Dysmobility Syndrome Independently Increases Fracture Risk in the Osteoporotic Fractures in Men (MrOS) Prospective Cohort Study

for the Osteoporotic Fractures in Men (MrOS) Study Research Group

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

We proposed the term “dysmobility syndrome” (DS) to identify individuals with impaired musculoskeletal health, a risk factor for falls and fractures. Whether DS is associated with increased risk of incident fracture is unknown. The Osteoporotic Fractures in Men (MrOS) study enrolled 5994 men ages ≥65 years, between March 2000 and April 2002. We used baseline data to determine whether DS increased fracture risk, independent of the Fracture Risk Assessment Tool (FRAX). Men met DS criteria at baseline if they had three or more of the following: appendicular lean mass/height 2 <7.26 kg/m 2 , total body fat >30%, spine or hip T-score ≤ –2.5, grip strength <30 kg, gait speed <1.0 m/s, and one or more fall within 12 months. We examined whether baseline DS increased the risk of hip and major osteoporotic fractures (MOFs) over a median of 14 years (IQR, 9 to 15 years). Among 5834 men mean age 74 ± 6 years, 471 (8%) had DS and 635 (11%) experienced an MOF, including 274 (5%) hip fractures. Age (per SD increase) conferred an HR of 1.72 (95% CI, 1.59 to 1.86), DS conferred an HR of 3.45 (95% CI, 2.78 to 4.29) and FRAX calculated with BMD (per %) conferred an HR of 1.10 (95% CI, 1.08 to 1.11) for MOF. Prediction of MOF using the FRAX score provided a concordance value of 0.67 ± 0.012 (concordance values are mean ± SE). Concordance increased to 0.69 ± 0.012 by adding DS and to 0.70 ± 0.012 by adding DS and age to the multivariate model. Kaplan-Meier curves indicated that men with both DS and a FRAX risk above the National Osteoporosis Foundation (NOF) treatment thresholds had higher MOF (HR 6.23; 95% CI, 3.10 to 12.54) and hip (HR 7.73; 95% CI, 5.95 to 10.04) fracture risk than men with neither condition. We suggest further studies to determine the optimal criteria for DS, and to test DS as a predictor of falls and fractures, especially in women.

Original languageEnglish (US)
Pages (from-to)1622-1629
Number of pages8
JournalJournal of Bone and Mineral Research
Volume33
Issue number9
DOIs
StatePublished - Sep 2018

Fingerprint

Osteoporotic Fractures
Cohort Studies
Prospective Studies
Hip
Hip Fractures
Hand Strength
Osteoporosis
Spine

Keywords

  • DYSMOBILITY SYNDROME
  • FALLS
  • FRAX
  • MUSCLE
  • OBESITY
  • OSTEOPOROSIS
  • SARCOPENIA

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

Cite this

Dysmobility Syndrome Independently Increases Fracture Risk in the Osteoporotic Fractures in Men (MrOS) Prospective Cohort Study. / for the Osteoporotic Fractures in Men (MrOS) Study Research Group.

In: Journal of Bone and Mineral Research, Vol. 33, No. 9, 09.2018, p. 1622-1629.

