Osteosarcopenia is more than sarcopenia and osteopenia alone

Abstract

Background: Sarcopenia and osteopenia/osteoporosis show a high prevalence in old age and incur a high risk for falls, fractures, and further functional decline. Physical performance and bone metabolism in patients suffering from the so-called osteosarcopenia-the combination of sarcopenia and osteopenia-are currently still unknown.

Aims: This study investigates physical performance and bone metabolism in osteosarcopenic, prefrail, community-dwelling older adults.

Methods: 68 prefrail adults between 65 and 94 years were assigned to four groups according to mean DXA results: osteosarcopenic [low T-score and low appendicular lean mass (aLM)], sarcopenic (low aLM), osteopenic (low T-score), and controls. Multiple linear regression analysis, adjusted for age, gender, physical activity, and 25-OH-vitamin D3 serum level, was used to identify the influence of being osteosarcopenic, sarcopenic, or osteopenic on physical performance (hand grip, chair rise test, sit-to-stand power, gait speed, SPPB) and serum markers for increased bone turnover [osteocalcin, β-crosslaps and procollagen type 1 amino-terminal propeptide (P1NP)].

Results: Only osteosarcopenic participants showed significantly reduced hand grip strength, increased chair rising time, and STS power time as well as significantly increased bone turnover markers.

Discussion: Due to low physical performance and high bone turnover, older adults with osteosarcopenia have to be regarded as the most at-risk population for fractures and further functional decline.

Conclusions: Up-to-date osteoporosis and post-fracture management of older persons should aim at both, bone and muscle.

Keywords: Frailty; Osteopenia; Osteoporosis; Osteosarcopenia; Sarcopenia.