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

Abstract

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. 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. A total of 484 community-dwelling older adults (69.6% women) with a median age of 76years [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). 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.