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© 2017. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

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.

Details

Title
Musculoskeletal decline and mortality: prospective data from the Geelong Osteoporosis Study
Author
Pasco, Julie A 1   VIAFID ORCID Logo  ; Mohebbi, Mohammadreza 2 ; Holloway, Kara L 3 ; Sharon L. Brennan‐Olsen 4 ; Hyde, Natalie K 3 ; Kotowicz, Mark A 1 

 Deakin University, Geelong, Australia; Melbourne Medical School‐Western Campus, University of Melbourne, St Albans, Australia; University Hospital Geelong, Geelong, Australia 
 Biostatistics Unit, Faculty of Health, Deakin University, Burwood, Australia 
 Deakin University, Geelong, Australia 
 Deakin University, Geelong, Australia; Melbourne Medical School‐Western Campus, University of Melbourne, St Albans, Australia; Institute for Health and Ageing, Australian Catholic University, Melbourne, Australia 
Pages
482-489
Section
Original Articles
Publication year
2017
Publication date
Jun 2017
Publisher
John Wiley & Sons, Inc.
ISSN
21905991
e-ISSN
21906009
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2290032040
Copyright
© 2017. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.