Advertisement

Calcified Tissue International

, Volume 105, Issue 1, pp 26–36 | Cite as

Associations of Sarcopenia and Its Components with Bone Structure and Incident Falls in Swedish Older Adults

  • David ScottEmail author
  • Jonas Johansson
  • Lachlan B. McMillan
  • Peter R. Ebeling
  • Peter Nordstrom
  • Anna Nordstrom
Original Research

Abstract

The aim of this study was to compare bone structure parameters and likelihood of falls across European Working Group on Sarcopenia in Older People (EWGSOP2) sarcopenia categories. 3334 Swedish 70-year olds had appendicular lean mass (normalized to height; ALMHt), lumbar spine and total hip areal BMD (aBMD) estimated by dual-energy X-ray absorptiometry. Volumetric BMD (vBMD) and structure at the distal and proximal tibia and radius were estimated by peripheral quantitative computed tomography. Hand grip strength and timed up-and-go were assessed, and sarcopenia was defined according to EWGSOP2 criteria. Incident falls were self-reported 6 and 12 months after baseline. Only 0.8% and 1.0% of participants had probable and confirmed sarcopenia, respectively. Almost one-third of participants with confirmed sarcopenia reported incident falls, compared with 20% for probable sarcopenia and 14% without sarcopenia (P = 0.025). Participants with confirmed sarcopenia had poorer bone parameters (all P < 0.05) except endosteal circumference at the proximal radius and tibia, while those with probable sarcopenia had lower cortical area at the proximal radius (B = − 5.9; 95% CI − 11.7, − 0.1 mm2) and periosteal and endosteal circumferences at the proximal tibia (− 3.3; − 6.4, − 0.3 and − 3.8; − 7.5, − 0.1 mm2, respectively), compared with those without sarcopenia. Compared with probable sarcopenia, confirmed sarcopenic participants had significantly lower lumbar spine and total hip aBMD, distal radius and tibia total vBMD, and proximal radius and tibia cortical vBMD, area and thickness (all P < 0.05). Swedish 70-year olds with confirmed sarcopenia demonstrate poorer BMD and bone architecture than those with probable and no sarcopenia, and have increased likelihood of incident falls.

Keywords

Sarcopenia Muscle Falls Bone Osteoporosis Older adults 

Notes

Acknowledgements

This study was funded by the Swedish Research Council (Grant No. 2011–2976). David Scott is supported by a NHMRC RD Wright Biomedical Career Development Fellowship (GNT1123014). The authors would like to thank Healthy Ageing Initiative research personnel Magnus Lindblom, David Lapveteläinen, and Jim Viklund, who were responsible for data collection.

Compliance with Ethical Standards

Conflict of interest

David Scott, Jonas Johansson, Lachlan B. McMillan, Peter R. Ebeling, Peter Nordstrom and Anna Nordstrom declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

The study was approved by the Umeå University Research Ethics Committee and complied with the World Medical Association’s Declaration of Helsinki. All participants provided written informed consent.

Supplementary material

223_2019_540_MOESM1_ESM.docx (20 kb)
Supplementary material 1 (DOCX 20 KB)

