Dysmobility syndrome is associated with prevalent morphometric vertebral fracture in older adults: the Korean Urban-Rural Elderly (KURE) study
In a community-dwelling elderly cohort, dysmobility syndrome was associated with elevated odds of morphometric vertebral fracture or any prevalent fracture, independent of age and covariates. Dysmobility syndrome improved discrimination for fracture when added to the FRAX score.
Dysmobility syndrome was coined to indicate patients with impaired musculoskeletal health. Data on the association of dysmobility syndrome with prevalent morphometric vertebral fracture (VF) in elderly persons are limited.
A total of 1369 community-dwelling elderly subjects (mean age 71.6 years; women 66%) were analyzed. Dysmobility syndrome was defined as ≥ 3 components among falls, low lean mass, high fat mass, osteoporosis, low grip strength, and low timed get-up-and-go performance. VF was defined as a ≥ 25% reduction in the height of vertebral bodies in plain radiographs. Modified cutpoints of each component at which elevate the odds of fracture were investigated using receiver-operating characteristics analysis. Net reclassification improvement (NRI) and integrated discrimination index (IDI) were calculated to assess additive discriminatory value of dysmobility syndrome over FRAX.
The prevalence of VF and any fracture composite of VF and non-VF was 16% and 25%, respectively, increasing according to number of dysmobility components (from 0 to 5; VF 10–35%; any fracture 16–45%). Dysmobility syndrome was associated with elevated odds of VF (adjusted OR [aOR] 1.52, 95% CI 1.08–2.15) or any fracture (aOR 1.46, 95% CI 1.07–1.98) but no longer with non-VF (aOR 1.31, 95% CI 0.86–1.98) in multivariate model, whereas modified definition showed robust association with non-VF (aOR 1.79, 95% CI 1.23–2.60). Dysmobility syndrome improved discrimination for prevalent fracture when added to FRAX (NRI 0.25, 95% CI 0.13–0.37; IDI 0.020, 95% CI 0.014–0.026).
Dysmobility syndrome was associated with elevated odds of morphometric VF in community-dwelling older adults, independent of age and covariates.
KeywordsDysmobility syndrome Falls Osteoporosis Sarcopenia Obesity
We thank all our participants and the technical staff of the KURE study.
This study was funded by the Research of Korea Centers for Disease Control and Prevention (2013-E63007-01, 2013-E63007-02).
Compliance with ethical standards
The study was approved by the Institutional Review Board (IRB) of Severance Hospital (IRB no. 4-2012-0172), with written informed consent obtained from all participants. All procedures performed in studies involving human participants were in accordance with the ethical standards of the IRB and with the 1964 Helsinki Declaration and its later amendments.
Conflicts of interest
- 2.Tran T, Bliuc D, van Geel T, Adachi JD, Berger C, van den Bergh J, Eisman JA, Geusens P, Goltzman D, Hanley DA, Josse RG, Kaiser SM, Kovacs CS, Langsetmo L, Prior JC, Nguyen TV, Center JR (2017) Population-wide impact of non-hip non-vertebral fractures on mortality. J Bone Miner Res 32:1802–1810CrossRefGoogle Scholar
- 8.Buehring B, Hansen KE, Lewis BL, Cummings SR, Lane NE, Binkley N, et al (2018) Dysmobility syndrome independently increases fracture risk in the osteoporotic fractures in men (MrOS) prospective cohort study. J Bone Miner Res. https://doi.org/10.1002/jbmr.3455
- 9.Kendler DL, Bauer DC, Davison KS, Dian L, Hanley DA, Harris ST et al (2016) Vertebral fractures: clinical importance and management. Am J Med 129(221):e221–e210Google Scholar
- 11.Genant HK, Jergas M, Palermo L, Nevitt M, Valentin RS, Black D et al (1996) Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis: The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 11:984–996CrossRefGoogle Scholar
- 14.Hong N, Kim CO, Youm Y, Kim HC, Rhee Y (2018) Low peak jump power is associated with elevated odds of dysmobility syndrome in community-dwelling elderly individuals: the Korean Urban Rural Elderly (KURE) study. Osteoporos Int 29:1427–1436. https://doi.org/10.1007/s00198-018-4466-0 CrossRefPubMedGoogle Scholar
- 16.Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, Chou MY, Chen LY, Hsu PS, Krairit O, Lee JSW, Lee WJ, Lee Y, Liang CK, Limpawattana P, Lin CS, Peng LN, Satake S, Suzuki T, Won CW, Wu CH, Wu SN, Zhang T, Zeng P, Akishita M, Arai H (2014) Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc 15:95–101CrossRefGoogle Scholar
- 20.Anonymous (1968) Nutritional anaemias. Report of a WHO scientific group. World Health Organ Tech Rep Ser 405:5–37Google Scholar
- 31.Sun G, French CR, Martin GR, Younghusband B, Green RC, Xie YG, Mathews M, Barron JR, Fitzpatrick DG, Gulliver W, Zhang H (2005) Comparison of multifrequency bioelectrical impedance analysis with dual-energy X-ray absorptiometry for assessment of percentage body fat in a large, healthy population. Am J Clin Nutr 81:74–78CrossRefGoogle Scholar