title: Phenotype of osteosarcopenia in older individuals with a history of falling.
abstract: OBJECTIVE
  In older persons, the combination of osteopenia/osteoporosis and sarcopenia has been proposed as a subset of frailer individuals at higher risk of institutionalization, falls, and fractures. However, the particular clinical, biochemical, and functional characteristics of the osteosarcopenic (OS) patients remain unknown. In this study, we used a clinical definition of osteosarcopenia aiming to determine the clinical, functional, and biochemical features that are unique to these patients within a population of older people who fall.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Falls and Fractures Clinic, Nepean Hospital (Penrith, NSW, Australia).
  
  
  METHODS
  A total of 680 people (mean age = 79, 65% women) assessed between 2009 and 2013.
  
  
  METHODS
  Assessment included medical history, physical examination, bone densitometry and body composition by dual-energy X-ray absorptiometry, posturography, grip strength, gait parameters (GaitRITE), and blood tests for nutrition and secondary causes of sarcopenia and osteoporosis. Patients were divided into 4 groups: (1) osteopenic (BMD <-1.0 SD), (2) sarcopenic, (3) OS, and (4) nonsarcopenic/nonosteopenic. Difference between groups was assessed with 1-way ANOVA and χ(2) analysis. Multivariable linear regression evaluated the association between the groups and measures of physical function. Multivariable logistic regression evaluated risk factors for being in the OS group.
  
  
  RESULTS
  Mean age of the OS patients was 80.4 ± 7.0 years. Our analyses showed that OS patients are older, mostly women, are at high risk for depression and malnutrition, have body mass index lower than 25, and showed a higher prevalence of peptic disease, inflammatory arthritis, maternal hip fracture, history of atraumatic fracture, and impaired mobility.
  
  
  CONCLUSIONS
  We have reported a set of characteristics that are highly prevalent in OS patients. This study could be used to inform the design of future trials and to develop interventions to prevent institutionalization and poor outcomes in this particular set of high-risk patients.
authors.affiliation: Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia; Musculoskeletal Ageing Research Program, Sydney Medical School Nepean, The University of Sydney, Penrith, NSW, Australia.
authors.forename: Ya Ruth
authors.initials: YR
authors.lastname: Huo
authors.affiliation: Musculoskeletal Ageing Research Program, Sydney Medical School Nepean, The University of Sydney, Penrith, NSW, Australia; Department of Geriatric Medicine, Falls and Fractures Clinic, Nepean Hospital, Penrith, NSW, Australia.
authors.forename: Pushpa
authors.initials: P
authors.lastname: Suriyaarachchi
authors.affiliation: Musculoskeletal Ageing Research Program, Sydney Medical School Nepean, The University of Sydney, Penrith, NSW, Australia; Department of Geriatric Medicine, Falls and Fractures Clinic, Nepean Hospital, Penrith, NSW, Australia; Research Group on Geriatrics and Gerontology, Faculty of Health Sciences, International Association of Gerontology and Geriatrics Collaborative Centre, University of Caldas, Manizales, Colombia.
authors.forename: Fernando
authors.initials: F
authors.lastname: Gomez
authors.affiliation: Musculoskeletal Ageing Research Program, Sydney Medical School Nepean, The University of Sydney, Penrith, NSW, Australia; Department of Geriatric Medicine, Falls and Fractures Clinic, Nepean Hospital, Penrith, NSW, Australia; Research Group on Geriatrics and Gerontology, Faculty of Health Sciences, International Association of Gerontology and Geriatrics Collaborative Centre, University of Caldas, Manizales, Colombia.
authors.forename: Carmen L
authors.initials: CL
authors.lastname: Curcio
authors.affiliation: Department of Geriatric Medicine, Falls and Fractures Clinic, Nepean Hospital, Penrith, NSW, Australia.
authors.forename: Derek
authors.initials: D
authors.lastname: Boersma
authors.affiliation: Gait and Brain Laboratory, Parkwood Hospital and Lawson Health Research Institute, University of Western Ontario, London, ON, Canada.
authors.forename: Susan W
authors.initials: SW
authors.lastname: Muir
authors.affiliation: Gait and Brain Laboratory, Parkwood Hospital and Lawson Health Research Institute, University of Western Ontario, London, ON, Canada.
authors.forename: Manuel
authors.initials: M
authors.lastname: Montero-Odasso
authors.affiliation: Musculoskeletal Ageing Research Program, Sydney Medical School Nepean, The University of Sydney, Penrith, NSW, Australia; Department of Geriatric Medicine, Falls and Fractures Clinic, Nepean Hospital, Penrith, NSW, Australia.
authors.forename: Piumali
authors.initials: P
authors.lastname: Gunawardene
authors.affiliation: Musculoskeletal Ageing Research Program, Sydney Medical School Nepean, The University of Sydney, Penrith, NSW, Australia; Department of Geriatric Medicine, Falls and Fractures Clinic, Nepean Hospital, Penrith, NSW, Australia.
authors.forename: Oddom
authors.initials: O
authors.lastname: Demontiero
authors.affiliation: Musculoskeletal Ageing Research Program, Sydney Medical School Nepean, The University of Sydney, Penrith, NSW, Australia; Department of Geriatric Medicine, Falls and Fractures Clinic, Nepean Hospital, Penrith, NSW, Australia. Electronic address: gustavo.duque@sydney.edu.au.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Duque
mesh_terms: D015502:Absorptiometry, Photon; D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D015577:Geriatric Assessment / Q000379:methods; D018737:Hand Strength; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D055948:Sarcopenia / Q000175:diagnosis / Q000453:epidemiology*; D012720:Severity of Illness Index; D017678:Sex Distribution; D013997:Time Factors
keywords: Sarcopenia; falls; institutionalization; osteopenia; osteoporosis; osteosarcopenia