Sarcopenia and osteoporosis in Portuguese centenarians

To evaluate the prevalence of sarcopenia and osteoporosis in centenarians and its association with body composition and past physical activity (PPA).

We conducted an observational cross-sectional study in a representative nationwide population of 253 Portuguese centenarians. A clinically oriented questionnaire and anthropometric and body composition analysis by bioimpedance were executed. Sarcopenia was determined using a muscle mass (MM) index cutoff ⩽16.7 kg/m². Osteoporosis was defined through estimated bone mass (BM), according to gender and body weight. Inadequate physical performance was considered when the timed-up-and-go test was >12 s.

BM and MM were gender dependent, even after adjusting for multiple variables. We found a protective effect of intense PPA on sarcopenia risk (OR=0.41, 95% CI=0.20-0.82, P=0.013). Those with worse physical function status presented a significantly higher risk for osteoporosis (OR=8.9, 95% CI=1.94-40.08, P=0.005). Multivariate models showed that low MM, BM and fat mass (FM) were predictors of underweight in centenarians. Underweight, male gender, worst physical function, hypohydration and sarcopenia were associated with increased osteoporosis risk. The risk for sarcopenia was higher in women (P=0.002), in those underweight (P=0.005) and in osteoporotic individuals (P<0.0001). Conversely, increased MM was protective against osteoporosis (P<0.0001), whereas higher BM decreased the risk for sarcopenia (P=0.005).

Gender was revealed to be a relevant factor influencing BM and MM in centenarians. MM and BM were better predictors of underweight than was dehydration. Healthy BM and MM were positively related with PPA intensity and determined physical performance, having a positive impact on the centenarian's independence. During aging, improving physical function might add to sarcopenia and osteoporosis prevention, besides prevention of femur neck fractures and cardiovascular diseases.