The contribution of musculoskeletal factors to physical frailty: a cross-sectional study

Abstract

Background Musculoskeletal conditions and physical frailty have overlapping constructs. We aimed to quantify individual contributions of musculoskeletal factors to frailty. Methods Participants included 347 men and 360 women aged ≥60 yr (median ages; 70.8 (66.1–78.6) and 71.0 (65.2–77.5), respectively) from the Geelong Osteoporosis Study. Frailty was defined as ≥3, pre-frail 1–2, and robust 0, of the following; unintentional weight loss, weakness, low physical activity, exhaustion, and slowness. Measures were made of femoral neck BMD, appendicular lean mass index (ALMI, kg/m2) and whole-body fat mass index (FMI, kg/m2) by DXA (Lunar), SOS, BUA and SI at the calcaneus (Lunar Achilles Insight) and handgrip strength by dynamometers. Binary and ordinal logistic regression models and AUROC curves were used to quantify the contribution of musculoskeletal parameters to frailty. Potential confounders included anthropometry, smoking, alcohol, prior fracture, FMI, SES and comorbidities. Results Overall, 54(15.6%) men and 62(17.2%) women were frail. In adjusted-binary logistic models, SI, ALMI and HGS were associated with frailty in men (OR = 0.73, 95%CI 0.53–1.01; OR=0.48, 0.34–0.68; and OR = 0.11, 0.06–0.22; respectively). Muscle measures (ALMI and HGS) contributed more to this association than did bone (SI) (AUROCs 0.77, 0.85 vs 0.71, respectively). In women, only HGS was associated with frailty in adjusted models (OR = 0.30 95%CI 0.20–0.45, AUROC = 0.83). In adjusted ordinal models, similar results were observed in men; for women, HGS and ALMI were associated with frailty (ordered OR = 0.30 95%CI 0.20–0.45; OR = 0.56, 0.40–0.80, respectively). Conclusion Muscle deficits appeared to contribute more than bone deficits to frailty. This may have implications for identifying potential musculoskeletal targets for preventing or managing the progression of frailty.

Frailty syndrome in women with osteoporosis, should physicians consider screening? A cross-sectional study

“…This investigation revealed a significant and independent association between frailty syndrome and osteoporosis, following the study of Calado et al Regarding the BMD correlation with frailty, although the correlation between femoral and lumbar T-score and frailty syndrome was significant in bivariate analysis, the correlation was not significant in the regression model when other covariates, including age, were considered. The absence of a significant and independent correlation between BMD T-scores and frailty syndrome was aligned with previous research ( Tembo et al, 2021a ; Tembo et al, 2021b ). This data suggests that frailty syndrome and mineral density may not correlate linearly, but a particular decline in bone mineral density may be attributed to frailty syndrome.…”

“…However, two additional studies detected no significant correlation between frailty and BMD. One was conducted on 287 men aged ≥50, while the other was conducted on 707 older adults of all genders aged ≥60 years ( Tembo et al, 2021a ; Tembo et al, 2021b ). Other studies reported a significant association between concomitant sarcopenia and osteoporosis; however, there was no significant association between osteoporosis and frailty syndrome.…”

Association between Immunosenescence, Mitochondrial Dysfunction and Frailty Syndrome in Older Adults

“…Our data suggest that mitochondrial dysfunction may be considered a hallmark of frailty and targeted as a possible therapeutic intervention [19]. Mitochondrial function is correlated with muscular strength, performance and mass, and these are key features of sarcopenia, which is associated with physical frailty [27,56]. Here, we have confirmed previous data suggesting that mitochondrial impairment is a key feature of sarcopenia [19,30].…”

A Critical Appraisal of the Diagnostic and Prognostic Utility of the Anti-Inflammatory Marker IL-37 in a Clinical Setting: A Case Study of Patients with Diabetes Type 2

“…The role of non-cardiovascular comorbidities, which usually co-exist with T2D and CVD, in contributing to inflammation and the development of frailty, should also not be neglected. Literature evidence, together with results from this study, highlight the importance of musculoskeletal and gastrointestinal disorders in these conditions [ 72 , 73 ].…”