TY - JOUR
T1 - Frailty and bone health in European men
AU - Cook, Michael J
AU - Oldroyd, Alexander
AU - Pye, Stephen R
AU - Ward, Kate A
AU - Gielen, Evelien
AU - Ravindrarajah, Rathi
AU - Adams, Judith E
AU - Lee, David
AU - Bartfai, Gyorgy
AU - Boonen, Steven
AU - Casanueva, Felipe
AU - Forti, Gianni
AU - Giwercman, Aleksander
AU - Han, Thang S
AU - Huhtaniemi, Ilpo T
AU - Kula, Krzysztof
AU - Lean, Michael E
AU - Pendleton, Neil
AU - Punab, Margus
AU - Vanderschueren, Dirk
AU - Wu, Frederick C
AU - O'Neill, Terence W
AU - EMAS Study Group
N1 - © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society.
PY - 2017
Y1 - 2017
N2 - 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.
AB - 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.
KW - Frailty, male health, heel ultrasound, bone mineral density.
U2 - 10.1093/ageing/afw205
DO - 10.1093/ageing/afw205
M3 - Article
C2 - 27852598
SN - 0002-0729
VL - 46
SP - 635
EP - 641
JO - Age and Ageing
JF - Age and Ageing
IS - 4
ER -