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Associations of components of sarcopenia with risk of fracture in the Osteoporotic Fractures in Men (MrOS) study

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Abstract

Summary

Our aim was to evaluate the associations between the individual components of sarcopenia and fracture types. In this cohort, the risk of experiencing any clinical, hip, or major osteoporotic fracture is greater in men with slow walking speed in comparison to normal walking speed.

Introduction

The association between the components of sarcopenia and fractures has not been clearly elucidated and has hindered the development of appropriate therapeutic interventions. Our aim was to evaluate the associations between the individual components of sarcopenia, specifically lean mass, strength, and physical performance and fracture (any fracture, hip fracture, major osteoporotic fracture) in the Osteoporotic Fractures in Men (MrOS) study.

Methods

The Osteoporotic Fractures in Men study (MrOS) recruited 5995 men ≥ 65 years of age. We measured appendicular lean mass (ALM) by dual-energy X-ray absorptiometry (low as residual value < 20th percentile for the cohort), walking speed (fastest trial of usual pace, values < 0.8 m/s were low), and grip strength (max score of 2 trials, values < 30 kg were low). Information on fractures was assessed tri-annually over an average follow-up of 12 years and centrally adjudicated. Cox proportional hazard models estimated the hazard ratio (HR) (95% confidence intervals) for slow walking speed, low grip strength, and low lean mass.

Results

Overall, 1413 men had a fracture during follow-up. Slow walking speed was associated with an increased risk for any HR = 1.39, 1.05–1.84; hip HR = 2.37, 1.54–3.63; and major osteoporotic, HR = 1.89, 1.34–2.67 in multi-variate-adjusted models. Low lean mass and low grip strength were not significantly associated with fracture.

Conclusions

In this cohort of older adult men, the risk of experiencing any, hip, or major osteoporotic fracture is greater in men with slow walking speed in comparison to men with normal walking speed, but low grip strength and low lean mass were not associated with fracture.

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Data availability

https://mrosonline.ucsf.edu

Code availability

Not applicable

References

  1. Bhasin S, Travison T, Manini TM, Patel S et al (2020) Sarcopenia definition: the position statements of the sarcopenia definition and outcomes consortium. J Am Geriatr Soc:1–9

  2. (1988) Epidemiologic and methodologic problems in determining nutritional status of older persons. Albuquerque, New Mexico: American Journal of Clinical Nutrition

  3. Orwoll ES et al (2020) The importance of muscle versus fat mass in sarcopenic obesity: a re-evaluation using D3- Creatine Muscle Mass Versus DXA Lean Mass Measurements. The Journals of Gerontology: Series A 75(7):1362–1368

    Article  CAS  Google Scholar 

  4. Delmonico MJ et al (2007) Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women. J Am Geriatr Soc 55(5):769–774

    Article  Google Scholar 

  5. McLean RR et al (2018) Lower lean mass measured by dual-energy X-ray absorptiometry (DXA) is not associated with increased risk of hip fracture in women: the Framingham osteoporosis study. Calcif Tissue Int 103(1):16–23

    Article  CAS  Google Scholar 

  6. Harvey NC et al (2019) Appendicular lean mass and fracture risk assessment: implications for FRAX® and sarcopenia. Osteoporos Int 30(3):537–539

    Article  CAS  Google Scholar 

  7. Cawthon PM et al (2015) Evaluation of the usefulness of consensus definitions of sarcopenia in older men: results from the observational osteoporotic Fractures in Men Cohort study. J Am Geriatr Soc 63(11):2247–2259

    Article  Google Scholar 

  8. Patel SM et al (2020) Sarcopenia definition & outcomes consortium defined low grip strength in two cross-sectional, population-based cohorts. J Am Geriatr Soc 68(7):1438–1444

    Article  Google Scholar 

  9. Grosicki GJ et al (2020) Application of cut-points for low muscle strength and lean mass in mobility-limited older adults. J Am Geriatr Soc 68(7):1445–1453

    Article  Google Scholar 

  10. Cawthon PM et al (2008) Physical performance and risk of hip fractures in older men. J Bone Miner Res 23(7):1037–1044