Research output: Contribution to journalArticle

for the Osteoporotic Fractures in Men (MrOS) Study Research Group. / Dysmobility Syndrome Independently Increases Fracture Risk in the Osteoporotic Fractures in Men (MrOS) Prospective Cohort Study. In: Journal of Bone and Mineral Research. 2018 ; Vol. 33, No. 9. pp. 1622-1629.
@article{690c3451e96542fda655b32f7a91ad95,
title = "Dysmobility Syndrome Independently Increases Fracture Risk in the Osteoporotic Fractures in Men (MrOS) Prospective Cohort Study",
abstract = "We proposed the term “dysmobility syndrome” (DS) to identify individuals with impaired musculoskeletal health, a risk factor for falls and fractures. Whether DS is associated with increased risk of incident fracture is unknown. The Osteoporotic Fractures in Men (MrOS) study enrolled 5994 men ages ≥65 years, between March 2000 and April 2002. We used baseline data to determine whether DS increased fracture risk, independent of the Fracture Risk Assessment Tool (FRAX). Men met DS criteria at baseline if they had three or more of the following: appendicular lean mass/height 2 <7.26 kg/m 2 , total body fat >30{\%}, spine or hip T-score ≤ –2.5, grip strength <30 kg, gait speed <1.0 m/s, and one or more fall within 12 months. We examined whether baseline DS increased the risk of hip and major osteoporotic fractures (MOFs) over a median of 14 years (IQR, 9 to 15 years). Among 5834 men mean age 74 ± 6 years, 471 (8{\%}) had DS and 635 (11{\%}) experienced an MOF, including 274 (5{\%}) hip fractures. Age (per SD increase) conferred an HR of 1.72 (95{\%} CI, 1.59 to 1.86), DS conferred an HR of 3.45 (95{\%} CI, 2.78 to 4.29) and FRAX calculated with BMD (per {\%}) conferred an HR of 1.10 (95{\%} CI, 1.08 to 1.11) for MOF. Prediction of MOF using the FRAX score provided a concordance value of 0.67 ± 0.012 (concordance values are mean ± SE). Concordance increased to 0.69 ± 0.012 by adding DS and to 0.70 ± 0.012 by adding DS and age to the multivariate model. Kaplan-Meier curves indicated that men with both DS and a FRAX risk above the National Osteoporosis Foundation (NOF) treatment thresholds had higher MOF (HR 6.23; 95{\%} CI, 3.10 to 12.54) and hip (HR 7.73; 95{\%} CI, 5.95 to 10.04) fracture risk than men with neither condition. We suggest further studies to determine the optimal criteria for DS, and to test DS as a predictor of falls and fractures, especially in women.",
keywords = "DYSMOBILITY SYNDROME, FALLS, FRAX, MUSCLE, OBESITY, OSTEOPOROSIS, SARCOPENIA",
author = "{for the Osteoporotic Fractures in Men (MrOS) Study Research Group} and Bjoern Buehring and Hansen, {Karen E.} and Lewis, {Brian L.} and Cummings, {Steven R.} and Lane, {Nancy E.} and Neil Binkley and Ensrud, {Kristine E} and Cawthon, {Peggy M.}",
year = "2018",
month = "9",
doi = "10.1002/jbmr.3455",
language = "English (US)",
volume = "33",
pages = "1622--1629",
journal = "Journal of Bone and Mineral Research",
issn = "0884-0431",
publisher = "Wiley-Blackwell",
number = "9",

}

TY - JOUR

T1 - Dysmobility Syndrome Independently Increases Fracture Risk in the Osteoporotic Fractures in Men (MrOS) Prospective Cohort Study

AU - for the Osteoporotic Fractures in Men (MrOS) Study Research Group

AU - Buehring, Bjoern

AU - Hansen, Karen E.

AU - Lewis, Brian L.

AU - Cummings, Steven R.

AU - Lane, Nancy E.

AU - Binkley, Neil

AU - Ensrud, Kristine E

AU - Cawthon, Peggy M.

