Musculoskeletal decline and mortality: prospective data from the Geelong Osteoporosis Study
Journal article
Pasco, Julie, Mohebbi, Mohammadreza, Holloway, Kara, Brennan-Olsen, Sharon, Hyde, Natalie and Kotowicz, Mark. (2017). Musculoskeletal decline and mortality: prospective data from the Geelong Osteoporosis Study. Journal of Cachexia, Sarcopenia and Muscle. 8(3), pp. 482 - 489. https://doi.org/10.1002/jcsm.12177
Authors | Pasco, Julie, Mohebbi, Mohammadreza, Holloway, Kara, Brennan-Olsen, Sharon, Hyde, Natalie and Kotowicz, Mark |
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Abstract | Background We aimed to examine the relationship between musculoskeletal deterioration and all-cause mortality in a cohort of women studied prospectively over a decade. Methods A cohort of 750 women aged 50–94 years was followed for a decade after femoral neck bone mineral density (BMD) and appendicular lean mass (ALM) were measured using dual energy X-ray absorptiometry, in conjunction with comorbidities, health behaviour data, and other clinical measures. The outcome was all-cause mortality identified from the Australian National Deaths Index. Using Cox proportional hazards models and age as the time variable, mortality risks were estimated according to BMD groups (ideal-BMD, osteopenia, and osteoporosis) and ALM groups (T-scores > 1.0 high, 2.0 to 1.0 medium, < 2.0 low). Results During 6712 person years of follow-up, there were 190 deaths, the proportions increasing with diminishing BMD: 10.7% (23/215) ideal-BMD, 23.5% (89/378) osteopenia, 49.7% (78/157) osteoporosis; and with diminishing ALM: 17.0% (59/345) high, 26.2% (79/301) medium, 50.0% (52/104) low. In multivariable models adjusted for smoking, polypharmacy, and mobility, compared with those with ideal BMD, mortality risk was greater for those with osteopenia [hazard ratio (HR) 1.77, 95% confidence interval (CI) 1.11–2.81] and osteoporosis (HR 2.61, 95%CI 1.60–4.24). Similarly, compared with those with high ALM, adjusted mortality risk was greater for medium ALM (HR 1.36, 95%CI 0.97–1.91) and low ALM (HR 1.65, 95%CI 1.11–2.45). When BMD and ALM groups were tested together in the model, BMD remained a predictor of mortality (HR 1.74, 95%CI 1.09–2.78; HR 2.82, 95%CI 1.70–4.70; respectively), and low ALM had borderline significance (HR 1.52, 95%CI 1.00–2.31), which was further attenuated after adjusting for smoking, polypharmacy, and mobility. Conclusions Poor musculoskeletal health increased the risk for mortality independent of age. This appears to be driven mainly by a decline in bone mass. Low lean mass independently exacerbated mortality risk, and this appeared to operate through poor health exposures. |
Year | 2017 |
Journal | Journal of Cachexia, Sarcopenia and Muscle |
Journal citation | 8 (3), pp. 482 - 489 |
Publisher | B M J Group |
ISSN | 2190-5991 |
Digital Object Identifier (DOI) | https://doi.org/10.1002/jcsm.12177 |
Scopus EID | 2-s2.0-85007373732 |
Open access | Open access |
Page range | 482 - 489 |
Research Group | Institute for Health and Ageing |
Publisher's version | License |
Place of publication | Germany |
Editors | S. D. Anker and S. von Haehling |
https://acuresearchbank.acu.edu.au/item/8q3qw/musculoskeletal-decline-and-mortality-prospective-data-from-the-geelong-osteoporosis-study
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OA_Pasco_2017_Musculoskeletal_decline_and_mortality_prospective_data.pdf | |
License: CC BY-NC 4.0 |
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