Severity of Locomotive Syndrome Increases the Risk of Mortality: A Retrospective Study of Patients With Osteoporosis.

PURPOSE

In female patients with osteoporosis, low body mass index (BMI), impaired locomotive function, and low bone mineral density (BMD) are presumed to be associated with an increased risk of mortality; however, the specific factors contributing to all-cause mortality have not yet been clearly identified. The purpose of this study was to determine the incidence of death among osteoporotic women in the community and to explore the factors involved in mortality risk.

METHODS

A total of 451 postmenopausal women undergoing outpatient osteoporosis treatment at our hospital between November 2013 and March 2024 were longitudinally evaluated in this study. Underlying diseases, history of femoral and vertebral fractures, femoral and lumbar spine BMD, locomotive syndrome (LS) risk tests, and BMI were obtained at baseline. The LS risk test results were utilized to classify LS severity, which was assessed on a four-point scale ranging from stage 0 (robust) to stage 3 (severe deterioration). This study used all-cause mortality as the outcome, and we examined factors related to mortality using Cox proportional hazards regression analysis. Covariates included in the Cox proportional hazards regression analysis were age, BMI, history of femoral and vertebral fractures, lumbar spine and femoral BMD, underlying diseases, and LS severity.

RESULTS

The mean follow-up was 5.0 years (2.7 years), and death occurred in 20 of 451 patients. The incidence of mortality in this study was 0.91 cases per 100 person-years of risk. Cox proportional hazards regression analysis adjusted for all variables, and this study showed that cardiovascular disease (CD) (hazard ratio (HR) = 5.209, 95% confidence interval (CI) 1.794-15.128, p-value = 0.002) and severity of LS (HR = 2.006, 95% CI 1.063-3.784, 0.032) were shown to be independent risk factors for the occurrence of all-cause mortality.

CONCLUSION

To the best of our knowledge, this is the first study to demonstrate a significant association between the severity of LS and mortality in patients with osteoporosis. The severity of LS may be useful as a screening tool for all-cause mortality in women with osteoporosis.