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Associations of osteoporosis and sarcopenia with frailty and multimorbidity among participants of the Hertfordshire Cohort Study

Associations of osteoporosis and sarcopenia with frailty and multimorbidity among participants of the Hertfordshire Cohort Study
Associations of osteoporosis and sarcopenia with frailty and multimorbidity among participants of the Hertfordshire Cohort Study
Background: Ageing is commonly associated with sarcopenia (SP) and osteoporosis (OP), both of which are associated with disability, impaired quality of life and mortality. The aims of this study were to explore the relationships between SP, OP, frailty and multimorbidity in community dwelling older adults participating in the Hertfordshire Cohort Study (HCS), and to determine whether co-existence of osteoporosis and sarcopenia was associated with a significantly heavier health burden. Methods: At baseline, 405 participants self-reported their comorbidities. Cut-offs for low grip strength and appendicular lean mass index were used according to the EWSGOP2 criteria to define SP. OP was diagnosed when T-scores of < -2.5 were present at the femoral neck or the participant reported use of the anti-osteoporosis medications including hormone replacement therapy (HRT), raloxifene or bisphosphonates. Frailty was defined using the standard Fried definition. Results: 199 men and 206 women were included in the study. Baseline median (IQR) age of participants was 75.5 (73.4 - 77.9) years. 26 (8%) and 66 (21.4%) of the participants had SP and OP respectively. 83 (20.5%) reported 3 or more comorbidities. The prevalence of pre-frailty and frailty in the study sample was 57.5% and 8.1% respectively. Having SP only was strongly associated with frailty (OR 8.28, 95% CI 1.27, 54.03; p=0.027) while the association between having OP alone and frailty was weaker (OR 2.57, 95% CI 0.61,10.78; p=0.196). The likelihood of being frail was substantially higher in the presence of co-existing SP and OP (OR 26.15, 95% CI 3.13,218.76; p=0.003). SP alone and OP alone were both associated with having 3 or more comorbidities (OR 4.71, 95% CI 1.50, 14.76, p=0.008 and OR 2.86, 95% CI 1.32, 6.22; p=0.008 respectively) though the co-existence of SP and OP was not significantly associated with multimorbidity (OR. 3.45, 95% CI 0.59, 20.26; p=0.171). Conclusions: Individuals living with frailty were often osteosarcopenic. Multimorbidity was common in individuals with either sarcopenia or osteoporosis. Early identification of SP and OP not only allows implementation of treatment strategies but also presents an opportunity to mitigate frailty risk.
Frailty, Multimorbidity, Osteoporosis, Osteosarcopenia, Prevalence, Sarcopenia
2190-5991
Laskou, Faidra
3959d6e2-ccfa-4d97-8311-16f27b893365
Fuggle, Nicholas
9ab0c81a-ac67-41c4-8860-23e0fdb1a900
Patel, Harnish
e1c0826f-d14e-49f3-8049-5b945d185523
Jameson, Karen A
d5fb142d-06af-456e-9016-17497f94e9f2
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Laskou, Faidra
3959d6e2-ccfa-4d97-8311-16f27b893365
Fuggle, Nicholas
9ab0c81a-ac67-41c4-8860-23e0fdb1a900
Patel, Harnish
e1c0826f-d14e-49f3-8049-5b945d185523
Jameson, Karen A
d5fb142d-06af-456e-9016-17497f94e9f2
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1

Laskou, Faidra, Fuggle, Nicholas, Patel, Harnish, Jameson, Karen A, Cooper, Cyrus and Dennison, Elaine (2021) Associations of osteoporosis and sarcopenia with frailty and multimorbidity among participants of the Hertfordshire Cohort Study. Journal of Cachexia, Sarcopenia and Muscle. (doi:10.1002/jcsm.12870).

Record type: Article

Abstract

Background: Ageing is commonly associated with sarcopenia (SP) and osteoporosis (OP), both of which are associated with disability, impaired quality of life and mortality. The aims of this study were to explore the relationships between SP, OP, frailty and multimorbidity in community dwelling older adults participating in the Hertfordshire Cohort Study (HCS), and to determine whether co-existence of osteoporosis and sarcopenia was associated with a significantly heavier health burden. Methods: At baseline, 405 participants self-reported their comorbidities. Cut-offs for low grip strength and appendicular lean mass index were used according to the EWSGOP2 criteria to define SP. OP was diagnosed when T-scores of < -2.5 were present at the femoral neck or the participant reported use of the anti-osteoporosis medications including hormone replacement therapy (HRT), raloxifene or bisphosphonates. Frailty was defined using the standard Fried definition. Results: 199 men and 206 women were included in the study. Baseline median (IQR) age of participants was 75.5 (73.4 - 77.9) years. 26 (8%) and 66 (21.4%) of the participants had SP and OP respectively. 83 (20.5%) reported 3 or more comorbidities. The prevalence of pre-frailty and frailty in the study sample was 57.5% and 8.1% respectively. Having SP only was strongly associated with frailty (OR 8.28, 95% CI 1.27, 54.03; p=0.027) while the association between having OP alone and frailty was weaker (OR 2.57, 95% CI 0.61,10.78; p=0.196). The likelihood of being frail was substantially higher in the presence of co-existing SP and OP (OR 26.15, 95% CI 3.13,218.76; p=0.003). SP alone and OP alone were both associated with having 3 or more comorbidities (OR 4.71, 95% CI 1.50, 14.76, p=0.008 and OR 2.86, 95% CI 1.32, 6.22; p=0.008 respectively) though the co-existence of SP and OP was not significantly associated with multimorbidity (OR. 3.45, 95% CI 0.59, 20.26; p=0.171). Conclusions: Individuals living with frailty were often osteosarcopenic. Multimorbidity was common in individuals with either sarcopenia or osteoporosis. Early identification of SP and OP not only allows implementation of treatment strategies but also presents an opportunity to mitigate frailty risk.

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Accepted/In Press date: 29 October 2021
e-pub ahead of print date: 6 December 2021
Published date: 6 December 2021
Additional Information: Funding Information: F.L. and H.P.P. are supported by the NIHR Southampton Biomedical Research Centre, Nutrition, and the University of Southampton. This report is independent research, and the views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. These funding bodies had no role in writing of the manuscript or decision to submit for publication. Publisher Copyright: © 2021 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders.
Keywords: Frailty, Multimorbidity, Osteoporosis, Osteosarcopenia, Prevalence, Sarcopenia

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Local EPrints ID: 452630
URI: http://eprints.soton.ac.uk/id/eprint/452630
ISSN: 2190-5991
PURE UUID: d0d0faf3-ceef-4e86-b819-713c23590853
ORCID for Faidra Laskou: ORCID iD orcid.org/0000-0002-8481-6343
ORCID for Nicholas Fuggle: ORCID iD orcid.org/0000-0001-5463-2255
ORCID for Harnish Patel: ORCID iD orcid.org/0000-0002-0081-1802
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961

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Date deposited: 11 Dec 2021 11:29
Last modified: 24 Jan 2024 02:55

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Contributors

Author: Faidra Laskou ORCID iD
Author: Nicholas Fuggle ORCID iD
Author: Harnish Patel ORCID iD
Author: Karen A Jameson
Author: Cyrus Cooper ORCID iD
Author: Elaine Dennison ORCID iD

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