[Association between a low bone mass and prefrailty in community-dwelling older women and their physical,...

The combination of frailty and osteoporosis increases the fracture risk more than either condition alone. Therefore, it is necessary to clarify the characteristics of older adults with a combination of pre-frailty, a precursor to frailty, and a low bone mass and to consider appropriate preventive interventions. This study aimed to clarify the characteristics of older women with combined pre-frailty and a reduced bone mass, a precursor to frailty, and to obtain findings that contribute to both early detection and screening.

A total of 292 community-dwelling women aged ≥ 65 years were classified into four groups based on the presence or absence of a low bone mass and prefrailty: a normal, low bone mass, prefrail, and a low bone mass with prefrail groups. The physical, psychological, and cognitive functions were compared between the groups. A multinomial logistic regression analysis was conducted to identify the associated factors.

The proportions in each group were 29.8% in the normal group, 27.7% in the low bone mass group, 18.5% in the pre-frail group, and 24.0% in the low bone mass and pre-frail group. In the prefrail group, the Geriatric Depression Scale-5 (GDS-5; odds ratio [OR]= 2.536, 95% confidence interval [CI]: 1.586-4.057) and a fear of falling (OR=2.662, 95%CI: 1.227-5.779) emerged as significant associated factors. In the low bone mass with prefrailty group, significant factors included TUG (OR=1.979, 95%CI: 1.188-3.296), MMSE (OR=0.771, 95%CI: 0.633-0.940), GDS-5 (OR=2.775, 95%CI: 1.732-4.368), and a fear of falling (OR=2.303, 95%CI: 1.091-4.860). However, no significant associated factors were identified in the low bone mass group.

The combination of a reduced bone mass and pre-frailty resulted in a more multifaceted functional decline than either condition alone. These findings suggest the usefulness of screening for a reduced bone mass and frailty in community-dwelling older women.