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Dysmobility syndrome is associated with prevalent morphometric vertebral fracture in older adults: the Korean Urban-Rural Elderly (KURE) study

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Abstract

Summary

In a community-dwelling elderly cohort, dysmobility syndrome was associated with elevated odds of morphometric vertebral fracture or any prevalent fracture, independent of age and covariates. Dysmobility syndrome improved discrimination for fracture when added to the FRAX score.

Introduction

Dysmobility syndrome was coined to indicate patients with impaired musculoskeletal health. Data on the association of dysmobility syndrome with prevalent morphometric vertebral fracture (VF) in elderly persons are limited.

Methods

A total of 1369 community-dwelling elderly subjects (mean age 71.6 years; women 66%) were analyzed. Dysmobility syndrome was defined as ≥ 3 components among falls, low lean mass, high fat mass, osteoporosis, low grip strength, and low timed get-up-and-go performance. VF was defined as a ≥ 25% reduction in the height of vertebral bodies in plain radiographs. Modified cutpoints of each component at which elevate the odds of fracture were investigated using receiver-operating characteristics analysis. Net reclassification improvement (NRI) and integrated discrimination index (IDI) were calculated to assess additive discriminatory value of dysmobility syndrome over FRAX.

Results

The prevalence of VF and any fracture composite of VF and non-VF was 16% and 25%, respectively, increasing according to number of dysmobility components (from 0 to 5; VF 10–35%; any fracture 16–45%). Dysmobility syndrome was associated with elevated odds of VF (adjusted OR [aOR] 1.52, 95% CI 1.08–2.15) or any fracture (aOR 1.46, 95% CI 1.07–1.98) but no longer with non-VF (aOR 1.31, 95% CI 0.86–1.98) in multivariate model, whereas modified definition showed robust association with non-VF (aOR 1.79, 95% CI 1.23–2.60). Dysmobility syndrome improved discrimination for prevalent fracture when added to FRAX (NRI 0.25, 95% CI 0.13–0.37; IDI 0.020, 95% CI 0.014–0.026).

Conclusions

Dysmobility syndrome was associated with elevated odds of morphometric VF in community-dwelling older adults, independent of age and covariates.

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Acknowledgements

We thank all our participants and the technical staff of the KURE study.

Funding

This study was funded by the Research of Korea Centers for Disease Control and Prevention (2013-E63007-01, 2013-E63007-02).

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea

    Namki Hong & Yumie Rhee

  2. Graduate School, Yonsei University College of Medicine, Seoul, South Korea

    Namki Hong

  3. Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Chang Oh Kim

  4. Department of Sociology, Yonsei University College of Social Sciences, Seoul, South Korea

    Yoosik Youm

  5. Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Jin-Young Choi

  6. Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea

    Hyeon Chang Kim

Authors
  1. Namki Hong
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  2. Chang Oh Kim
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  3. Yoosik Youm
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  6. Yumie Rhee
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Corresponding author

Correspondence to Yumie Rhee.

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Ethical approval

The study was approved by the Institutional Review Board (IRB) of Severance Hospital (IRB no. 4-2012-0172), with written informed consent obtained from all participants. All procedures performed in studies involving human participants were in accordance with the ethical standards of the IRB and with the 1964 Helsinki Declaration and its later amendments.

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Hong, N., Kim, C.O., Youm, Y. et al. Dysmobility syndrome is associated with prevalent morphometric vertebral fracture in older adults: the Korean Urban-Rural Elderly (KURE) study. Arch Osteoporos 13, 86 (2018). https://doi.org/10.1007/s11657-018-0500-2

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