Frequency and risk factors of fractures in elderly patients with sarcopenia

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Abstract

Aim. To determine the frequency and risk factors for fractures in patients with sarcopenia aged 65 years and older living in the community dwellings.

Material and methods. This cross-sectional, single-center study included 230 people aged 65 years and older (70 men and 160 women, median age 75 (interquartile range 68–79) years) who received consultations in a medical institution in Saint Petersburg. The diagnosis of sarcopenia was made according to the EWGSOP2 (European Working Group on Sarcopenia in Older People 2) criteria (2018). Phosphorus-calcium metabolism and vitamin D level were assessed; physical activity was evaluated using the International Physical Activity Questionnaire (IPAQ), and depression was assessed using the Hospital Anxiety and Depression Scale (HADS). All patients underwent dual-energy X-ray absorptiometry to diagnose osteoporosis and received anti-osteoporotic therapy with bisphosphonates.

Results. A high fracture rate was found in patients with sarcopenia compared to patients without it (39.4 % versus 26.7 %; p < 0.01) due to proximal hip fractures (18.8 and 7.7 %, respectively; p < 0.01). Sarcopenia increased the risk of fractures 1.52-fold (95 % confidence interval (CI) 1.01–2.28; p = 0.049), and hip fractures by 2.28-fold (95 % CI 1.28–4.05; p = 0.003). The risk of fractures was higher in patients with low muscle strength (odds ratio (OR) 5.459; 95 % CI 1.918–6.561; p = 0.0023), low muscle mass (OR 3.284; 95 % CI 1.394–4.253; p = 0.0064), in those who fell and had a fear of falling (OR 2.639; 95 % CI 1.824–3.275; p = 0.0081 and OR 1.363; 95 % CI 1.003–1.853; p = 0.0476, respectively), body mass index < 25 kg / m2 (OR 3.465; 95 % CI 1.55–4.482; p = 0.0065) and serum 25-OH vitamin D level < 20 ng / mL (OR 1.882; 95 % CI 1.172–3.224; p = 0.0067).

Conclusion. A high fracture rate was found in patients with sarcopenia due to hip fractures associated with low muscle strength and muscle mass, falls and fear of falling, body mass index, and serum vitamin D deficiency.

About the authors

Yu. A. Safonova

I.I. Mechnikov North-West State Medical University, Ministry of Health of Russia; V.A. Nasonova Clinical Rheumatology Hospital No. 25

Author for correspondence.
Email: jula_safonova@mail.ru
ORCID iD: 0000-0003-2923-9712
Russian Federation, 41 Kirochnaya St., Saint Petersburg 191015; 30 Bolshaya Podyacheskaya St., Saint Petersburg 190068

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