    Article  Google Scholar 

  11. Kirk B et al (2020) Sarcopenia definitions and outcomes consortium (SDOC) criteria are strongly associated with malnutrition, depression, falls, and fractures in high-risk older persons. J Am Med Dir Assoc

  12. Cawthon PM, Travison TG, Manini TM, Patel S, Pencina KM, Fielding RA, Magaziner JM, Newman AB, Brown T, Kiel DP, Cummings SR, Shardell M, Guralnik JM, Woodhouse LJ, Pahor M, Binder E, D'Agostino RB, Quian-Li X, Orwoll E et al (2020) Establishing the link between lean mass and grip strength cut points with mobility disability and other health outcomes: proceedings of the sarcopenia definition and outcomes consortium conference. J Gerontol A Biol Sci Med Sci 75(7):1317–1323

    Article  Google Scholar 

  13. Orwoll ES (2005) Design and baseline characteristics of the Osteoporotic Fractures in Men (MrOS) study- a large observational study of the determinants of fractures in older men. Contemp Clin Trials 26(5):557–568

    Article  Google Scholar 

  14. Newman AB et al (2003) Sarcopenia: alternative definitions and associations with lower extremity function. J Am Geriatr Soc 51(11):1602–1609

    Article  Google Scholar 

  15. Cruz-Jentoft AJ et al (2010) Sarcopenia: European consensus definition and diagnosis: report of the European Working Group on sarcopenia in older people. Age Aging 39(4):412–423

    Article  Google Scholar 

  16. Perera S et al (2016) Gait speed predicts incident disability: a pooled analysis. J Gerontol A Biol Sci Med Sci 71(1):63–71

    Article  Google Scholar 

  17. Studenski S et al (2011) Gait speed and survival in older adults. JAMA 305(1):50–58

    Article  CAS  Google Scholar 

  18. Chalhoub D et al (2015) Risk of non-spine fractures in older adults with sarcopenia, low bone mass, or both. J Am Geriatr Soc 63(9):1733–1740

    Article  Google Scholar 

  19. Lewis CE et al (2007) Predictors of non-spine fracture in elderly men: the MrOS study. J Bone Miner Res 22(2):211–219. https://doi.org/10.1359/jbmr.061017

    Article  PubMed  Google Scholar 

  20. Sanders KM et al (1998) The exclusion of high trauma fractures may underestimate the prevalence of bone fragility fractures in the community: the Geelong osteoporosis study. J Bone Miner Res 13(8):1337–1342

    Article  CAS  Google Scholar 

  21. Mackey DC et al (2007) High-trauma fractures and low bone mineral density in older women and men. Jama 298(20):2381–2388

    Article  CAS  Google Scholar 

  22. Washburn RA et al (1993) The physical activity scale for the elderly (PASE): development and evaluation. J Clin Epidemiol 46(2):153–162

    Article  CAS  Google Scholar 

  23. D'Ath P et al (1994) Screening, detection and management of depression in elderly primary care attenders. I: the acceptability and performance of the 15 item Geriatric Depression Scale (GDS15) and the development of short versions. Fam Pract 11(3):260–266

    Article  CAS  Google Scholar 

  24. Teng EL, Chui HC (1987) The modified mini-mental state (3MS) examination. J Clin Psychiatry 48(8):314–318

    CAS  PubMed  Google Scholar 

  25. Williams TS, Sherman EMS, Strauss E (2011) Modified mini-mental state examination. In: Kreutzer JS, DeLuca J, Caplan B (eds) Encyclopedia of Clinical Neuropsychology. Springer New York, New York, NY, pp 1650–1653

    Chapter  Google Scholar 

  26. Pahor M et al (1994) Drug data coding and analysis in epidemiologic studies. Eur J Epidemiol 10(4):405–411

    Article  CAS  Google Scholar 

  27. Kuh D et al (2005) Grip strength, postural control, and functional leg power in a representative cohort of british men and women: associations with physical activity, health status, and socioeconomic conditions. The Journals of Gerontology: Series A 60(2):224–231

