title: Risk of Nonspine Fractures in Older Adults with Sarcopenia, Low Bone Mass, or Both.
abstract: OBJECTIVE
  To test the hypothesis that men and women with low bone mineral density (BMD) and sarcopenia have a higher risk of fracture than those with only one or neither conditions.
  
  
  METHODS
  The Osteoporotic Fractures in Men Study and the Study of Osteoporotic Fractures in women are prospective observational studies with a mean follow up of 9 (2000-2012) and 8 years (1997-2009), respectively.
  
  
  METHODS
  U.S. clinical centers.
  
  
  METHODS
  Men (n = 5,544; mean age 73.7) and women (n = 1,114; mean age 77.6) aged 65 and older, able to walk without assistance, and without bilateral hip replacement.
  
  
  METHODS
  Sarcopenia was defined as low appendicular lean mass plus slowness or weakness and low BMD according to the World Health Organization definition of a T-score less than -1.0. Participants were classified as having normal BMD and no sarcopenia (3,367 men, 308 women), sarcopenia only (79 men, 48 women), low BMD only (1,986 men, 626 women), and low BMD and sarcopenia (112 men, 132 women).
  
  
  RESULTS
  Men with low BMD and sarcopenia (hazard ratio (HR)=3.79, 95% confidence interval (CI)=2.65-5.41) and men with low BMD only (HR=1.67, 95% CI=1.45-1.93) but not men with sarcopenia only (HR=1.14, 95% CI=0.62-2.09) had greater risk of fracture than men with normal BMD and no sarcopenia. Women with low BMD and sarcopenia (HR=2.27, 95% CI=1.37-3.76) and women with low BMD alone (HR=2.62, 95% CI=1.74-3.95), but not women with only sarcopenia, had greater risk of fracture than women with normal BMD and no sarcopenia.
  
  
  CONCLUSIONS
  Men with low BMD and sarcopenia are at especially high risk of fracture. Sarcopenia alone did not increase fracture risk in either group.
authors: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors: Didier
authors: D
authors: Chalhoub
authors: California Pacific Medical Center, San Francisco, California.
authors: Peggy M
authors: PM
authors: Cawthon
authors: Division of Epidemiology and Community Health, Department of Medicine, University of Minnesot aand Minneapolis VA Health Care System, Minneapolis, Minnesota.
authors: Kristine E
authors: KE
authors: Ensrud
authors: School of Medicine, Stanford University, Stanford, California.
authors: Marcia L
authors: ML
authors: Stefanick
authors: University of California at San Diego, La Jolla, California.
authors: Deborah M
authors: DM
authors: Kado
authors: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors: Robert
authors: R
authors: Boudreau
authors: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors: Susan
authors: S
authors: Greenspan
authors: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors: Anne B
authors: AB
authors: Newman
authors: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors: Joseph
authors: J
authors: Zmuda
authors: Oregon Health & Sciences University, Portland, Oregon.
authors: Eric S
authors: ES
authors: Orwoll
authors: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors: Jane A
authors: JA
authors: Cauley
mesh_terms: D000368:Aged; D015519:Bone Density; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010024:Osteoporosis / Q000150:complications*; D058866:Osteoporotic Fractures / Q000453:epidemiology* / Q000209:etiology*; D011446:Prospective Studies; D018570:Risk Assessment; D055948:Sarcopenia / Q000150:complications*
keywords: bone-muscle interactions; epidemiology; fracture risk assessment; osteoporosis; sarcopenia