Frailty and hip osteoarthritis in men in the MrOS cohort

Frailty has been associated in previous studies with increased mortality and morbidity, but little has been published on its association with arthritis. This study examined the association of hip osteoarthritis to frailty status in a longitudinal observational cohort of older men in the Osteoporotic Fractures in Men Study.

Participants (N = 4,130) were men aged 65 years and older with complete frailty status and hip radiographs. We defined frailty as three or more of the following components: unintentional weight loss, weakness, self-reported exhaustion, low activity level, and slow walking speed. Men with intermediate stage status met one or two criteria while robust men had none. We defined radiographic hip osteoarthritis (RHOA) as a modified Croft score greater than or equal to 2 on hip radiograph. The relation of RHOA or total hip replacement (THR) to frailty status was examined in cross-sectional and incident analyses using logistic regression.

Prevalence of robust, intermediate, and frail status was 50%, 42%, and 8%, respectively. RHOA or THR was associated with increased odds of being frail or intermediate compared with robust (adjusted odds ratio = 1.45, 95% confidence interval [CI] 1.18, 1.78). Men with RHOA or THR were 1.27 times more likely to have incident frail or intermediate status compared with robust (95% CI: 1.19, 1.38).

RHOA and THR are associated with greater frailty status in older men, suggesting that interventions to reduce frailty should be evaluated in older men with either RHOA or THR.