title: Severe osteopenia and osteoporosis, sarcopenia, and frailty status in community-dwelling older women: results from the Women's Health and Aging Study (WHAS) II.
abstract: OBJECTIVE
  The goal of this study was to examine the associations between severe osteopenia and osteoporosis and/or sarcopenia on frailty status, a major geriatric syndrome in community-dwelling older women.
  
  
  METHODS
  Cross-sectional analysis.
  
  
  METHODS
  Women's Health and Aging Studies II (WHAS-II), Baltimore, Maryland.
  
  
  METHODS
  The analytic sample for this study included 250 women aged 76-86 years old who underwent DXA evaluation at round 4. Frailty was determined using validated screening criteria. Severe osteopenia was defined as BMD between -2.0 SD and -2.49 SD and osteoporosis as BMD less than -2.5 SD (lumbar spine and/or proximal femur). Sarcopenia was determined by the appendicular lean mass by height(2) (aLM/ht(2) method) and considered present when the value was less then -2 SD compared to young women.
  
  
  RESULTS
  Mean age of study subjects was 79.6 (±2.7) years. Overall prevalence of frailty was 6.8% (n=17). Severe osteopenia/osteoporosis occurred in 42.1% (n=7) in the frail group, 28% (n=33) in the pre frail group and 25.2% in the robust group. Sarcopenia was present in 52.9% (n=9) in the frail group, 42% (n=50) in the pre frail and 41.2% (n=47) in the robust group. Almost sixteen percent (n=39) had severe osteopenia/osteoporosis concomitant to sarcopenia. In an adjusted logistic regression model, severe osteopenia/osteoporosis (OR: 2.1; 95% CI: 0.68-6.6, p=0.196) and sarcopenia (OR: 3.1; 95% CI: 0.88-11.1; p=0.077) were individually associated with frailty, though not statistically significant. On the other hand, the likelihood of being frail was substantially higher in the presence of these two syndromes (OR: 6.4; 95% CI: 1.1-36.8, p=0.037).
  
  
  CONCLUSIONS
  These findings suggest a concomitant impact of severe osteopenia/osteoporosis plus sarcopenia in regard to frailty status in a sample of oldest old women living in the community.
authors.affiliation: Center on Aging and Health of the Johns Hopkins University, Baltimore, MD 21205, USA. frisoli@uol.com.br
authors.forename: Alberto
authors.initials: A
authors.lastname: Frisoli
authors.forename: Paulo Henrique
authors.initials: PH
authors.lastname: Chaves
authors.forename: Sheila Jean McNeill
authors.initials: SJ
authors.lastname: Ingham
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015142:Baltimore / Q000453:epidemiology; D001851:Bone Diseases, Metabolic / Q000150:complications / Q000453:epidemiology*; D016330:Frail Elderly; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000150:complications / Q000453:epidemiology*