Poor bone microarchitecture in older men with impaired physical performance--the STRAMBO study

Area of Science:

• Gerontology
• Bone Biology
• Orthopedics

Background:

• Physical performance declines with age, increasing fall risk.
• Bone microarchitecture changes with aging, potentially affecting bone strength.
• Understanding the relationship between physical function and bone health is crucial for preventing fractures in older men.

Purpose of the Study:

• To investigate the association between bone microarchitecture and physical performance in men aged 60 and older.
• To determine if poor physical performance correlates with reduced bone mineral density and altered bone structure.

Main Methods:

• Assessed bone microarchitecture and volumetric bone mineral density (vBMD) at the distal radius and tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT) in 810 men (≥60 years).
• Measured areal bone mineral density (aBMD) at the hip, spine, whole body, and distal radius via dual-energy X-ray absorptiometry (DXA).
• Evaluated physical performance using chair stands, static balance, and dynamic balance tests, creating a composite score.

Main Results:

• Men with poorer physical performance (failing ≥1 test) exhibited lower total hip aBMD and compromised bone microarchitecture at the distal tibia (lower total vBMD, cortical thickness, trabecular vBMD, and increased trabecular spacing heterogeneity).
• Worse performance (failing ≥2 tests) was associated with significantly lower aBMD at the hip and poorer tibial microarchitecture, including reduced cortical vBMD and trabecular number.
• Men reporting falls had lower total hip aBMD and reduced cortical vBMD at the distal tibia.

Conclusions:

• Poor physical performance in older men is significantly associated with lower hip areal bone mineral density.
• Compromised bone microarchitecture, particularly at the distal tibia, is linked to diminished physical function in aging men.
• These findings underscore the importance of assessing both bone health and physical performance in older men to identify individuals at higher risk for falls and fractures.