Association between Frailty, Osteoporosis, Falls and Hip Fractures among Community-Dwelling People Aged 50 Years and Older in Taiwan: Results from I-Lan Longitudinal Aging Study.
BACKGROUND
Association of frailty with adverse clinical outcomes has been reported in Western countries, but data from the Asian population are scarce. This study aimed to evaluate the epidemiology of frailty among community-dwelling middle-aged and elderly population and to explore its association with musculoskeletal health in Taiwan.


METHODS
I-Lan Longitudinal Aging Study (ILAS) data were retrieved for this study. Frailty was defined by the Fried's criteria; a comparison of demographic characteristics, physical performance, and body composition, including skeletal muscle mass and bone mineral density (BMD), as well as recent falls, history of hip fractures and the functional status of subjects with different frailty statuses were accomplished.


RESULTS
Overall, the data of 1,839 participants (mean age: 63.9±9.3 years, male 47.5%) were obtained for analysis. The prevalence of pre-frailty was 42.3% in men and 38.8% in women, whereas the prevalence of frailty was 6.9% and 6.7% in men and women, respectively. Frailty was significantly associated with older age, the male gender, larger waist circumference, lower skeletal muscle index, lower hip BMD, poorer physical function, poorer nutritional status, and poorer cognitive function. Also, frailty was significantly associated with osteoporosis (OR: 7.73, 95% CI: 5.01-11.90, p<0.001), history of hip fractures (OR: 8.66, 95% CI: 2.47-30.40, p = 0.001), and recent falls (O.R: 2.53, 95% CI: 1.35-4.76, p = 0.004).


CONCLUSIONS
Frailty and pre-frailty, in Taiwan, was closely associated with recent falls, history of hip fractures and osteoporosis among community-dwelling people 50 years of age and older. Furthermore, frailty intervention programs should take an integrated approach towards strengthening both and muscle mass, as well as prevention of falls.
Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
Li-Kuo
LK
Liu
Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Institute of Public Health, National Yang Ming University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, I-Lan County, Taiwan.
Wei-Ju
WJ
Lee
Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Institute of Public Health, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
Liang-Yu
LY
Chen
Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Institute of Public Health, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
An-Chun
AC
Hwang
Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
Ming-Hsien
MH
Lin
Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Institute of Public Health, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
Li-Ning
LN
Peng
Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.
Liang-Kung
LK
Chen
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology* / Q000502:physiology; D001823:Body Composition; D015519:Bone Density; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology*; D010024:Osteoporosis / Q000503:physiopathology*; D013624:Taiwan