Musculoskeletal decline, intrinsic capacity and all-cause mortality for men in the Geelong Osteoporosis Study — ASN Events
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  3. Musculoskeletal decline, intrinsic capacity and all-cause mortality for men in the Geelong Osteoporosis Study

Musculoskeletal decline, intrinsic capacity and all-cause mortality for men in the Geelong Osteoporosis Study (#202)

Julie A Pasco 1 2 , Amanda L Stuart 1 , Kara B Anderson 1 , Kara L Holloway-Kew 1 , Gustavo Duque 3 4 5 , Ana Maria Ayala-Copete 3 6 , Lana J Williams 1
  1. Deakin University, IMPACT-Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, VICTORIA, Australia
  2. School of Public Health and Preventive Medicine, Monash University, Melbourne, VICTORIA, Australia
  3. Bone, Muscle & Geroscience Group, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
  4. Simone & Edouard Schouela RUISSS McGill Centre of Excellence for Sustainable Health of Seniors (Schouela CEDurable), , Montreal, QC, Canada
  5. Division of Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC, Canada
  6. Pontificia Universidad Javeriana, Geriatric Medicine, Bogotá, Colombia

Background/Aim: Although musculoskeletal decline has been associated with negative health outcomes, its relationship with intrinsic capacity (IC) - a marker of healthy ageing that considers a combination of physical and mental abilities – and death remains unclear. We investigated sarcopenia, osteoporosis and IC in association with all-cause mortality in men.

Methods: Following 15-y follow-up assessments (2016-2019) for 519 men (33-96y), all-cause mortality was ascertained until the end of 2022 by data linkage with the National Deaths Index. Sarcopenia was identified using EWGSOP2: probable sarcopenia (handgrip strength<31kg) by dynamometry was confirmed by low DXA-derived appendicular lean mass (ALM/h2<6.94kg/m2). Femoral neck BMD identified osteopenia/osteoporosis as T-score <-1.0 and osteoporosis as T-score <-2.5. Composite IC scores were calculated from five domains: vitality (nourishment, dietary quality), cognition (Mini-Mental State Examination), psychological wellbeing (Hospital Anxiety and Depression Scale), sensory abilities (vision, hearing) and locomotion (gait speed and timed Up-&-Go). Scores for each domain ranged from 0 (unhealthy) to 2 (healthy), except locomotion (0-4) because of its importance to independence. Composite IC scores were dichotomised at the median (low-IC<10). Binary logistic regression modelling determined associations between sarcopenia, osteoporosis and low-IC with the odds for mortality.

Results: Composite IC scores ranged from 4 to 12. There were 40 deaths during follow-up. Participants who died were more likely to have poor health: those who died-v-survived for probable-sarcopenia [11/40(27.5%)-v-36/479(7.5%), p<0.001], confirmed-sarcopenia [4/40(10.0%)-v-2/479(0.4%), p<0.001], osteopenia/osteoporosis [22/40(55.0%)-v-199/479(41.5%), p=0.098], osteoporosis [5/40(12.5%)-v-9/479(1.9%), p=0.003] and low-IC [35/40(87.5%)-v-183/479(38.2%), p<0.001].

An age-adjusted model for death included: probable-sarcopenia [1.31 (0.54-3.20), p=0.550], osteopenia/osteoporosis [OR 0.93 (0.44-1.94), p=0.852] and low-IC [OR 4.17 (95%CI 1.48-11.7), p=0.007]. The pattern was clearer when more severe musculoskeletal deficits were used: confirmed-sarcopenia [9.03 (0.96-85.0), p=0.055], osteoporosis [OR 3.37 (0.79-14.3), p=0.100] and low-IC [OR 4.63 (95%CI 1.60-13.4), p=0.005]. No interaction terms were identified.

Conclusions: Poor muscle and bone health in conjunction with a low composite IC-score was associated with increased mortality risk. Multivariable models indicated that, despite being inter-related, muscle health, bone health and intrinsic capacity each showed independent and additive associations with mortality. The stronger associations observed with more severe musculoskeletal impairment suggest a potential dose effect, although conclusions are constrained by small numbers.