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Associations between osteoporosis, the severity of sarcopenia and fragility fractures in community-dwelling older adults

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Key summary points

AbstractSection Aim

To investigate the association between bone mineral density (BMD) and the severity of sarcopenia using the revised European Working Group on Sarcopenia in Older People (EWGSOP2) definition.

AbstractSection Findings

Osteoporosis was associated with a greater risk of sarcopenia when using the European definition.

AbstractSection Message

Health care professionals should screen for sarcopenia in those with osteoporosis.

Abstract

Purpose

To investigate the association between bone mineral density (BMD) and the severity of sarcopenia using the revised European Working Group on Sarcopenia in Older People (EWGSOP2) definition.

Methods

BMD [dual energy X-ray absorptiometry (DXA)], appendicular lean mass (DXA), handgrip strength (hydraulic dynamometer) and gait speed (over 4-m) were used to screen for osteoporosis and sarcopenia. Participants were categorized as osteoporotic according to the World Health Organization definition (T score ≤ − 2.5), and classified with probable sarcopenia or confirmed sarcopenia according to the EWGSOP2 criteria. Fasting biochemistry profile, fragility fractures, malnutrition index, geriatric depression scale and fear of falling, were also measured using validated procedures.

Results

A total of 484 community-dwelling older adults (69.6% women) with a median age of 76 years [Interquartile range (IQR) 70–81] were included in this study. Osteoporosis prevalence increased from 47.6% in non-sarcopenia to 65.5% in probable sarcopenia and 78.1% in those with confirmed sarcopenia (p < 0.05). After adjusting for age, sex and vitamin D in multivariate models, osteoporosis was associated with a greater risk of confirmed sarcopenia [odds ratio (OR) 2.885, 95% CI 1.155, 7.204, p = 0.023]. The number of fragility fractures was also higher in those with confirmed sarcopenia versus those without (p = 0.013), but this finding did not remain significant in adjusted models (p = 0.078).

Conclusion

Prevalence of osteoporosis increased across the severity of sarcopenia, and osteoporosis was associated with a greater risk of sarcopenia. As such, health care professionals should screen for sarcopenia in those with low BMD.

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Data availability

All data are available in this manuscript.

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Acknowledgements

The authors would like to thank the participants and the Australian Institute for Musculoskeletal Science (AIMSS) for providing support for this study.

Author information

Author notes

  1. Ben Kirk and Steven Phu contributed equally to this work.

Authors and Affiliations

  1. Department of Medicine, Western Health, Melbourne Medical School, University of Melbourne, St. Albans, Melbourne, VIC, Australia

    Ben Kirk, Steven Phu, Sharon L. Brennan-Olsen, Ebrahim Bani Hassan & Gustavo Duque

  2. Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, 176 Furlong Road, St. Albans, Melbourne, VIC, 3121, Australia

    Ben Kirk, Steven Phu, Sharon L. Brennan-Olsen, Ebrahim Bani Hassan & Gustavo Duque

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  1. Ben Kirk
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Contributions

BK, SP, EBH, SLBO and GD designed the study; BK, SP and EBH collected the data; BK, SP and GD analyzed the data; BK primarily wrote the paper; all authors read and approved the final manuscript.

Corresponding author

Correspondence to Gustavo Duque.

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Conflict of interest

The authors declare that they have no conflict of interest.

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 [Western Health Low Risk Ethics Panel at Sunshine Hospital (ID: QA2018.106_44499), Melbourne Health Human Research Ethics Committee (2017.327), and Western Health Office for Research (HREC/17/MH/381)] and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all study participants.

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Kirk, B., Phu, S., Brennan-Olsen, S.L. et al. Associations between osteoporosis, the severity of sarcopenia and fragility fractures in community-dwelling older adults. Eur Geriatr Med 11, 443–450 (2020). https://doi.org/10.1007/s41999-020-00301-6

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  • DOI: https://doi.org/10.1007/s41999-020-00301-6

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