Sarcopenia definitions and their association with fracture risk in older Swedish women
Sarcopenia definitions and their association with fracture risk in older Swedish women
The purpose of this study was to investigate the prevalence of three sarcopenia definitions and their associations with fracture risk in older Swedish women when adjusted for fracture risk assessment (FRAX)-based risk factors; 2,883 women with a mean age of 77.8 years were included. Sarcopenia was defined based on the Sarcopenia Definitions and Outcomes Consortium (SDOC; low handgrip strength [kg] and gait speed (m/s)), revised European Working Group on Sarcopenia in Older People (EWGSOP2; low appendicular lean mass index, appendicular lean mass [ALM]/height; kg/m2], and hand grip strength [kg]), and Asian Working Group for Sarcopenia (AWGS; low ALM (kg), and hand grip strength [kg]) definitions. Femoral neck T-score was obtained from dual-energy X-ray absorptiometry. All fractures, confirmed by X-ray or medical record review, were subsequently categorized as major osteoporotic fractures (MOFs) and hip fractures. Deaths were verified through regional registers. The total follow-up time was 6.4 ± 1.3 (mean ± SD) yr. Cox regression (hazard ratios [HR] and 95% CIs) analyses were performed with adjustment for age, FRAX variables, and femoral neck T-score. Sarcopenia prevalence was 4.5% (n = 129) according to SDOC, 12.5% (n = 360) for EWGSOP2, and 10.3% (n = 296) defined by AWGS. Individuals with sarcopenia defined by SDOC had a higher mortality risk than individuals without sarcopenia (HR: 3.41; 95% CI: 2.51, 4.62) after adjusting for age and FRAX variables. Sarcopenia according to EWGSOP2 and AWGS was not associated with an increased fracture risk after adjusting for age and FRAX variables. Individuals with sarcopenia defined by SDOC had a higher risk for any fractures (HR: 1.48; 95% CI: 1.10, 1.99) and MOF (HR: 1.42; 95% CI: 1.03, 1.98) compared with individuals without sarcopenia after adjusting for clinical risk factors used in FRAX. In conclusion, sarcopenia defined by SDOC, incorporating muscle function/strength, was the only sarcopenia definition associated with fracture risk in older women.
Aged, Aged, 80 and over, Female, Fractures, Bone/epidemiology, Hand Strength, Humans, Risk Assessment, Risk Factors, Sarcopenia/epidemiology, Sweden/epidemiology, fracture, older adults, sarcopenia
453-461
Gandham, Anoohya
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Gregori, Giulia
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Johansson, Lisa
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Johansson, Helena
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Harvey, Nicholas C.
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Vandenput, Liesbeth
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McCloskey, Eugene
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Kanis, John A.
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Litsne, Henrik
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Axelsson, Kristian
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Lorentzon, Mattias
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April 2024
Gandham, Anoohya
f60a43f3-79b8-4cf4-8319-ff757ace34a6
Gregori, Giulia
df66af7e-21a1-497c-973b-19164777ed4e
Johansson, Lisa
54820beb-ecca-43fd-9208-283c2fef0f3d
Johansson, Helena
04f12338-4dd1-437b-b9bc-e0884130c215
Harvey, Nicholas C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Vandenput, Liesbeth
0910d143-4b58-4579-82b0-3810272f1814
McCloskey, Eugene
6d3df4aa-b438-4a83-bd06-06b6cbe3980f
Kanis, John A.
f1621d8d-8afb-4d97-9679-2165d88a344d
Litsne, Henrik
e95cdd34-5e70-482e-a53c-45189411cd14
Axelsson, Kristian
1b319953-04ae-4f73-b221-dd56fd312993
Lorentzon, Mattias
9d78ed25-2b0c-46c5-a2db-a8b246af0956
Gandham, Anoohya, Gregori, Giulia, Johansson, Lisa, Johansson, Helena, Harvey, Nicholas C., Vandenput, Liesbeth, McCloskey, Eugene, Kanis, John A., Litsne, Henrik, Axelsson, Kristian and Lorentzon, Mattias
(2024)
Sarcopenia definitions and their association with fracture risk in older Swedish women.
Journal of Bone and Mineral Research, 39 (4), , [zjae026].
(doi:10.1093/jbmr/zjae026).
Abstract
The purpose of this study was to investigate the prevalence of three sarcopenia definitions and their associations with fracture risk in older Swedish women when adjusted for fracture risk assessment (FRAX)-based risk factors; 2,883 women with a mean age of 77.8 years were included. Sarcopenia was defined based on the Sarcopenia Definitions and Outcomes Consortium (SDOC; low handgrip strength [kg] and gait speed (m/s)), revised European Working Group on Sarcopenia in Older People (EWGSOP2; low appendicular lean mass index, appendicular lean mass [ALM]/height; kg/m2], and hand grip strength [kg]), and Asian Working Group for Sarcopenia (AWGS; low ALM (kg), and hand grip strength [kg]) definitions. Femoral neck T-score was obtained from dual-energy X-ray absorptiometry. All fractures, confirmed by X-ray or medical record review, were subsequently categorized as major osteoporotic fractures (MOFs) and hip fractures. Deaths were verified through regional registers. The total follow-up time was 6.4 ± 1.3 (mean ± SD) yr. Cox regression (hazard ratios [HR] and 95% CIs) analyses were performed with adjustment for age, FRAX variables, and femoral neck T-score. Sarcopenia prevalence was 4.5% (n = 129) according to SDOC, 12.5% (n = 360) for EWGSOP2, and 10.3% (n = 296) defined by AWGS. Individuals with sarcopenia defined by SDOC had a higher mortality risk than individuals without sarcopenia (HR: 3.41; 95% CI: 2.51, 4.62) after adjusting for age and FRAX variables. Sarcopenia according to EWGSOP2 and AWGS was not associated with an increased fracture risk after adjusting for age and FRAX variables. Individuals with sarcopenia defined by SDOC had a higher risk for any fractures (HR: 1.48; 95% CI: 1.10, 1.99) and MOF (HR: 1.42; 95% CI: 1.03, 1.98) compared with individuals without sarcopenia after adjusting for clinical risk factors used in FRAX. In conclusion, sarcopenia defined by SDOC, incorporating muscle function/strength, was the only sarcopenia definition associated with fracture risk in older women.
Text
zjae026
- Accepted Manuscript
More information
Accepted/In Press date: 25 January 2024
Published date: April 2024
Additional Information:
Publisher Copyright:
© The Author(s) 2024.
Keywords:
Aged, Aged, 80 and over, Female, Fractures, Bone/epidemiology, Hand Strength, Humans, Risk Assessment, Risk Factors, Sarcopenia/epidemiology, Sweden/epidemiology, fracture, older adults, sarcopenia
Identifiers
Local EPrints ID: 488187
URI: http://eprints.soton.ac.uk/id/eprint/488187
ISSN: 0884-0431
PURE UUID: a5669b4c-c6c5-4347-a6ac-8cc285d6b792
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Date deposited: 18 Mar 2024 17:31
Last modified: 01 Jun 2024 01:38
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Contributors
Author:
Anoohya Gandham
Author:
Giulia Gregori
Author:
Lisa Johansson
Author:
Helena Johansson
Author:
Liesbeth Vandenput
Author:
Eugene McCloskey
Author:
John A. Kanis
Author:
Henrik Litsne
Author:
Kristian Axelsson
Author:
Mattias Lorentzon
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