Overlap between Osteosarcopenia and Frailty and their Association with Poor Health Conditions: The Bushehr Elderly Health Program.

BACKGROUND: The aim of this study was to investigate the association of osteosarcopenia with frailty and poor health conditions among older Iranian adults. METHODS: This cross-sectional study analyzed data from the Bushehr Elderly Health Program. Osteosarcopenia was defined as the presence of osteopenia/osteoporosis and sarcopenia, while the Fried criteria were used to assess frailty. We assessed the history of falls and health-related quality of life (HRQoL), including physical and mental component summaries (PCS and MCS, respectively), history of fractures, activities of daily living (ADL), and instrumental activities of daily living (IADL), as indicators of poor health conditions. RESULTS: This study included a total of 2,371 older adults. The prevalence rates of osteosarcopenia-only, frailty-only, and osteosarcopenia with frailty were 17.4%, 3%, and 4.8%, respectively. The prevalence of a history of falls, poor ADL, and poor IADL was significantly higher in the frailty-only and osteosarcopenia with frailty groups. Osteosarcopenia with frailty was significantly associated with a history of falls (adjusted odds ratio [adjOR]=1.94; 95% confidence interval [CI], 1.20-3.15), poor ADL (adjOR=2.85; 95% CI, 1.81-4.50), and poor IADL (adjOR=5.09; 95% CI, 2.85-9.11). However, the frailty-only group also showed an association with falls and poor ADL and IADL. Only osteosarcopenia was associated with an increased OR for fracture. Frailty had the greatest effect on the MCS and PCS scores, whereas osteosarcopenia with frailty had a moderate impact. CONCLUSION: Osteosarcopenia with frailty significantly increased the odds of falls, poor ADL, poor IADL, and lower HRQoL compared with the robust group. Combined osteosarcopenia and frailty were not associated with poor health. These findings indicate the importance of diagnosing osteosarcopenia and frailty as separate entities to provide appropriate interventions and treatment.

Relationship Between Sarcopenia and Electrocardiographic Abnormalities in Older People: The Bushehr Elderly Health Program.

Background: Sarcopenia is characterized by low skeletal muscle mass and function, which is associated with cardiovascular risk factors and may even be related to adverse cardiovascular events and mortality. This study aimed to evaluate whether sarcopenia is related to electrocardiographic (ECG) abnormalities in a large sample of older adults. Methods: We performed a cross-sectional study based on the data collected during the Bushehr Elderly Health (BEH) cohort study. Body composition was measured by dual X-ray absorptiometry (DXA) and muscle strength was measured using a digital dynamometer for each hand of every participant. A person who had low muscle strength, as well as low muscle mass was identified as having sarcopenia. The subjects were classified into three groups according to the Minnesota Code (MC) as major, minor ECG abnormalities and participants with no abnormalities ECG. Results: Of the 2,426 participants, 354 (14.6%) had major ECG abnormalities and 193 (8%) had minor ECG abnormalities. Sarcopenia was associated with an increased risk of major ECG abnormality in all models. After adjustment for confounders of CHD in full model, the OR for major ECG abnormality was 1.47 (95% CI 1.11-1.95) in those with sarcopenia. Low muscle strength and low muscle performance were both with an increased risk of major ECG abnormality in all models. Sarcopenia and low muscle strength increased 28% and 62% risk of any ECG abnormality in the full models [sarcopenia: 1.28(1.01-1.63), low muscle strength: 1.62(1.30-2.03)], respectively. Conclusions: This study showed that sarcopenia and its components are associated with ECG abnormalities in Iranian older people. Although some older adults have higher cardiovascular risk factors, these data showed that further factors such as sarcopenia may be identified as a particular risk factor for future cardiovascular events. Therefore, sarcopenia could be added to the screening of the older population to reduce the risk of cardiovascular events.

Development of a Simple and Practical Screening Tool for Detection of Sarcopenia in Older People: The Bushehr Elderly Health Program.

Background: Sarcopenia is defined by the loss of muscle mass and function with a considerable prevalence which increases morbidity and mortality. We aimed to develop and validate a simple tool for screening of sarcopenia in Iranian older population. Methods: In this study, we included 2,211 adults aged 60 years or older that participated in the stage II of Bushehr Elderly Health (BEH) program, a population-based prospective cohort study. We defined sarcopenia as reduced skeletal muscle strength plus low muscle mass. The study sample was divided into two parts; development set which were allocated to the development of the model (n = 1,499) and validation set (n = 712) were allocated to validation of the model. Results: There were 22.9% of men and 23.2% women classified as having sarcopenia based on EWGSOP-2.After selection of variables, the final models named SarSA-Mod (Sarcopenia Scoring Assessment Models) were developed with area to under curves (AUC) of 0.82 (0.79-0.86) and 0.87 (0.84-0.90) in men and women, respectively. The final model included "age," "weight," and "calf circumference" in both sexes. The sensitivity and specificity and positive and negative predictive values for sarcopenia were 84.3, 76.0, 49.8, and 94.5% for women, 85.4, 64.8, 40.2, and 94.2% for men, respectively. The model performance was tested in the validation set with accuracy 91 and 84% among women and men, respectively. Conclusions: Sarcopenia could be detected using SarSA-Mod, as a simple screening test with high accuracy among both sexes. Also, this screening test is valid, feasible, reliable and cost-effective compared to other tools.