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Associations of body composition trajectories with bone mineral density, muscle function, falls, and fractures in older men: the concord health and ageing in men project
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posted on 2020-05-01, 00:00 authored by David ScottDavid Scott, M J Seibel, R Cumming, V Naganathan, F Blyth, D G Le Couteur, D J Handelsman, B Hsu, L M Waite, V HiraniBackground: Weight loss increases fracture risk in older adults. We aimed to determine associations of 2-year body composition trajectories with subsequent falls and fractures in older men. Methods: We measured appendicular lean mass (ALM) and total fat mass (FM) by dual-energy X-ray absorptiometry at baseline and Year 2 in 1,326 community-dwelling men aged ≥70 and older. Body composition trajectories were determined from residuals of a linear regression of change in ALM on change in FM (higher values indicate maintenance of ALM over FM), and a categorical variable for change in ALM and FM (did not lose [≥-5% change] versus lost [<-5% change]). Bone mineral density (BMD), hand grip strength, and gait speed were assessed at Years 2 and 5. After Year 2, incident fractures (confirmed by radiographical reports) and falls were recorded for 6.8 years. Results: Compared with men who did not lose ALM or FM, men who did not lose ALM but lost FM, and men who lost both ALM and FM, had reduced falls (-24% and-34%, respectively; both p <. 05). Men who lost ALM but did not lose FM had increased falls (incidence rate ratio = 1.73; 95% CI 1.37-2.18). ALM/FM change residuals were associated with improved lumbar spine BMD (B = 0.007; 95% CI 0.002-0.012 g/cm2 per SD increase) and gait speed (0.015; 0.001-0.029 m/s), and reduced hip fractures (hazard ratio = 0.68; 95% CI 0.47-0.99). Conclusions: Fracture risk may be increased in older men who lose higher ALM relative to FM. Weight loss interventions for obese older men should target maintenance of lean mass.
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Journals of Gerontology - Series A Biological sciences and medical sciencesVolume
75Issue
5Pagination
939 - 945Publisher
Oxford University pressLocation
Oxford, Eng.Publisher DOI
ISSN
1079-5006eISSN
1758-535XLanguage
engPublication classification
C1 Refereed article in a scholarly journalUsage metrics
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