Phenotype of Osteosarcopenia in Older Individuals With a History of Falling

被引：191

作者：

Huo, Ya Ruth ^{[1
,2
]}

Suriyaarachchi, Pushpa ^{[2
,3
]}

Gomez, Fernando ^{[2
,3
,4
]}

Curcio, Carmen L. ^{[2
,3
,4
]}

Boersma, Derek ^{[3
]}

Muir, Susan W. ^{[5
,6
]}

Montero-Odasso, Manuel ^{[5
,6
]}

Gunawardene, Piumali ^{[2
,3
]}

Demontiero, Oddom ^{[2
,3
]}

Duque, Gustavo ^{[2
,3
]}

机构：

[1] Univ New S Wales, Fac Med, Kensington, NSW 2033, Australia

[2] Univ Sydney, Sydney Med Sch Nepean, Musculoskeletal Ageing Res Program, Penrith, NSW 2751, Australia

[3] Nepean Hosp, Dept Geriatr Med, Falls & Fractures Clin, Penrith, NSW, Australia

[4] Univ Caldas, Res Grp Geriatr & Gerontol, Fac Hlth Sci, Int Assoc Gerontol & Geriatr Collaborat Ctr, Manizales, Colombia

[5] Univ Western Ontario, Parkwood Hosp, Gait & Brain Lab, London, ON, Canada

[6] Univ Western Ontario, Lawson Hlth Res Inst, London, ON, Canada

来源：

JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION | 2015年 / 16卷 / 04期

关键词：

Sarcopenia; osteopenia; osteoporosis; osteosarcopenia; falls; institutionalization; BONE-MINERAL DENSITY; MUSCLE STRENGTH; URIC-ACID; SARCOPENIA; OSTEOPOROSIS; ASSOCIATION; WOMEN; MASS; OSTEOPENIA; OBESITY;

D O I：

10.1016/j.jamda.2014.10.018

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Objectives: In older persons, the combination of osteopenia/osteoporosis and sarcopenia has been proposed as a subset of frailer individuals at higher risk of institutionalization, falls, and fractures. However, the particular clinical, biochemical, and functional characteristics of the osteosarcopenic (OS) patients remain unknown. In this study, we used a clinical definition of osteosarcopenia aiming to determine the clinical, functional, and biochemical features that are unique to these patients within a population of older people who fall. Design: Cross-sectional study. Setting: Falls and Fractures Clinic, Nepean Hospital (Penrith, NSW, Australia). Participants: A total of 680 people (mean age = 79, 65% women) assessed between 2009 and 2013. Measurements: Assessment included medical history, physical examination, bone densitometry and body composition by dual-energy X-ray absorptiometry, posturography, grip strength, gait parameters (GaitRITE), and blood tests for nutrition and secondary causes of sarcopenia and osteoporosis. Patients were divided into 4 groups: (1) osteopenic (BMD < -1.0 SD), (2) sarcopenic, (3) OS, and (4) nonsarcopenic/nonosteopenic. Difference between groups was assessed with 1-way ANOVA and chi(2) analysis. Multivariable linear regression evaluated the association between the groups and measures of physical function. Multivariable logistic regression evaluated risk factors for being in the OS group. Results: Mean age of the OS patients was 80.4 +/- 7.0 years. Our analyses showed that OS patients are older, mostly women, are at high risk for depression and malnutrition, have body mass index lower than 25, and showed a higher prevalence of peptic disease, inflammatory arthritis, maternal hip fracture, history of atraumatic fracture, and impaired mobility. Conclusion: We have reported a set of characteristics that are highly prevalent in OS patients. This study could be used to inform the design of future trials and to develop interventions to prevent institutionalization and poor outcomes in this particular set of high-risk patients. (C) 2015 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

引用

页码：290 / 295

页数：6

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