMI a weak positive correlation (ρ = 0.148, p = 0.02). In multivariable analyses, kinesiophobia was independently associated with lower BMD (β, −8.897 mg/cm³; 95% CI, −13.715 to −4.079; P