TY - JOUR
T1 - Phenotype of osteosarcopenia in older individuals with a history of falling
AU - Huo, Ya Ruth
AU - Suriyaarachchi, Pushpa
AU - Gomez, Fernando
AU - Curcio, Carmen L.
AU - Boersma, Derek
AU - Muir, Susan W.
AU - Montero-Odasso, Manuel
AU - Gunawardene, Piumali
AU - Demontiero, Oddom
AU - Duque, Gustavo
PY - 2015
Y1 - 2015
N2 - 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 χ2 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.
AB - 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 χ2 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.
KW - falls (accidents)
KW - muscle strength
KW - older people
KW - osteopenia
UR - http://handle.westernsydney.edu.au:8081/1959.7/uws:41068
U2 - 10.1016/j.jamda.2014.10.018
DO - 10.1016/j.jamda.2014.10.018
M3 - Article
SN - 1525-8610
VL - 16
SP - 290
EP - 295
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 4
ER -
