Background Ageing is associated with changes in body composition most notably, loss of muscle mass and strength (sarcopenia) and bone mass (osteopenia/osteoporosis) which if associated with physical inactivity may progress to become severe enough to compromise the individual’s independence. Due to the ageing of the populations and the lessened physical activity (PA), sarcopenia and (osteopenia/osteoporosis) are emerging as major health concerns. Sarcopenia and (osteopenia/osteoporosis) are important independent predictors of physical disability and functional decline in population-based studies and are linked to poor balance, gait speed, falls, and fractures in older adults.
Objectives The aim of this study was to examine the prevalence and effect of osteopenia/osteoporosis and/or sarcopenia on frailty, a major geriatric syndrome in community-dwelling older adults.
Methods The present cross-sectional study enrolled 255 older adults aged 65 years and above who underwent dual energy X-ray absorptiometry (DEXA). Osteopenia was defined by a densitometric T-score for bone mineral density (BMD) (g/cm2) below -1.0 and osteoporosis by a T-score below -2.5. Appendicular skeletal lean body mass (ASM) was calculated by soft tissue DEXA and sarcopenia assessed by the formula (ASM)/Height (H). Sarcopeniawas defined as a relative skeletal muscle index (RSMI) (appendicular skeletal muscle mass divided by height) below 5.45 kg/m2. Frailty was determined using validated screening criteria.
Results The mean age of the participants was 66.7 years. The overall prevalence of osteopenia/osteoporosis and sarcopenia was 69% (n=175) and 43% (n=109) respectively. Eighteen percent (n=46) had severe osteopenia/osteoporosis concomitant to sarcopenia. In an adjusted logistic regression model, severe osteopenia/osteoporosis (OR: 2.4; 95% CI: 0.78–2.6, p=0.016) and sarcopenia (OR: 2.6; 95% CI: 0.94–2.2; p=0.019) were individually associated with frailty. Furthermore, the likelihood of being frail was substantially higher in the presence of osteopenia/osteoporosis and sarcopenia (OR: 5.8; 95% CI: 3.1–5.3, p=0.017).
Conclusions The results of the present study indicate that sarcopenia and osteopenia/osteoporosis occur in a substantial number of community-dwelling older adults. Furthermore, the findings of this study show that a combination of osteopenia/osteoporosis and sarcopenia results in significant frailty in older adults. Osteopenia/osteoporosis and sarcopenia should be considered as risk factors for frailty and consequently active ageing takes on a renewed sense of urgency in older adults. Sarcopenia screening simultaneous to bone mineral density (BMD) examinations by DEXA is thus feasible to identify older adults with these conditions who are most in need of exercise interventions to increase muscle and BMD. The overall prevention strategy should be to encourage older adults to remain active throughout ageing to help preserve functional ability and prevent frailty.
Disclosure of Interest None Declared