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J Nutr Health Aging Volume 19, Number 4, 2015
COMPREHENSIVE NUTRITIONAL STATUS IN SARCO-OSTEOPOROTIC OLDER FALLERS
Y.R. HUO1,2, P. SURIYAARACHCHI2,3, F. GOMEZ2-4, C.L. CURCIO2-4, D. BOERSMA3, P. GUNAWARDENE2,3, O. DEMONTIERO2,3, G. DUQUE2,3
1. Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia; 2. Musculoskeletal Ageing Research Program, Sydney Medical School Nepean, The University of Sydney, Penrith, NSW, Australia, 2750; 3. Falls and Fractures Clinic, Department of Geriatric Medicine, Nepean Hospital, Penrith, NSW, Australia; 4. Research Group on Geriatrics and Gerontology, Faculty of Health Sciences, International Association of Gerontology and Geriatrics Collaborative Centre, University of Caldas, Manizales, Colombia. Corresponding author: Prof. Gustavo Duque, MD, PhD, FRACP, Ageing Bone Research Program, Sydney Medical School Nepean, The University of Sydney, PO Box 63 Penrith NSW 2751, Australia, Tel: +61 2 4734 4278; Facsimile: +61 2 4734 2614, Email: [email protected]
Abstract: Objectives: In older persons, the combination of osteoporosis and sarcopenia has been proposed as a subset of frailer individuals at higher risk of falls and fractures. However, the particular nutritional status of the sarco-osteoporotic (SOP) patients remains unknown. The goal of this study was to obtain a comprehensive picture of nutritional status in SOP patients. Design: Cross-sectional study. Setting: Falls & Fractures Clinic, Nepean Hospital (Penrith, Australia). Participants: 680 subjects (mean age=79, 65% female) assessed between 2008-2013. Measurements: Assessment included medical history, mini-nutritional assessment, physical examination, bone densitometry and body composition by DXA, and blood tests for nutritional status (albumin, creatinine, hemoglobin, vitamin D, vitamin B-12, calcium, phosphate and folate). Patients were divided in 4 groups: 1) osteopenia/osteoporosis (BMD<-1.0 SD); 2) sarcopenia; 3) SOP; and 4) normal (no sarcopenia/ no osteoporosis). Difference between groups was assessed with one-way ANOVA and chi square analysis. Multivariable linear regression evaluated the association between the groups and measures of nutritional parameters. Results: Sarcopenia was present in 47.4% of those with osteopenia (167/352) and 62.7% in those with osteoporosis (91/145). Mean age of the SOP was 80.47 years. SOP patients showed significantly higher prevalence of falls and fractures. Univariate analyses showed that SOP were more likely than normal to have a BMI< 25 (OR 2.42 95%CI 1.45-4.041, p<0.001), a MNA score <12 (OR 2.0, 95%CI 1.15-3.49, p<0.05), serum folate <20 nmol/L (OR 4.0 95%CI 1.35-11.87, p<0.01) and hemoglobin <120g/L (OR...