Severe osteopenia and osteoporosis, sarcopenia, and frailty status in community-dwelling older women: Results from the Women's Health and Aging Study (WHAS) II

ObjectivesThe goal of this study was to examine the associations between severe osteopenia and osteoporosis and/or sarcopenia on frailty status, a major geriatric syndrome in community-dwelling older women.DesignCross-sectional analysis.SettingWomen's Health and Aging Studies II (WHAS-II), Baltimore, Maryland.Participants and measurementsThe analytic sample for this study included 250 women aged 76-86 years old who underwent DXA evaluation at round 4. Frailty was determined using validated screening criteria. Severe osteopenia was defined as BMD between − 2.0 SD and − 2.49 SD and osteoporosis as BMD less than − 2.5 SD (lumbar spine and/or proximal femur). Sarcopenia was determined by the appendicular lean mass by height2 (aLM/ht2 method) and considered present when the value was less then − 2 SD compared to young women.ResultsMean age of study subjects was 79.6 (± 2.7) years. Overall prevalence of frailty was 6.8% (n = 17). Severe osteopenia/osteoporosis occurred in 42.1% (n = 7) in the frail group, 28% (n = 33) in the pre frail group and 25.2% in the robust group. Sarcopenia was present in 52.9% (n = 9) in the frail group, 42% (n = 50) in the pre frail and 41.2% (n = 47) in the robust group. Almost sixteen percent (n = 39) had severe osteopenia/osteoporosis concomitant to sarcopenia. In an adjusted logistic regression model, severe osteopenia/osteoporosis (OR: 2.1; 95% CI: 0.68-6.6, p = 0.196) and sarcopenia (OR: 3.1; 95% CI: 0.88-11.1; p = 0.077) were individually associated with frailty, though not statistically significant. On the other hand, the likelihood of being frail was substantially higher in the presence of these two syndromes (OR: 6.4; 95% CI: 1.1-36.8, p = 0.037).ConclusionThese findings suggest a concomitant impact of severe osteopenia/osteoporosis plus sarcopenia in regard to frailty status in a sample of oldest old women living in the community.

Research Highlights► We evaluate the association of sarcopenia and low bone mass with frailty status. ► Cross sectional analysis of community-dwelling older women cohort-WHASII were performed. ► Sarcopenia and severe osteopenia/osteoporosis were very prevalent in frailty and pre frail. ► The likelihood of frailty was significant enhanced, only in the presence of both syndromes.