Frailty syndrome in women with osteoporosis, should physicians consider screening? A cross-sectional study

Shiva Rahimipour Anaraki; Ali Mohammadian; Samaneh Saghafian Larijani; Maryam Niksolat; Vahid Rashedi; Milad Gholizadeh Mesgarha

doi:10.1016/j.bonr.2023.101722

Frailty syndrome in women with osteoporosis, should physicians consider screening? A cross-sectional study

Bone Rep. 2023 Oct 31:19:101722. doi: 10.1016/j.bonr.2023.101722. eCollection 2023 Dec.

Authors

Shiva Rahimipour Anaraki¹, Ali Mohammadian², Samaneh Saghafian Larijani³, Maryam Niksolat³, Vahid Rashedi⁴, Milad Gholizadeh Mesgarha¹

Affiliations

¹ Faculty of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.
² Faculty of Medicine, Shahid Beheshti University of Medical sciences, Tehran, Iran.
³ Firoozabadi Clinical and Research Development Unit, Iran University of Medical Sciences, Tehran, Iran.
⁴ Iranian Research Center on Aging, Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Abstract

Despite its high prevalence and profound impact, frailty syndrome often goes undiagnosed. The study revealed a significant correlation between osteoporosis and frailty syndrome, with predictive accuracy exceeding 75 %. Given these findings and the existing recommendation for osteoporosis screening in older women, we underscore the importance of concurrently screening osteoporotic women for frailty.

Introduction: Frailty syndrome, a prevalent and significant geriatric condition, impacts healthcare costs and quality of life. Previous reviews have associated frailty syndrome with osteoporosis, but original research on this link is limited and has produced conflicting results. This study aims to investigate the relationship between frailty syndrome, osteoporosis, bone mineral densitometry T-score, and other influencing factors.

Methods: In this cross-sectional study, post-menopausal women underwent screening for osteoporosis and frailty syndrome using bone mineral densitometry and the Fried phenotype. Exclusion criteria included a history of diseases related to bone loss or medications affecting bone metabolism. Bivariate and multivariable tests were used to examine the correlation between frailty syndrome and various covariates, including the diagnosis of osteoporosis.

Results: A total of 272 women aged 60 to 89 years (mean age 68.57 ± 6.22) were evaluated. Osteoporosis was prevalent in 44.9 % of participants, and frailty syndrome was identified in 36.4 %. The regression model identified age, menopausal age, and the diagnosis of osteoporosis as variables significantly and independently associated with frailty syndrome. A T-score lower than -2.5 in the femur neck or lumbar spine exhibited a sensitivity of 86.6 % and specificity of 76.5 % in predicting frailty syndrome.

Conclusion: Older adults with osteoporosis face an increased risk of frailty syndrome. Therefore, we recommend that primary care providers screen osteoporotic women for frailty syndrome and, when appropriate, refer this group to geriatric specialists for further evaluation.

Keywords: Bone densitometry; Frailty; Fried phenotype; Older adults; Osteoporosis.