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Musculoskeletal decline and mortality: prospective data from the Geelong Osteoporosis Study

Pasco, Julie A., Mohebbi, Mohammadreza, Holloway, Kara L., Brennan-Olsen, Sharon L., Hyde, Natalie K. and Kotowicz, Mark A. 2017, Musculoskeletal decline and mortality: prospective data from the Geelong Osteoporosis Study, Journal of cachexia, sarcopenia and muscle, vol. 8, no. 3, pp. 482-489, doi: 10.1002/jcsm.12177.

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Title Musculoskeletal decline and mortality: prospective data from the Geelong Osteoporosis Study
Author(s) Pasco, Julie A.ORCID iD for Pasco, Julie A. orcid.org/0000-0002-8968-4714
Mohebbi, MohammadrezaORCID iD for Mohebbi, Mohammadreza orcid.org/0000-0001-9713-7211
Holloway, Kara L.ORCID iD for Holloway, Kara L. orcid.org/0000-0001-5064-2990
Brennan-Olsen, Sharon L.
Hyde, Natalie K.
Kotowicz, Mark A.ORCID iD for Kotowicz, Mark A. orcid.org/0000-0002-8094-1411
Journal name Journal of cachexia, sarcopenia and muscle
Volume number 8
Issue number 3
Start page 482
End page 489
Total pages 8
Publisher Wiley
Place of publication Chichester, Eng.
Publication date 2017-06
ISSN 2190-6009
Keyword(s) Dual energy X-ray absorptiometry
Lean mass
Mortality risk
Musculoskeletal health
Osteoporosis
Osteosarcopenia
Sarcopenia
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
BONE-MINERAL DENSITY
MUSCLE MASS
SKELETAL-MUSCLE
SARCOPENIC OBESITY
REFERENCE RANGES
AUSTRALIAN MEN
OLDER-ADULTS
WOMEN
PREDICTOR
STRENGTH
Summary Background
We aimed to examine the relationship between musculoskeletal deterioration and all-cause mortality in a cohort of women studied prospectively over a decade.

Methods
A cohort of 750 women aged 50–94 years was followed for a decade after femoral neck bone mineral density (BMD) and appendicular lean mass (ALM) were measured using dual energy X-ray absorptiometry, in conjunction with comorbidities, health behaviour data, and other clinical measures. The outcome was all-cause mortality identified from the Australian National Deaths Index. Using Cox proportional hazards models and age as the time variable, mortality risks were estimated according to BMD groups (ideal-BMD, osteopenia, and osteoporosis) and ALM groups (T-scores > −1.0 high, −2.0 to −1.0 medium, <−2.0 low).

Results
During 6712 person years of follow-up, there were 190 deaths, the proportions increasing with diminishing BMD: 10.7% (23/215) ideal-BMD, 23.5% (89/378) osteopenia, 49.7% (78/157) osteoporosis; and with diminishing ALM: 17.0% (59/345) high, 26.2% (79/301) medium, 50.0% (52/104) low. In multivariable models adjusted for smoking, polypharmacy, and mobility, compared with those with ideal BMD, mortality risk was greater for those with osteopenia [hazard ratio (HR) 1.77, 95% confidence interval (CI) 1.11–2.81] and osteoporosis (HR 2.61, 95%CI 1.60–4.24). Similarly, compared with those with high ALM, adjusted mortality risk was greater for medium ALM (HR 1.36, 95%CI 0.97–1.91) and low ALM (HR 1.65, 95%CI 1.11–2.45). When BMD and ALM groups were tested together in the model, BMD remained a predictor of mortality (HR 1.74, 95%CI 1.09–2.78; HR 2.82, 95%CI 1.70–4.70; respectively), and low ALM had borderline significance (HR 1.52, 95%CI 1.00–2.31), which was further attenuated after adjusting for smoking, polypharmacy, and mobility.

Conclusions
Poor musculoskeletal health increased the risk for mortality independent of age. This appears to be driven mainly by a decline in bone mass. Low lean mass independently exacerbated mortality risk, and this appeared to operate through poor health exposures.
Language eng
DOI 10.1002/jcsm.12177
Field of Research 110314 Orthopaedics
Socio Economic Objective 920502 Health Related to Ageing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution non-commercial licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30091513

Document type: Journal Article
Collections: School of Medicine
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.