Self-reported frailty is associated with low calcaneal bone mineral density in a multiracial population of community-dwelling elderly.
BACKGROUND
Low bone mineral density (BMD) is associated with frailty assessed using performance-based measures. However, the latter can be cumbersome and difficult to standardize. We examined whether an easily obtained self-reported frailty measure also predicted low BMD.


METHODS
In 230 elderly (82% female, 58% African-American), calcaneal BMD was measured by DXA and frailty evaluated using the VES-13 questionnaire. In addition to the original scoring, we developed a modified scoring system which provided a broader assessment of frailty and excluded age, which is a known independent predictor of BMD. A telephone interview conducted 6 years later ascertained interval fragility fractures and survival status.


RESULTS
A higher modified frailty score was associated with lower BMD (p = 0.002), even after adjusting for age, weight, sex, and race and was more predictive of death at 6 years (p = 0.009) than the original score (p = 0.08). Based on our model, a subject with the highest frailty score differed from an otherwise similar subject with the lowest score by a calcaneal BMD of 1.4 T-score units, corresponding to 2-3 times higher fracture risk.


CONCLUSIONS
Self-reported frailty is associated with low calcaneal BMD and can be used to identify subjects with a greater risk of osteoporosis than expected from traditional risk factors.
Ma
S-L
SL
Department of Medicine, University of Chicago, Chicago, IL, USA.
Oyler
J
J
Glavin
S
S
Alavi
A
A
Vokes
T
T
D015502:Absorptiometry, Photon; D000203:Activities of Daily Living; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D002111:Calcaneus / Q000503:physiopathology*; D004812:Epidemiologic Methods; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D008297:Male; D010024:Osteoporosis / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology