Ya Ruth Huo1, Pushpa Suriyaarachchi2, Fernando Gomez3, Carmen L Curcio3, Derek Boersma4, Susan W Muir5, Manuel Montero-Odasso5, Piumali Gunawardene2, Oddom Demontiero2, Gustavo Duque6. 1. Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia; Musculoskeletal Ageing Research Program, Sydney Medical School Nepean, The University of Sydney, Penrith, NSW, Australia. 2. Musculoskeletal Ageing Research Program, Sydney Medical School Nepean, The University of Sydney, Penrith, NSW, Australia; Department of Geriatric Medicine, Falls and Fractures Clinic, Nepean Hospital, Penrith, NSW, Australia. 3. Musculoskeletal Ageing Research Program, Sydney Medical School Nepean, The University of Sydney, Penrith, NSW, Australia; Department of Geriatric Medicine, Falls and Fractures Clinic, Nepean Hospital, Penrith, NSW, Australia; Research Group on Geriatrics and Gerontology, Faculty of Health Sciences, International Association of Gerontology and Geriatrics Collaborative Centre, University of Caldas, Manizales, Colombia. 4. Department of Geriatric Medicine, Falls and Fractures Clinic, Nepean Hospital, Penrith, NSW, Australia. 5. Gait and Brain Laboratory, Parkwood Hospital and Lawson Health Research Institute, University of Western Ontario, London, ON, Canada. 6. Musculoskeletal Ageing Research Program, Sydney Medical School Nepean, The University of Sydney, Penrith, NSW, Australia; Department of Geriatric Medicine, Falls and Fractures Clinic, Nepean Hospital, Penrith, NSW, Australia. Electronic address: gustavo.duque@sydney.edu.au.
Abstract
OBJECTIVES: In older persons, the combination of osteopenia/osteoporosis and sarcopenia has been proposed as a subset of frailer individuals at higher risk of institutionalization, falls, and fractures. However, the particular clinical, biochemical, and functional characteristics of the osteosarcopenic (OS) patients remain unknown. In this study, we used a clinical definition of osteosarcopenia aiming to determine the clinical, functional, and biochemical features that are unique to these patients within a population of older people who fall. DESIGN: Cross-sectional study. SETTING: Falls and Fractures Clinic, Nepean Hospital (Penrith, NSW, Australia). PARTICIPANTS: A total of 680 people (mean age = 79, 65% women) assessed between 2009 and 2013. MEASUREMENTS: Assessment included medical history, physical examination, bone densitometry and body composition by dual-energy X-ray absorptiometry, posturography, grip strength, gait parameters (GaitRITE), and blood tests for nutrition and secondary causes of sarcopenia and osteoporosis. Patients were divided into 4 groups: (1) osteopenic (BMD <-1.0 SD), (2) sarcopenic, (3) OS, and (4) nonsarcopenic/nonosteopenic. Difference between groups was assessed with 1-way ANOVA and χ(2) analysis. Multivariable linear regression evaluated the association between the groups and measures of physical function. Multivariable logistic regression evaluated risk factors for being in the OS group. RESULTS: Mean age of the OS patients was 80.4 ± 7.0 years. Our analyses showed that OS patients are older, mostly women, are at high risk for depression and malnutrition, have body mass index lower than 25, and showed a higher prevalence of peptic disease, inflammatory arthritis, maternal hip fracture, history of atraumatic fracture, and impaired mobility. CONCLUSION: We have reported a set of characteristics that are highly prevalent in OS patients. This study could be used to inform the design of future trials and to develop interventions to prevent institutionalization and poor outcomes in this particular set of high-risk patients.
OBJECTIVES: In older persons, the combination of osteopenia/osteoporosis and sarcopenia has been proposed as a subset of frailer individuals at higher risk of institutionalization, falls, and fractures. However, the particular clinical, biochemical, and functional characteristics of the osteosarcopenic (OS) patients remain unknown. In this study, we used a clinical definition of osteosarcopenia aiming to determine the clinical, functional, and biochemical features that are unique to these patients within a population of older people who fall. DESIGN: Cross-sectional study. SETTING: Falls and Fractures Clinic, Nepean Hospital (Penrith, NSW, Australia). PARTICIPANTS: A total of 680 people (mean age = 79, 65% women) assessed between 2009 and 2013. MEASUREMENTS: Assessment included medical history, physical examination, bone densitometry and body composition by dual-energy X-ray absorptiometry, posturography, grip strength, gait parameters (GaitRITE), and blood tests for nutrition and secondary causes of sarcopenia and osteoporosis. Patients were divided into 4 groups: (1) osteopenic (BMD <-1.0 SD), (2) sarcopenic, (3) OS, and (4) nonsarcopenic/nonosteopenic. Difference between groups was assessed with 1-way ANOVA and χ(2) analysis. Multivariable linear regression evaluated the association between the groups and measures of physical function. Multivariable logistic regression evaluated risk factors for being in the OS group. RESULTS: Mean age of the OS patients was 80.4 ± 7.0 years. Our analyses showed that OS patients are older, mostly women, are at high risk for depression and malnutrition, have body mass index lower than 25, and showed a higher prevalence of peptic disease, inflammatory arthritis, maternal hip fracture, history of atraumatic fracture, and impaired mobility. CONCLUSION: We have reported a set of characteristics that are highly prevalent in OS patients. This study could be used to inform the design of future trials and to develop interventions to prevent institutionalization and poor outcomes in this particular set of high-risk patients.
Authors: Bjoern Buehring; Karen E Hansen; Brian L Lewis; Steven R Cummings; Nancy E Lane; Neil Binkley; Kristine E Ensrud; Peggy M Cawthon Journal: J Bone Miner Res Date: 2018-06-21 Impact factor: 6.741
Authors: William Gilbert; Robert Bragg; Ahmed M Elmansi; Meghan E McGee-Lawrence; Carlos M Isales; Mark W Hamrick; William D Hill; Sadanand Fulzele Journal: Cytokine Date: 2019-07-20 Impact factor: 3.861