Osteosarcopenia, sarcopenia, and their associations with validated recent fragility fractures in older women: applying seven definitions in the FRISBEE 2 study.

PURPOSE

We assessed the associations between osteosarcopenia, sarcopenia (according to seven definitions), and the presence of radiologically validated recent osteoporotic fractures in community-dwelling older women from the Fracture Risk Brussels Epidemiological Enquiry (FRISBEE2) study.

METHODS

Retrospective cohort design. The FRISBEE2 study includes 907 community-dwelling women aged 77 (75-81) years. Sarcopenia (according to six consensual definitions: EWGSOP2 "probable" and "confirmed"; IWGS; SCWD; SDOC; FNIH, and as seventh, an exploratory, potential framework for the GLIS), osteoporosis (T-score ≤ - 2.5SD), and osteosarcopenia (osteoporosis plus each of the 7 sarcopenia definitions) were assessed at baseline. We recorded and radiologically validated recent (i.e., within 2 years before baseline) central or major osteoporotic fractures (MOFs). Multivariate regression models adjusted for age, BMI, sedentary lifestyle, and comorbidities, were used to evaluate associations between osteosarcopenia and sarcopenia at baseline with the presence of recent fractures.

RESULTS

As expected, the prevalence of osteosarcopenia and sarcopenia varied widely depending on the definitions used. Out of the 907 included women, 47 (5.2%) had experienced a recent fracture. The crude analysis showed significant associations between osteosarcopenia, osteoporosis, and sarcopenia and the presence of recent fractures. In the multivariate analysis, only EWGSOP2-defined probable sarcopenia (i.e., low handgrip strength) was associated with recent fractures [OR = 2.14 (1.05-4.35); p = 0.035].

CONCLUSIONS

Older women with a history of recent fracture had EWGSOP2-defined probable sarcopenia (i.e., low handgrip strength). A recent central or MOF should alert on probable sarcopenia. Further prospective studies are needed to explore the role of muscle strength as a modifiable risk factor for fractures.