Aging Clinical and Experimental Research

, Volume 27, Supplement 1, pp 11–16 | Cite as

Prevalent fragility fractures as risk factor for skeletal muscle function deficit and dysmobility syndrome in post-menopausal women

  • Giovanni IolasconEmail author
  • Antimo Moretti
  • Maria Teresa Giamattei
  • Silvia Migliaccio
  • Francesca Gimigliano
Original Article



Fragility fractures are a major burden for health and social care in elderly people. In order to identify earlier the “frail elders”, new concepts of “dysmobility syndrome” and skeletal muscle function deficit (SMFD), including sarcopenia, osteoporosis, obesity, and mobility limitation, leading to a higher risk of fractures, have been recently introduced. There are very few studies investigating the association between fragility fractures and both the dysmobility syndrome and the SMFD.


The objective of our study is to investigate the role of previous fragility fractures as a risk factor in determining the dysmobility syndrome and/or the SMFD in post-menopausal women.


In this case–control study, we retrospectively examined data from the medical records of post-menopausal women aged 50 or older. We divided the study population in two groups. The first group includes women with a previous fragility fracture (cases) and the other group includes women without any previous osteoporotic fracture (controls). We identified the subjects with “dysmobility syndrome”, “dynapenic SMFD”, “sarcopenic SMFD”, and “mixed SMFD” in both groups. Data collected refer to a 6-month period.


We retrieved data of 121 post-menopausal women, 77 (63.64 %) had already sustained a fragility fracture at any site (cases). The risk for dysmobility syndrome was significantly higher (adjusted OR for age and serum 25-OH vitamin D3 of 2.46) in the cases compared with the controls.

Discussion and conclusions

An early diagnosis of conditions limiting mobility, including dysmobility syndrome, might be useful to identify, among patients with osteoporotic fractures, those who might have a higher risk of a new fragility fracture.


Fragility fractures Osteoporosis Sarcopenia Dysmobility syndrome Skeletal muscle function deficit 


Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest. No funding was received in support of this study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/ or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Hernlund E, Svedbom A, Ivergård M et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8(1–2):136PubMedCentralCrossRefPubMedGoogle Scholar
  2. 2.
    Iolascon G, Gravina P, Luciano F et al (2013) Characteristics and circumstances of falls in hip fractures. Aging Clin Exp Res 25(Suppl 1):S133–S135CrossRefPubMedGoogle Scholar
  3. 3.
    Deandrea S, Lucenteforte E, Bravi F et al (2010) Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology 21(5):658–668CrossRefPubMedGoogle Scholar
  4. 4.
    Martín-Martín LM, Arroyo-Morales M, Sánchez-Cruz JJ et al (2015) Factors influencing performance-oriented mobility after hip fracture. J Aging Health 27(5):827-842CrossRefPubMedGoogle Scholar
  5. 5.
    Vochteloo AJ, Borger van der Burg BL, Röling MA et al (2012) Contralateral hip fractures and other osteoporosis-related fractures in hip fracture patients: incidence and risk factors. An observational cohort study of 1229 patients. Arch Orthop Trauma Surg 132(8):1191–1197PubMedCentralCrossRefPubMedGoogle Scholar
  6. 6.
    Rosenberg IH (1989) Summary comments: epidemiological and methodological problems in determining nutritional status of older persons. Am J Clin Nutr 50:1231–1233Google Scholar
  7. 7.
    Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al (2010) European working group on sarcopenia in older people. Age Ageing 39(4):412–423PubMedCentralCrossRefPubMedGoogle Scholar
  8. 8.
    Studenski SA, Peters KW, Alley DE et al (2014) The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci 69(5):547–558PubMedCentralCrossRefPubMedGoogle Scholar
  9. 9.
    Correa-de-Araujo R, Hadley E (2014) Skeletal muscle function deficit: a new terminology to embrace the evolving concepts of sarcopenia and age-related muscle dysfunction. J Gerontol A Biol Sci Med Sci 69(5):591–594PubMedCentralCrossRefPubMedGoogle Scholar
  10. 10.
    Copês RM, Comim FV, Langer FW et al (2015) Obesity and fractures in postmenopausal women: a primary-care cross-sectional study at Santa Maria, Brazil. J Clin Densitom 18(2):165–171CrossRefPubMedGoogle Scholar
  11. 11.
    Zhang P, Peterson M, Su GL et al (2015) Visceral adiposity is negatively associated with bone density and muscle attenuation. Am J Clin Nutr 101(2):337–343CrossRefPubMedGoogle Scholar
  12. 12.
    Malkov S, Cawthon PM, Peters KW et al (2015) Hip fractures risk in older men and women associated with DXA-derived measures of thigh subcutaneous fat thickness, cross-sectional muscle area, and muscle density. J Bone Miner Res 30(8):1414–1421CrossRefPubMedGoogle Scholar
  13. 13.
    Leslie WD, Orwoll ES, Nielson CM et al (2014) Estimated lean mass and fat mass differentially affect femoral bone density and strength index but are not FRAX independent risk factors for fracture. J Bone Miner Res 29(11):2511–2519CrossRefPubMedGoogle Scholar
  14. 14.
    Stenholm S, Harris TB, Rantanen T et al (2008) Sarcopenic obesity: definition, cause and consequences. Curr Opin Clin Nutr Metab Care 11(6):693–700PubMedCentralCrossRefPubMedGoogle Scholar
  15. 15.
    Wannamethee SG, Atkins JL (2015) Muscle loss and obesity: the health implications of sarcopenia and sarcopenic obesity. Proc Nutr Soc 27:1–8CrossRefGoogle Scholar
  16. 16.
    Scott D, Sanders KM, Aitken D et al (2014) Sarcopenic obesity and dynapenic obesity: 5-year associations with falls risk in middle-aged and older adults. Obesity (Silver Spring) 22(6):1568–1574CrossRefGoogle Scholar
  17. 17.
    Binkley N, Krueger D, Buehring B (2013) What’s in a name revisited: should osteoporosis and sarcopenia be considered components of “dysmobility syndrome?”. Osteoporos Int 24(12):2955–2959CrossRefPubMedGoogle Scholar
  18. 18.
    Looker AC (2015) Dysmobility syndrome and mortality risk in US men and women age 50 years and older. Osteoporos Int 26(1):93–102CrossRefPubMedGoogle Scholar
  19. 19.
    Cooper R, Bann D, Wloch EG et al (2015) “Skeletal muscle function deficit” in a nationally representative british birth cohort in early old age. J Gerontol A Biol Sci Med Sci 70(5):604–607PubMedCentralCrossRefPubMedGoogle Scholar
  20. 20.
    Schousboe JT, Shepherd JA, Bilezikian JP et al (2013) Executive summary of the 2013 International Society for Clinical Densitometry Position Development Conference on bone densitometry. J Clin Densitom 16(4):455–466CrossRefPubMedGoogle Scholar
  21. 21.
    Linn BS, Linn MW, Gurel L (1968) Cumulative illness rating scale. J Am Geriatr Soc 16(5):622–626CrossRefPubMedGoogle Scholar
  22. 22.
    Kanis JA, Johnell O, De Laet C et al (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35(2):375–382CrossRefPubMedGoogle Scholar
  23. 23.
    Yu R, Leung J, Woo J (2014) Incremental predictive value of sarcopenia for incident fracture in an elderly Chinese cohort: results from the Osteoporotic Fractures in Men (MrOs) Study. J Am Med Dir Assoc 15(8):551–558CrossRefPubMedGoogle Scholar
  24. 24.
    Hida T, Shimokata H, Sakai Y et al (2015) Sarcopenia and sarcopenic leg as potential risk factors for acute osteoporotic vertebral fracture among older women. Eur Spine J. [Epub ahead of print]Google Scholar
  25. 25.
    Barry BK, Carson RG (2004) The consequences of resistance training for movement control in older adults. J Gerontol A Biol Sci Med Sci 59(7):730–754CrossRefPubMedGoogle Scholar
  26. 26.
    Frontera WR, Hughes VA, Fielding RA et al (2000) Roubenoff R Aging of skeletal muscle: a 12-yr longitudinal study. J Appl Physiol (1985) 88(4):1321–1326Google Scholar
  27. 27.
    Cherin P, Voronska E, Fraoucene N et al (2014) Prevalence of sarcopenia among healthy ambulatory subjects: the sarcopenia begins from 45 years. Aging Clin Exp Res 26(2):137–146CrossRefPubMedGoogle Scholar
  28. 28.
    Osteoporosis prevention, diagnosis, and therapy. NIH Consens Statement (2000) 17(1):1–45Google Scholar
  29. 29.
    Kanis JA (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int 4(6):368–381CrossRefPubMedGoogle Scholar
  30. 30.
    Kelly TL, Wilson KE, Heymsfield SB (2009) Dual energy X-ray absorptiometry body composition reference values from NHANES. PLoS One 4(9):e7038PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Giovanni Iolascon
    • 1
    Email author
  • Antimo Moretti
    • 1
  • Maria Teresa Giamattei
    • 1
  • Silvia Migliaccio
    • 2
  • Francesca Gimigliano
    • 3
  1. 1.Department of Medical and Surgical Specialties and DentistrySecond University of NaplesNaplesItaly
  2. 2.Department of Movement, Human and Health Sciences, Unit of EndocrinologyUniversity of Rome “Foro Italico”RomeItaly
  3. 3.Department of Mental and Physical Health and Preventive MedicineSecond University of NaplesNaplesItaly

Personalised recommendations