    Article  Google Scholar 

  28. Cawthon PM et al (2020) Establishing the link between lean mass and grip strength cut points with mobility disability and other health outcomes: proceedings of the sarcopenia definition and outcomes consortium conference. J Gerontol A Biol Sci Med Sci 75(7):1317–1323

    Article  Google Scholar 

  29. Kyrdalen IL et al (2019) Associations between gait speed and well-known fall risk factors among community-dwelling older adults. Physiother Res Int 24(1):e1743

    Article  Google Scholar 

  30. Bean JF et al (2002) The relationship between leg power and physical performance in mobility-limited older people. J Am Geriatr Soc 50(3):461–467

    Article  Google Scholar 

  31. Harvey NC et al (2018) Measures of Physical performance and muscle strength as predictors of fracture risk independent of FRAX, falls, and aBMD: a meta-analysis of the Osteoporotic Fractures in Men (MrOS) study. J Bone Miner Res 33(12):2150–2157

    Article  Google Scholar 

  32. Cawthon PM et al (2014) Physical performance and radiographic and clinical vertebral fractures in older men. J Bone Miner Res 29(9):2101–2108

    Article  Google Scholar 

  33. Middleton A, Fritz SL, Lusardi M (2015) Walking speed: the functional vital sign. J Aging Phys Act 23(2):314–322

    Article  Google Scholar 

  34. Shuman V et al (2020) Association between improved mobility and distal health outcomes. J Gerontol A Biol Sci Med Sci 75(12):2412–2417

    Article  Google Scholar 

  35. VanSwearingen JM et al (2011) Impact of exercise to improve gait efficiency on activity and participation in older adults with mobility limitations: a randomized controlled trial. Phys Ther 91(12):1740–1751

    Article  Google Scholar 

  36. Brach JS et al (2017) Effectiveness of a timing and coordination group exercise program to improve mobility in community-dwelling older adults: a randomized clinical trial. JAMA Intern Med 177(10):1437–1444

    Article  Google Scholar 

  37. Cawthon PM et al (2021) Muscle mass assessed by the D3-creatine dilution method and incident self-reported disability and mortality in a prospective observational study of community-dwelling older men. J Gerontol A Biol Sci Med Sci 76(1):123–130

    Article  CAS  Google Scholar 

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Funding

The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute on Aging (NIA), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Center for Advancing Translational Sciences (NCATS), and NIH Roadmap for Medical Research under the following grant numbers: U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, and UL1 TR000128. Additional support—Department of Epidemiology, University of Pittsburgh, NIH National Institute on Aging T32-AG000181 (Newman, AB).

Author information

Authors and Affiliations

  1. Department of Epidemiology Graduate School of Public Health University of Pittsburgh, Pittsburgh, PA, USA

    R.J. Harris, E.S. Strotmeyer, R.M. Boudreau & J.A. Cauley

  2. VA Boston Healthcare System, Boston, MA, USA

    R.J. Harris

  3. Research Institute, California Pacific Medical Center, San Francisco, CA, USA

    N. Parimi & P.M. Cawthon

  4. Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA

    J.S. Brach

  5. Department of Medicine, University of Arizona, Tucson, AZ, USA

    C.K. Kwoh

Authors
  1. R.J. Harris
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  2. N. Parimi
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  3. P.M. Cawthon
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  4. E.S. Strotmeyer
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  5. R.M. Boudreau
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  6. J.S. Brach
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  7. C.K. Kwoh
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  8. J.A. Cauley
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Corresponding author

Correspondence to R.J. Harris.

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Ethics approval

All the 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

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The study was approved through IRB boards at participating centers. All the participants completed the informed consent process.

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This article has been approved by the authors and the publications committee for the MrOS study.

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Harris, R., Parimi, N., Cawthon, P. et al. Associations of components of sarcopenia with risk of fracture in the Osteoporotic Fractures in Men (MrOS) study. Osteoporos Int 33, 1815–1821 (2022). https://doi.org/10.1007/s00198-022-06390-2

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  • DOI: https://doi.org/10.1007/s00198-022-06390-2

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