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


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.


Sarcopenia Muscle Falls Bone Osteoporosis Older adults 



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)


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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

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