Osteosarcopenia as a risk factor for fractures and mortality– 19-year follow-up of a population-based sample

Purpose This study assessed osteoporosis, sarcopenia and osteosarcopenia as risk factors for fractures and mortality during 19-year follow-up. Methods The study population consisted of 2142 individuals aged 55 and older participating in the Finnish population-based Health 2000 Survey. Probable sarcopenia was defined as grip strength below 27 kg for men and below 16 kg for women. Osteoporosis was identified by a bone density T-score below -2,5 via ultrasound or a self-reported diagnosis. Participants were divided into four categories: neither condition, probable sarcopenia only, osteoporosis only, or osteosarcopenia. Fractures and deaths were identified from the national registers until end of 2019. Results Over a mean follow-up of 19.1 years, 482 (23%) participants sustained a low-energy fracture of any type and [MN1] 1252 (59%) died. Osteosarcopenia, probable sarcopenia and osteoporosis were all associated with increased risk of any fracture and mortality compared to no sarcopenia no osteoporosis group. Osteoporosis alone was associated with lower mortality than osteosarcopenia (HR 0.69, 95% CI 0.51-0.95), but mortality did not differ between probable sarcopenia and osteosarcopenia (HR 0.80, 95% CI 0.59-1.07). No differences in the fracture risk between osteosarcopenia, sarcopenia and osteoporosis were observed. Conclusion While both sarcopenia and osteoporosis significantly increase fracture and mortality risks, their combination does not seem to additively elevate fracture risks. Osteoporosis is a stronger predictor for future fractures, whereas probable sarcopenia is more closely linked to mortality. Further research is warranted to determine the best ways to incorporate sarcopenia assessment into comprehensive fracture risk evaluation Mini-abstract Osteoporosis, sarcopenia, and osteosarcopenia were assessed as fracture and mortality risk factors over 19 years in 2,142 adults. All conditions increased fracture and mortality risks. Osteosarcopenia showed no higher fracture risk than sarcopenia or osteoporosis alone but had higher mortality risk compared to osteoporosis alone. [MN1]any fragility fracture/low-energy fracture?