PY - 2018/9

Y1 - 2018/9

N2 - We proposed the term “dysmobility syndrome” (DS) to identify individuals with impaired musculoskeletal health, a risk factor for falls and fractures. Whether DS is associated with increased risk of incident fracture is unknown. The Osteoporotic Fractures in Men (MrOS) study enrolled 5994 men ages ≥65 years, between March 2000 and April 2002. We used baseline data to determine whether DS increased fracture risk, independent of the Fracture Risk Assessment Tool (FRAX). Men met DS criteria at baseline if they had three or more of the following: appendicular lean mass/height 2 <7.26 kg/m 2 , total body fat >30%, spine or hip T-score ≤ –2.5, grip strength <30 kg, gait speed <1.0 m/s, and one or more fall within 12 months. We examined whether baseline DS increased the risk of hip and major osteoporotic fractures (MOFs) over a median of 14 years (IQR, 9 to 15 years). Among 5834 men mean age 74 ± 6 years, 471 (8%) had DS and 635 (11%) experienced an MOF, including 274 (5%) hip fractures. Age (per SD increase) conferred an HR of 1.72 (95% CI, 1.59 to 1.86), DS conferred an HR of 3.45 (95% CI, 2.78 to 4.29) and FRAX calculated with BMD (per %) conferred an HR of 1.10 (95% CI, 1.08 to 1.11) for MOF. Prediction of MOF using the FRAX score provided a concordance value of 0.67 ± 0.012 (concordance values are mean ± SE). Concordance increased to 0.69 ± 0.012 by adding DS and to 0.70 ± 0.012 by adding DS and age to the multivariate model. Kaplan-Meier curves indicated that men with both DS and a FRAX risk above the National Osteoporosis Foundation (NOF) treatment thresholds had higher MOF (HR 6.23; 95% CI, 3.10 to 12.54) and hip (HR 7.73; 95% CI, 5.95 to 10.04) fracture risk than men with neither condition. We suggest further studies to determine the optimal criteria for DS, and to test DS as a predictor of falls and fractures, especially in women.

AB - We proposed the term “dysmobility syndrome” (DS) to identify individuals with impaired musculoskeletal health, a risk factor for falls and fractures. Whether DS is associated with increased risk of incident fracture is unknown. The Osteoporotic Fractures in Men (MrOS) study enrolled 5994 men ages ≥65 years, between March 2000 and April 2002. We used baseline data to determine whether DS increased fracture risk, independent of the Fracture Risk Assessment Tool (FRAX). Men met DS criteria at baseline if they had three or more of the following: appendicular lean mass/height 2 <7.26 kg/m 2 , total body fat >30%, spine or hip T-score ≤ –2.5, grip strength <30 kg, gait speed <1.0 m/s, and one or more fall within 12 months. We examined whether baseline DS increased the risk of hip and major osteoporotic fractures (MOFs) over a median of 14 years (IQR, 9 to 15 years). Among 5834 men mean age 74 ± 6 years, 471 (8%) had DS and 635 (11%) experienced an MOF, including 274 (5%) hip fractures. Age (per SD increase) conferred an HR of 1.72 (95% CI, 1.59 to 1.86), DS conferred an HR of 3.45 (95% CI, 2.78 to 4.29) and FRAX calculated with BMD (per %) conferred an HR of 1.10 (95% CI, 1.08 to 1.11) for MOF. Prediction of MOF using the FRAX score provided a concordance value of 0.67 ± 0.012 (concordance values are mean ± SE). Concordance increased to 0.69 ± 0.012 by adding DS and to 0.70 ± 0.012 by adding DS and age to the multivariate model. Kaplan-Meier curves indicated that men with both DS and a FRAX risk above the National Osteoporosis Foundation (NOF) treatment thresholds had higher MOF (HR 6.23; 95% CI, 3.10 to 12.54) and hip (HR 7.73; 95% CI, 5.95 to 10.04) fracture risk than men with neither condition. We suggest further studies to determine the optimal criteria for DS, and to test DS as a predictor of falls and fractures, especially in women.

KW - DYSMOBILITY SYNDROME

KW - FALLS

KW - FRAX

KW - MUSCLE

KW - OBESITY

KW - OSTEOPOROSIS

KW - SARCOPENIA

UR - http://www.scopus.com/inward/record.url?scp=85051531188&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85051531188&partnerID=8YFLogxK

U2 - 10.1002/jbmr.3455

DO - 10.1002/jbmr.3455

M3 - Article

C2 - 29701911

AN - SCOPUS:85051531188

VL - 33

SP - 1622

EP - 1629

JO - Journal of Bone and Mineral Research

JF - Journal of Bone and Mineral Research

SN - 0884-0431

IS - 9

ER -