Frailty and osteosarcopenia in older men: a hidden vulnerability

BACKGROUND: Osteosarcopenia (OSP), the coexistence of osteoporosis (OP) and sarcopenia, is a growing but underrecognized concern in older men. Sharing common risk factors, frailty and OSP often coexist, increasing the risk of falls, fractures, and functional decline. This study aimed to investigate the association between frailty and OSP in male patients aged 65–70 years. METHODS: This cross-sectional study included 234 community-dwelling men aged 65–70 years who presented to a geriatrics outpatient clinic. OSP was defined by the presence of both low muscle strength and OP. Comprehensive geriatric assessments (CGA) and physical performance tests were performed. Clinical Frailty Scale (CFS) was used to assess frailty status. RESULTS: Our study included 234 male geriatric patients with a median age of 68 [66–69] years. Among them, 52 patients (22.3%) were diagnosed with OSP, while 182 (77.7%) were classified as non-OSP. OSP was independently associated with living with frailty (CFS ≥ 4) after adjusting for age, BMI, chronic renal disease (CRD), number of medications, malnutrition, arrhythmia, Katz Activities of Daily Living (ADL) scores, Lawton Instrumental ADL scores, and depression, serum 25-OH-D3 (OR = 3.38; 95% CI: 1.56–7.33; p = 0.002). Patients with OSP had higher CFS and lower MNA scores (p < 0.05). CRD and medication use were associated with increased OSP risk, while BMI > 25 was associated with lower risk (p < 0.05). CONCLUSIONS: Frailty is significantly associated with OSP in older men and may contribute to its development. Screening frail men aged 65–70 for both conditions may support early detection and prevention. Further studies are needed to clarify causality and guide interventions.