Abstract
Backgroundfrailty is associated with an increased risk of fragility fractures. Less is known, however, about the association between frailty and bone health.Methodsmen aged 40–79 years were recruited from population registers in eight European centres for participation in the European Male Aging Study. Subjects completed a comprehensive assessment which included quantitative ultrasound (QUS) scan of the heel (Hologic-SAHARA) and in two centres, dual-energy bone densitometry (dual-energy x-ray absorptiometry, DXA). Frailty was defined based on an adaptation of Fried's phenotype criteria and a frailty index (FI) was constructed. The association between frailty and the QUS and DXA parameters was determined using linear regression, with adjustments for age, body mass index and centre.Resultsin total, 3,231 subjects contributed data to the analysis. Using the Fried categorisation of frailty, pre-frail and frail men had significantly lower speed of sound (SOS), broadband ultrasound attenuation (BUA) and quantitative ultrasound index (QUI) compared to robust men (P< 0.05). Similar results were seen using the FI after categorisation into ‘high’, ‘medium’ and ‘low’ levels of frailty. Using the Fried categorisation, frail men had lower femoral neck bone mineral density (BMD) compared to robust men (P < 0.05), but not lower lumbar spine BMD. Using the FI categorisation, a ‘high’ level of frailty (FI > 0.35) was associated with lower lumbar spine BMD (P < 0.05) when compared to those with low (FI < 0.2), but not lower femoral neck BMD. When analysed as a continuous variable, higher FI was linked with lower SOS, BUA and QUI (P < 0.05).Conclusionsoptimisation of bone health as well as prevention of falls should be considered as strategies to reduce fractures in frail older people.
Highlights
The aging process is characterised by a complex alteration of anatomical, physiological and psychological factors
In this population survey we found a significant association between frailty and bone health parameters including low broadband ultrasound attenuation (BUA), speed of sound (SOS), quantitative ultrasound index (QUI) and femoral neck bone mineral density (BMD) using the Fried categorisation and lumbar spine BMD using the frailty index (FI) categorisation, though the magnitude of these effects was relatively small
There was some evidence of a doseresponse effect with those classified as pre-frail having BUA, SOS and QUI levels intermediate between those who were robust and those who were frail
Summary
The aging process is characterised by a complex alteration of anatomical, physiological and psychological factors. Frailty is linked with adverse health outcomes including an increased risk of falls and institutionalisation [2]. Frailty has been linked in prospective studies with an increased risk of future fractures, though whether this is related to the increased susceptibility to falls or whether there is in addition an associated reduction in bone strength remains uncertain [3]. Such data are important; knowledge of the factors which predispose to fracture, including bone strength, may help improve targeted preventative measures in this high risk group. The aim of this study was to investigate the relationship between frailty and bone health defined using both BMD and quantitative ultrasound (QUS) measurements, in a population of community dwelling European men
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
