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
AuthorsPasco, Julie, Mohebbi, Mohammadreza, Holloway, Kara, Brennan-Olsen, Sharon, Hyde, Natalie and Kotowicz, Mark
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.

Year2017
JournalJournal of Cachexia, Sarcopenia and Muscle
Journal citation8 (3), pp. 482 - 489
PublisherB M J Group
ISSN2190-5991
Digital Object Identifier (DOI)https://doi.org/10.1002/jcsm.12177
Scopus EID2-s2.0-85007373732
Open accessOpen access
Page range482 - 489
Research GroupInstitute for Health and Ageing
Publisher's version
License
Place of publicationGermany
EditorsS. D. Anker and S. von Haehling
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