Namki Hong1,2, Chang Oh Kim3, Yoosik Youm4, Jin-Young Choi5, Hyeon Chang Kim6, Yumie Rhee7. 1. Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea. 2. Graduate School, Yonsei University College of Medicine, Seoul, South Korea. 3. Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea. 4. Department of Sociology, Yonsei University College of Social Sciences, Seoul, South Korea. 5. Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea. 6. Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea. 7. Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea. yumie@yuhs.ac.
Abstract
In a community-dwelling elderly cohort, dysmobility syndrome was associated with elevated odds of morphometric vertebral fracture or any prevalent fracture, independent of age and covariates. Dysmobility syndrome improved discrimination for fracture when added to the FRAX score. INTRODUCTION: Dysmobility syndrome was coined to indicate patients with impaired musculoskeletal health. Data on the association of dysmobility syndrome with prevalent morphometric vertebral fracture (VF) in elderly persons are limited. METHODS: A total of 1369 community-dwelling elderly subjects (mean age 71.6 years; women 66%) were analyzed. Dysmobility syndrome was defined as ≥ 3 components among falls, low lean mass, high fat mass, osteoporosis, low grip strength, and low timed get-up-and-go performance. VF was defined as a ≥ 25% reduction in the height of vertebral bodies in plain radiographs. Modified cutpoints of each component at which elevate the odds of fracture were investigated using receiver-operating characteristics analysis. Net reclassification improvement (NRI) and integrated discrimination index (IDI) were calculated to assess additive discriminatory value of dysmobility syndrome over FRAX. RESULTS: The prevalence of VF and any fracture composite of VF and non-VF was 16% and 25%, respectively, increasing according to number of dysmobility components (from 0 to 5; VF 10-35%; any fracture 16-45%). Dysmobility syndrome was associated with elevated odds of VF (adjusted OR [aOR] 1.52, 95% CI 1.08-2.15) or any fracture (aOR 1.46, 95% CI 1.07-1.98) but no longer with non-VF (aOR 1.31, 95% CI 0.86-1.98) in multivariate model, whereas modified definition showed robust association with non-VF (aOR 1.79, 95% CI 1.23-2.60). Dysmobility syndrome improved discrimination for prevalent fracture when added to FRAX (NRI 0.25, 95% CI 0.13-0.37; IDI 0.020, 95% CI 0.014-0.026). CONCLUSIONS: Dysmobility syndrome was associated with elevated odds of morphometric VF in community-dwelling older adults, independent of age and covariates.
In a community-dwelling elderly cohort, dysmobility syndrome was associated with elevated odds of morphometric vertebral fracture or any prevalent fracture, independent of age and covariates. Dysmobility syndrome improved discrimination for fracture when added to the FRAX score. INTRODUCTION:Dysmobility syndrome was coined to indicate patients with impaired musculoskeletal health. Data on the association of dysmobility syndrome with prevalent morphometric vertebral fracture (VF) in elderly persons are limited. METHODS: A total of 1369 community-dwelling elderly subjects (mean age 71.6 years; women 66%) were analyzed. Dysmobility syndrome was defined as ≥ 3 components among falls, low lean mass, high fat mass, osteoporosis, low grip strength, and low timed get-up-and-go performance. VF was defined as a ≥ 25% reduction in the height of vertebral bodies in plain radiographs. Modified cutpoints of each component at which elevate the odds of fracture were investigated using receiver-operating characteristics analysis. Net reclassification improvement (NRI) and integrated discrimination index (IDI) were calculated to assess additive discriminatory value of dysmobility syndrome over FRAX. RESULTS: The prevalence of VF and any fracture composite of VF and non-VF was 16% and 25%, respectively, increasing according to number of dysmobility components (from 0 to 5; VF 10-35%; any fracture 16-45%). Dysmobility syndrome was associated with elevated odds of VF (adjusted OR [aOR] 1.52, 95% CI 1.08-2.15) or any fracture (aOR 1.46, 95% CI 1.07-1.98) but no longer with non-VF (aOR 1.31, 95% CI 0.86-1.98) in multivariate model, whereas modified definition showed robust association with non-VF (aOR 1.79, 95% CI 1.23-2.60). Dysmobility syndrome improved discrimination for prevalent fracture when added to FRAX (NRI 0.25, 95% CI 0.13-0.37; IDI 0.020, 95% CI 0.014-0.026). CONCLUSIONS:Dysmobility syndrome was associated with elevated odds of morphometric VF in community-dwelling older adults, independent of age and covariates.
Authors: N Hong; E Siglinsky; D Krueger; R White; C O Kim; H C Kim; Y Yeom; N Binkley; Y Rhee; B Buehring Journal: Osteoporos Int Date: 2020-09-07 Impact factor: 4.507