Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2017 Jul 1;46(4):635-641.
doi: 10.1093/ageing/afw205.

Frailty and bone health in European men

Michael J Cook  1 , Alexander Oldroyd  1 , Stephen R Pye  1   2 , Kate A Ward  3 , Evelien Gielen  4 , Rathi Ravindrarajah  5 , Judith E Adams  6 , David M Lee  7 , Gyorgy Bartfai  8 , Steven Boonen  9 , Felipe Casanueva  10 , Gianni Forti  11 , Aleksander Giwercman  12 , Thang S Han  13 , Ilpo T Huhtaniemi  14 , Krzysztof Kula  15 , Michael E Lean  16 , Neil Pendleton  17 , Margus Punab  18 , Dirk Vanderschueren  19 , Frederick C Wu  20 , Terence W O'Neill  1   2 ; EMAS Study Group
Affiliations
Multicenter Study

Frailty and bone health in European men

Michael J Cook et al. Age Ageing. .

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.

Keywords: Frailty; bone mineral density; heel ultrasound; male health; older people.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Marginal mean values (95% CI) of QUS and DXA parameters by FP and FI category
See this image and copyright information in PMC

References

    1. Walston J, Hadley EC, Ferrucci L et al. . Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. J Am Geriatr Soc 2006; 54: 991–1001. - PubMed
    1. Fransen M, Woodward M, Norton R, Robinson E, Butler M, Campbell AJ. Excess mortality or institutionalization after hip fracture: men are at greater risk than women. J Am Geriatr Soc 2002; 50: 685–90. - PubMed
    1. Ensrud KE, Ewing SK, Taylor BC et al. . Frailty and risk of falls, fracture, and mortality in older women: the study of osteoporotic fractures. J Gerontol A Biol Sci Med Sci 2007; 62: 744–51. - PubMed
    1. Ma SL, Oyler J, Glavin S, Alavi A, Vokes T. Self-reported frailty is associated with low calcaneal bone mineral density in a multiracial population of community-dwelling elderly. Osteoporosis Int 2009; 20: 1837–46. - PubMed
    1. Bleicher K, Cumming RG, Naganathan V et al. . Predictors of the rate of BMD loss in older men: findings from the CHAMP study. Osteoporosis Int 2013; 24: 1951–63. - PubMed

Publication types

MeSH terms

LinkOut - more resources