Frailty and bone health in European men

Cook, M. J. et al. (2017) Frailty and bone health in European men. Age and Ageing, 46(4), pp. 635-641. (doi:10.1093/ageing/afw205) (PMID:27852598)

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Abstract

Background: frailty is associated with an increased risk of fragility fractures. Less is known, however, about the association between frailty and bone health. Methods: men aged 40–79 years were recruited from population registers in eight European centres for participation in the European Male Aging Study. Subjects completed a comprehensive assessment which included quantitative ultrasound (QUS) scan of the heel (Hologic-SAHARA) and in two centres, dual-energy bone densitometry (dual-energy x-ray absorptiometry, DXA). Frailty was defined based on an adaptation of Fried's phenotype criteria and a frailty index (FI) was constructed. The association between frailty and the QUS and DXA parameters was determined using linear regression, with adjustments for age, body mass index and centre. Results: in total, 3,231 subjects contributed data to the analysis. Using the Fried categorisation of frailty, pre-frail and frail men had significantly lower speed of sound (SOS), broadband ultrasound attenuation (BUA) and quantitative ultrasound index (QUI) compared to robust men (P< 0.05). Similar results were seen using the FI after categorisation into ‘high’, ‘medium’ and ‘low’ levels of frailty. Using the Fried categorisation, frail men had lower femoral neck bone mineral density (BMD) compared to robust men (P < 0.05), but not lower lumbar spine BMD. Using the FI categorisation, a ‘high’ level of frailty (FI > 0.35) was associated with lower lumbar spine BMD (P < 0.05) when compared to those with low (FI < 0.2), but not lower femoral neck BMD. When analysed as a continuous variable, higher FI was linked with lower SOS, BUA and QUI (P < 0.05). Conclusions: optimisation of bone health as well as prevention of falls should be considered as strategies to reduce fractures in frail older people.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lean, Professor Michael
Authors: Cook, M. J., Oldroyd, A., Pye, S. R., Ward, K. A., Gielen, E., Ravindrarajah, R., Adams, J. E., Lee, D. M., Bartfai, G., Boonen, S., Casanueva, F., Forti, G., Giwercman, A., Han, T. S., Huhtaniemi, I. T., Kula, K., Lean, M. E., Pendleton, N., Punab, M., Vanderschueren, D., Wu, F. C., and O'Neill, T. W.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Age and Ageing
Publisher:Oxford University Press
ISSN:0002-0729
ISSN (Online):1468-2834
Published Online:16 November 2016
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in Age and Ageing 46(4):635-641
Publisher Policy:Reproduced under a Creative Commons License

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