References

  1. 1.
    Kanis JA, Melton LJ, Christiansen C, Johnston CC, Khaltaev N (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141CrossRefPubMedGoogle Scholar
  2. 2.
    Edwards MH, Gregson CL, Patel HP, Jameson KA, Harvey NC, Sayer AA, Dennison EM, Cooper C (2013) Muscle size, strength and physical performance and their associations with bone structure in the Hertfordshire Cohort Study. J Bone Miner Res 28:2295–2304CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Cruz-Jentoft AJ, Bahat G, Bauer J et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48:16–31CrossRefPubMedGoogle Scholar
  4. 4.
    He H, Liu Y, Tian Q, Papasian C, Hu T, Deng H-W (2016) Relationship of sarcopenia and body composition with osteoporosis. Osteoporos Int 27:473–482CrossRefPubMedGoogle Scholar
  5. 5.
    Landi F, Liperoti R, Russo A, Giovannini S, Tosato M, Capoluongo E, Bernabei R, Onder G (2012) Sarcopenia as a risk factor for falls in elderly individuals: Results from the ilSIRENTE study. Clin Nutr 31:652–658CrossRefPubMedGoogle Scholar
  6. 6.
    Wong AKO (2016) A comparison of peripheral imaging technologies for bone and muscle quantification: a mixed methods clinical review. Curr Osteoporos Rep 14:359–373CrossRefPubMedGoogle Scholar
  7. 7.
    Hirschfeld HP, Kinsella R, Duque G (2017) Osteosarcopenia: where bone, muscle, and fat collide. Osteoporos Int 28:2781–2790CrossRefPubMedGoogle Scholar
  8. 8.
    Bruyere O, Cavalier E, Reginster JY (2017) Vitamin D and osteosarcopenia: an update from epidemiological studies. Curr Opin Clin Nutr Metab Care 20:498–503CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Johansson J, Nordström A, Gustafson Y, Westling G, Nordström P (2017) Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals. Age Ageing 46(6):964–970CrossRefGoogle Scholar
  10. 10.
    Hind K, Oldroyd B, Truscott JG (2010) In vivo precision of the GE Lunar iDXA densitometer for the measurement of total-body, lumbar spine, and femoral bone mineral density in adults. J Clin Densitom 13:413–417CrossRefPubMedGoogle Scholar
  11. 11.
    Szabo KA, Webber CE, Gordon C, Adachi JD, Tozer R, Papaioannou A (2011) Reproducibility of peripheral quantitative computed tomography measurements at the radius and tibia in healthy pre- and postmenopausal women. Can Assoc Radiol J 62:183–189CrossRefPubMedGoogle Scholar
  12. 12.
    Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing 39:412–423CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Johansson J, Nordström A, Nordström P Objectively measured physical activity is associated with parameters of bone in 70-year-old men and women. Bone 81:72–79Google Scholar
  14. 14.
    Freedson PS, Melanson E, Sirard J (1998) Calibration of the computer science and applications, Inc. accelerometer. Med Sci Sports Exerc 30:777–781CrossRefPubMedGoogle Scholar
  15. 15.
    Menai M, van Hees VT, Elbaz A, Kivimaki M, Singh-Manoux A, Sabia S (2017) Accelerometer assessed moderate-to-vigorous physical activity and successful ageing: results from the Whitehall II study. Sci Rep 7:45772CrossRefPubMedCentralGoogle Scholar
  16. 16.
    Tudor-Locke C, Camhi SM, Troiano RP (2012) Peer reviewed: a catalog of rules, variables, and definitions applied to accelerometer data in the National Health and Nutrition Examination Survey, 2003–2006. Prev Chronic Dis 9:e113PubMedPubMedCentralGoogle Scholar
  17. 17.
    Laurent MR, Dubois V, Claessens F, Verschueren SMP, Vanderschueren D, Gielen E, Jardí F (2016) Muscle-bone interactions: from experimental models to the clinic? A critical update. Mol Cell Endocrinol 432:14–36CrossRefPubMedGoogle Scholar
  18. 18.
    Edwards MH, Ward KA, Ntani G, Parsons C, Thompson J, Sayer AA, Dennison EM, Cooper C (2015) Lean mass and fat mass have differing associations with bone microarchitecture assessed by high resolution peripheral quantitative computed tomography in men and women from the Hertfordshire Cohort Study. Bone 81:145–151CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Chalhoub D, Cawthon PM, Ensrud KE et al (2015) Risk of nonspine fractures in older adults with sarcopenia, low bone mass, or both. J Am Geriatr Soc 63:1733–1740CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Harris R, Chang Y, Beavers K et al (2017) Risk of fracture in women with sarcopenia, low bone mass, or both. J Am Geriatr Soc 65(12):2673–2678CrossRefGoogle Scholar
  21. 21.
    Scott D, Seibel M, Cumming R et al (2018) Does combined osteopenia/osteoporosis and sarcopenia confer greater risk of falls and fracture than either condition alone in older men? The Concord Health and Ageing in Men Project. J Gerontol A Biol Sci Med Sci.  https://doi.org/10.1093/gerona/gly162 CrossRefPubMedGoogle Scholar
  22. 22.
    Samu S, Juha S, Toni R, Risto H, Sirola J (2013) Relationship between postmenopausal osteoporosis and the components of clinical sarcopenia. Maturitas 75:175–180CrossRefGoogle Scholar
  23. 23.
    Troy KL, Mancuso ME, Butler TA, Johnson JE (2018) Exercise early and often: effects of physical activity and exercise on women’s bone health. Int J Environ Res Public Health 15:878CrossRefPubMedCentralGoogle Scholar
  24. 24.
    Kim S, Baker BS, Sharma-Ghimire P, Bemben DA, Bemben MG (2018) Association between bone-specific physical activity scores and pQCT-derived measures of bone strength and geometry in healthy young and middle-aged premenopausal women. Arch Osteoporos 13:83CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Phu S, Vogrin S, Zanker J, Bani Hassan E, Al Saedi A, Duque G (2019) Agreement between initial and revised european working group on sarcopenia in older people definitions. J Am Med Directors Assoc 20:382–383.e1CrossRefGoogle Scholar
  26. 26.
    Locquet M, Beaudart C, Petermans J, Reginster J-Y, Bruyère O (2019) EWGSOP2 Versus EWGSOP1: impact on the prevalence of sarcopenia and its major health consequences. J Am Med Directors Assoc 20:384–385CrossRefGoogle Scholar
  27. 27.
    Zanker J, Scott D, Reijnierse EM et al (2019) Establishing an operational definition of sarcopenia in Australia and New Zealand: delphi method based consensus statement. J Nutr Health Aging 23:105–110CrossRefGoogle Scholar
  28. 28.
    Clemson L, Fiatarone Singh MA, Bundy A, Cumming RG, Manollaras K, O’Loughlin P, Black D (2012) Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): randomised parallel trial. Br Med J 345:e4547CrossRefGoogle Scholar
  29. 29.
    Sanders KM, Lim K, Stuart AL, Macleod A, Scott D, Nicholson GC, Busija L (2017) Diversity in fall characteristics hampers effective prevention: the precipitants, the environment, the fall and the injury. Osteoporos Int 28(10):3005–3015CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Medicine, School of Clinical Sciences at Monash HealthMonash UniversityClaytonAustralia
  2. 2.Department of Medicine and Australian Institute of Musculoskeletal Science, Melbourne Medical School - Western CampusThe University of MelbourneSt AlbansAustralia
  3. 3.Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
  4. 4.Department of Public Health and Clinical Medicine, Occupational and Environmental MedicineUmeå UniversityUmeåSweden
  5. 5.Department of Community Medicine and Rehabilitation, Geriatric MedicineUmeå UniversityUmeåSweden
  6. 6.School of Sport SciencesUiT The Arctic University of NorwayTromsøNorway

Personalised recommendations