Severe osteopenia and osteoporosis, sarcopenia, and frailty status in community-dwelling older women: Results from the Women's Health and Aging Study (WHAS) II

Objectives: The goal of this study was to examine the associations between severe osteopenia and osteoporosis and/or sarcopenia on frailty status, a major geriatric syndrome in community-dwelling older women. Design: Cross-sectional analysis. Setting: Women's Health and Aging Studies II (WHAS-II), Baltimore, Maryland. Participants and measurements: The analytic sample for this study included 250 women aged 76-86 years old who underwent DXA evaluation at round 4. Frailty was determined using validated screening criteria. Severe osteopenia was defined as BMD between -2.0 SD and -2.49 SD and osteoporosis as BMD less than -2.5 SD (lumbar spine and/or proximal femur). Sarcopenia was determined by the appendicular lean mass by height(2) (aLM/ht(2) method) and considered present when the value was less then 2 SD compared to young women. Results: Mean age of study subjects was 79.6 (+/-2.7) years. Overall prevalence of frailty was 6.8% (n = 17). Severe osteopenia/osteoporosis occurred in 42.1% (n = 7) in the frail group, 28% (n = 33) in the pre frail group and 25.2% in the robust group. Sarcopenia was present in 52.9% (n = 9) in the frail group, 42% (n = 50) in the pre frail and 41.2% (n = 47) in the robust group. Almost sixteen percent (n = 39) had severe osteopenia/osteoporosis concomitant to sarcopenia. In an adjusted logistic regression model, severe osteopenia/osteoporosis (OR: 2.1; 95% Cl: 0.68-6.6, p = 0.196) and sarcopenia (OR: 3.1; 95% Cl: 0.88-11.1; p = 0.077) were individually associated with frailty, though not statistically significant. On the other hand, the likelihood of being frail was substantially higher in the presence of these two syndromes (OR: 6.4; 95% Cl: 1.1-36.8, p = 0.037). Conclusion: These findings suggest a concomitant impact of severe osteopenia/osteoporosis plus sarcopenia in regard to frailty status in a sample of oldest old women living in the community. (C) 2010 Elsevier Inc. All rights reserved.