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Updated: Mar 20, 2026
Author Spotlight: An Economic and Efficient Method for Quantitative Evaluation of Bone Microarchitecture in a Murine Osteoporosis Model
Published on: September 8, 2023
Trabecular Bone Score and Mortality Risk in a Population-Based Cohort of Older Adults
1Department of Medicine, Laredo Medical Center, Laredo, TX, USA.
Background:
Osteoporosis is consistently reported to increase mortality risk in older adults. Whether trabecular bone score (TBS), an indirect index of trabecular microarchitecture, increases mortality risk has not been widely studied.
Methods:
Participants aged 60 years and older in the National Health and Nutritional Examination Survey 2005 to 2008 with complete data on TBS lumbar vertebrae were linked to the public-use mortality files through December 31st, 2019. The X-tile software (version 3.6.1; Yale University) was used to obtain the overall and sex-specific optimal TBS cut-off values associated with all-cause mortality (log-rank test P<0.0001). Then, TBS was grouped into low (≤1.24), medium (1.25-1.39), and high (≥1.40) categories.
Results:
A total of 2,641 participants with a mean age of 69.8 (standard error 0.2) years comprised the study sample. Of those, 1,109 older adults died after a median follow-up of 140 months. Overall, survival probability progressively decreased across TBS categories, which was accentuated in subjects with low TBS. Cox regression analysis demonstrated that participants with low TBS had 47% (hazard ratio [HR], 1.47; 95% confidence interval [CI], 1.10-1.96) greater all-cause mortality risk than their counterparts with high TBS, even after accounting for potential confounders including bone mineral density. Notably, older adults with low TBS had 2-fold higher risk of cancer-related mortality than those with high TBS (HR, 2.07; 95% CI, 1.17-3.67).
Conclusions:
Low TBS was significantly associated with greater all-cause and cancer-related mortality in older adults.
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