Association of Bone Mineral Density with Frailty, Pre-Frailty, and Osteoporosis in Community-Dwelling Elderly: A Prospective Study

Abstract

Objectives: To examine the association of Bone Mineral Density (BMD) in the prediction of frailty, pre-frailty, osteoporosis, falls and health conditions in elderly men and women. Methods:A four-year prospective study (2009)(2010)(2011)(2012)(2013) with 106 elderly, both sexes, aged ≥ 60 years, of the city of Goiânia, Brazil. BMD was estimated using dual-energy X ray absorptiometry. Frailty was assessed subjectively, including the following components: unintentional weight loss, fatigue, and low physical activity, reduction of strength and gait speed. Results:Mean age was 70 years of age and Body Mass Index (BMI) was 26.7 kg/m 2 . The mean BMD for women was 1.042 (± 0.11) g/cm 2 while for men, mean BMD was 1.169 (± 0.12) g/cm 2 , (p = 0.000). After adjustments for age and BMI in women, lower BMD values were significantly associated with osteoporosis (p = 0.003), frailty (p = 0.033), and pre-frailty (p = 0.037).Conclusion: BMD was predictive of frailty, pre-frailty and osteoporosis in women. In men, no associations were established. KeywordsBone mineral density, Frailty, Osteoporosis, Muscle strength, Elderly creases in Bone Mineral Density (BMD) are due to the natural ageing process for both sexes, however more prevalent for women [3][4][5][6], with consequences such as increased risk of fractures [3,6], falls and incapacities in the female group [2].Within the last years, the frailty syndrome has been increasingly highlighted due to its complex nature [7], with high prevalence and mortality [8], and its relationship with different health conditions has been investigated [9,10]. The majority of studies has analyzed frailty as a predictor of low BMD and indicate a causal relationship with low BMD [2,3,11]. However, analysis of BMD as a predictor of frailty has not been extensively investigated [12,13]; existing research has presented controversial results. While research finds no association between frailty and BMD in older women, another study observed associations between low BMD and frailty markers such as: low strength and low gait speed in men [12,13].A plausible explanation for the relationship between frailty and low bone mineral density is that the parameters used as frailty markers in the elderly such as advanced age, weight loss, low body weight, sarcopenia, the low level of physical exercise, and impaired mobility, since mechanical crucial is loading to bone mass maintenance [14]. The research presented herein considers the current context of population ageing, as well as the importance of BMD in the general and bone health of elderly. The results presented herein can add relevant RESEARCH ARTICLE

Low Bone Mineral Density, Sedentary Lifestyle, and Depression as Risk Factors for Frailty Syndrome at a Home Care Facility in West Jakarta, Indonesia

“…10,11 In addition to gender, low bone mineral density is also related to frailty. 12,13 Interestingly, a study in Brazil showed an increase in frailty cases in the low category of PAL. 14 In Indonesia, the relationship between depression and frailty has been proven, suggesting depression as a risk factor for frailty.…”