Abstract
Objectives
We sought to examine the associations of osteosarcopenia with physical performance,
balance, and falls and fractures in community-dwelling older adults. Additionally,
we aimed to determine which clinical outcomes are associated with specific components
of osteosarcopenia.
Design
Cross-sectional study.
Setting and Participants
253 participants (77% women; aged 77.9 ± 0.42 years) who presented for a falls and
fractures risk assessment in Melbourne, Australia.
Methods
Participants were mobile, community-dwelling older adults (≥65 years) free of cognitive
impairment. Body composition (via dual-energy x-ray absorptiometry), physical performance
[via Timed Up and Go (TUG) and Short Physical Performance Battery (SPPB)], and balance
[via Four-Square Step test (FSS) and posturography] were examined. Falls in the past
year and fractures in the past 5 years were self-reported. Osteosarcopenia was defined
as (1) low bone mineral density (BMD) [T score <–1 standard deviation (SD)] combined
with sarcopenia and (2) osteoporosis (BMD T score ≤–2.5 SD) combined with severe sarcopenia.
For sarcopenia, we employed the criteria of the European Working Group on Sarcopenia
in Older People (EWGSOP1), the revised criteria (EWGSOP2), and that of the Foundation
for the National Institutes for Health (FNIH). Kruskal-Wallis and logistic regression
tests were used for statistical analysis.
Results
Osteosarcopenia was associated with worse SPPB, TUG, FSS, limit of stability, and
falls and fractures history. Additionally, osteosarcopenia (using the severe sarcopenia
classification) conferred an increased rate of falls [odds ratios (ORs) from 2.83
to 3.63; P < .05 for all] and fractures (ORs from 3.86 to 4.38; P < .05 for all) when employing the EWGSOP2 and FNIH definitions, respectively.
Conclusions and Implications
Compared with the nonosteosarcopenic group, those with osteosarcopenia had greater
impairment of physical performance and balance. The EWGSOP2 and FNIH criteria resulted
in the strongest associations with physical performance and self-reported falls and
fractures.
Keywords
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Article info
Publication history
Published online: October 25, 2019
Footnotes
W.S.L. and S.P. contributed equally to this work.
This work was supported by a Visiting Fellow Grant from the Australian Institute for Musculoskeletal Science (AIMSS) to B.K. E.B.H. holds an Australian Medical Research Frontiers Fund (MRFF: MACH-RART scheme 2019) Fellowship. S.B.O. is supported by a National Health and Medical Council (NHMRC, of Australia) Career Development Fellowship (1107510). W.S.L. is supported by the Brazilian National Council for Scientific and Technological Development (CNPq). R.C. is supported by a PhD scholarship from the “Studienstiftung des deutschen Volkes.”
The authors declare no conflicts of interest.
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© 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
