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Frailty and bone health in European men

Cook, Michael J.; Oldroyd, Alexander; Pye, Stephen R; Ward, Kate A; Gielen, Evelien; Ravindrarajah, Rathi; Adams, Judith E; Lee, David M; Bartfai, Gyorgy and Boonen, Steven, et al. (2017) In Age and Ageing 46(4). p.635-641
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... (More)

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.

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publication status
published
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keywords
bone mineral density, Frailty, heel ultrasound, male health, older people
in
Age and Ageing
volume
46
issue
4
pages
7 pages
publisher
Oxford University Press
external identifiers
  • scopus:85021735567
  • wos:000404605400019
ISSN
0002-0729
DOI
10.1093/ageing/afw205
language
English
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yes
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113e9dc7-347b-4aea-ac02-754e246d6675
date added to LUP
2017-08-08 16:18:56
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2018-01-07 12:14:12
@article{113e9dc7-347b-4aea-ac02-754e246d6675,
  abstract     = {<p>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&lt; 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 &lt; 0.05), but not lower lumbar spine BMD. Using the FI categorisation, a 'high' level of frailty (FI &gt; 0.35) was associated with lower lumbar spine BMD (P &lt; 0.05) when compared to those with low (FI &lt; 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 &lt; 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.</p>},
  articleno    = {afw205},
  author       = {Cook, Michael J. and Oldroyd, Alexander and Pye, Stephen R and Ward, Kate A and Gielen, Evelien and Ravindrarajah, Rathi and Adams, Judith E and Lee, David M and Bartfai, Gyorgy and Boonen, Steven and Casanueva, Felipe and Forti, Gianni and Giwercman, Aleksander and Han, Thang S and Huhtaniemi, Ilpo T. and Kula, Krzysztof and Lean, Michael E. and Pendleton, Neil and Punab, Margus and Vanderschueren, Dirk and Wu, Frederick C and O'Neill, Terence W. and Petrone, Luisa and Cilotti, Antonio and Borghs, Herman and Slowikowska-Hilczer, Jolanta and Walczak-Jedrzejowska, Renata and Huhtaniemi, Ilpo and Wu, Frederick Cw and Silman, Alan and O'Neill, Terence and Finn, Joseph D and Steer, Philip and Tajar, Abdelouahid and Lee, David and Pye, Stephen and Ocampo, Marta and Lage, Mary and Földesi, Imre and Fejes, Imre and Korrovitz, Paul and Jiang, Min and , },
  issn         = {0002-0729},
  keyword      = {bone mineral density,Frailty,heel ultrasound,male health,older people},
  language     = {eng},
  month        = {07},
  number       = {4},
  pages        = {635--641},
  publisher    = {Oxford University Press},
  series       = {Age and Ageing},
  title        = {Frailty and bone health in European men},
  url          = {http://dx.doi.org/10.1093/ageing/afw205},
  volume       = {46},
  year         = {2017},
}