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The fracture predictive ability of a musculoskeletal composite score in old men - Data from the MrOs Sweden study

Cronholm, Felix LU ; Rosengren, Björn E. LU ; Nilsson, Jan Åke LU ; Ohlsson, Claes; Mellström, Dan; Ribom, Eva and Karlsson, Magnus K. LU (2019) In BMC Geriatrics 19(1).
Abstract

Background: Detection of high-risk individuals for fractures are needed. This study assessed whether level of physical activity (PA) and a musculoskeletal composite score could be used as fracture predictive tools, and if the score could predict fractures better than areal bone mineral density (aBMD). Methods: MrOs Sweden is a prospective population-based observational study that at baseline included 3014 men aged 69-81 years. We assessed femoral neck bone mineral content (BMC), bone area, aBMD and total body lean mass by dual energy X-ray absorptiometry, calcaneal speed of sound by quantitative ultrasound and hand grip strength by a handheld dynamometer. PA was assessed by the Physical Activity Scale for the Elderly (PASE)... (More)

Background: Detection of high-risk individuals for fractures are needed. This study assessed whether level of physical activity (PA) and a musculoskeletal composite score could be used as fracture predictive tools, and if the score could predict fractures better than areal bone mineral density (aBMD). Methods: MrOs Sweden is a prospective population-based observational study that at baseline included 3014 men aged 69-81 years. We assessed femoral neck bone mineral content (BMC), bone area, aBMD and total body lean mass by dual energy X-ray absorptiometry, calcaneal speed of sound by quantitative ultrasound and hand grip strength by a handheld dynamometer. PA was assessed by the Physical Activity Scale for the Elderly (PASE) questionnaire. We followed the participants until the date of first fracture, death or relocation (median 9.6 years). A musculoskeletal composite score was calculated as mean Z-score of the five measured traits. A Cox proportional hazards model was used to analyze the association between the musculoskeletal traits, the composite score and incident fractures (yes/no) during the follow-up period. Data are presented as hazard ratios (HR) with 95% confidence intervals (95% CI) for fracture for a + 1 standard deviation (SD) change (+ 1 Z-score) in the various musculoskeletal traits as well as the composite score. We used a linear regression model to estimate the association between level of PA, measured as PASE-score and the different musculoskeletal traits as well as the composite score. Results: A + 1 SD higher composite score was associated with an incident fracture HR of 0.61 (0.54, 0.69), however not being superior to aBMD in fracture prediction. A + 1 SD higher PASE-score was associated with both a higher composite score and lower fracture incidence (HR 0.83 (0.76, 0.90)). Conclusions: The composite score was similar to femoral neck aBMD in predicting fractures, and also low PA predicted fractures. This highlights the need of randomized controlled trials to evaluate if PA could be used as a fracture preventive strategy.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bone mass, Men, Older, Osteoporosis, Physical activity
in
BMC Geriatrics
volume
19
issue
1
publisher
BioMed Central
external identifiers
  • scopus:85063368053
ISSN
1471-2318
DOI
10.1186/s12877-019-1106-2
language
English
LU publication?
yes
id
53d48d7f-de2f-4e57-b36e-3e8f6170b56d
date added to LUP
2019-04-08 10:42:44
date last changed
2019-04-30 04:10:26
@article{53d48d7f-de2f-4e57-b36e-3e8f6170b56d,
  abstract     = {<p>Background: Detection of high-risk individuals for fractures are needed. This study assessed whether level of physical activity (PA) and a musculoskeletal composite score could be used as fracture predictive tools, and if the score could predict fractures better than areal bone mineral density (aBMD). Methods: MrOs Sweden is a prospective population-based observational study that at baseline included 3014 men aged 69-81 years. We assessed femoral neck bone mineral content (BMC), bone area, aBMD and total body lean mass by dual energy X-ray absorptiometry, calcaneal speed of sound by quantitative ultrasound and hand grip strength by a handheld dynamometer. PA was assessed by the Physical Activity Scale for the Elderly (PASE) questionnaire. We followed the participants until the date of first fracture, death or relocation (median 9.6 years). A musculoskeletal composite score was calculated as mean Z-score of the five measured traits. A Cox proportional hazards model was used to analyze the association between the musculoskeletal traits, the composite score and incident fractures (yes/no) during the follow-up period. Data are presented as hazard ratios (HR) with 95% confidence intervals (95% CI) for fracture for a + 1 standard deviation (SD) change (+ 1 Z-score) in the various musculoskeletal traits as well as the composite score. We used a linear regression model to estimate the association between level of PA, measured as PASE-score and the different musculoskeletal traits as well as the composite score. Results: A + 1 SD higher composite score was associated with an incident fracture HR of 0.61 (0.54, 0.69), however not being superior to aBMD in fracture prediction. A + 1 SD higher PASE-score was associated with both a higher composite score and lower fracture incidence (HR 0.83 (0.76, 0.90)). Conclusions: The composite score was similar to femoral neck aBMD in predicting fractures, and also low PA predicted fractures. This highlights the need of randomized controlled trials to evaluate if PA could be used as a fracture preventive strategy.</p>},
  articleno    = {90},
  author       = {Cronholm, Felix and Rosengren, Björn E. and Nilsson, Jan Åke and Ohlsson, Claes and Mellström, Dan and Ribom, Eva and Karlsson, Magnus K.},
  issn         = {1471-2318},
  keyword      = {Bone mass,Men,Older,Osteoporosis,Physical activity},
  language     = {eng},
  month        = {03},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {BMC Geriatrics},
  title        = {The fracture predictive ability of a musculoskeletal composite score in old men - Data from the MrOs Sweden study},
  url          = {http://dx.doi.org/10.1186/s12877-019-1106-2},
  volume       = {19},
  year         = {2019},
}