The association between low lean mass and osteoporosis increases the risk of weakness, poor physical performance and frailty in Brazilian older adults: data from SARCOS study

Eur J Clin Nutr. 2021 Mar;75(3):446-455. doi: 10.1038/s41430-020-00753-w. Epub 2020 Sep 18.

Abstract

Purpose: To characterize the phenotypes of older adults with low lean mass and osteoporosis, concomitantly or isolated, in regards to poor physical performance and frailty status.

Design: Cross-sectional analysis of the SARCopenia and OSteoporosis in Older Adults with Cardiovascular Diseases Study (SARCOS).

Setting: Outpatient geriatric cardiology clinic.

Participants and method: 385 older adults underwent DXA analysis. Low lean mass was diagnosed according to FNIH and low BMD by a T-score ≤ -2.5 SD. Subjects were grouped into: I-Low lean mass and Osteoporosis (LLMO); II-Low lean mass (LLM); III-Osteoporosis (OP), and IV-Controls. Poor physical performance was diagnosed by weakness or slow walking speed or impaired mobility. Frailty was diagnosed by CHS criteria.

Results: The mean age was 78.22 ± 7.16 years. The prevalence of LLMO, LLM, and OP were 14.8%, 39.5%, and 19.2%, respectively. LLMO subjects were older, predominantly women, with a high percentage of body fat (HTBF). LLM was represented by obese men, while individuals with OP were preferably women, older and leaner. In a regression analyses, LLMO presented an OR: 6.42 (2.63‒15.65; p < 0.001) for weakness, OR: 2.55 (1.09‒5.95; p = 0.030) for impaired mobility, and OR: 14.75 (2.72‒79.94; p = 0.002) for frailty. After adjusting for HTBF, the OR for frailty, decreased to 7.25 (1.11-47.21; p = 0.038). LLM and OP were associated only with weakness with an OR: 3.06 (1.36-6.84; p = 0.006) and OR: 3.14 (1.29-7.62; p = 0.011), respectively.

Conclusion: In Brazilian older community-dwelling outpatient adults, the phenotype characterized by low lean mass and osteoporosis presents a higher association with impaired mobility, weakness and frailty status compared to the others phenotyeps and controls. A high percentage of body fat presents a synergistic effect with low lean mass and osteoporosis phenotype in regards to frailty.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brazil / epidemiology
  • Cross-Sectional Studies
  • Female
  • Frailty* / epidemiology
  • Geriatric Assessment
  • Humans
  • Male
  • Osteoporosis* / epidemiology
  • Physical Functional Performance
  • Sarcopenia* / epidemiology