Mid-thigh muscle and bone masses are sensitive indices of bone and muscle loss in older fallers — ASN Events
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Mid-thigh muscle and bone masses are sensitive indices of bone and muscle loss in older fallers (#105)

Ebrahim Bani Hassan 1 2 , Pushpa Suriyaarachchi 3 , Derek Boersma 3 , Gustavo Duque 1 2
  1. AIMSS (Australian Institute for Musculoskeletal Science), The University of Melbourne, St. Albans, VIC, Australia
  2. Department of Medicine-Western Health, The University of Melbourne,, St. Albans, VIC, Australia
  3. Falls and Fractures Clinic, Department of Geriatric Medicine, Nepean Hospital, Penrith, NSW, Australia

Introduction:Osteosarcopenia, defined as a synchronic loss of muscle and bone mass, is highly prevalent (~37%) in Australian older population1. Diagnostic methods for this syndrome, which is considered an important risk factor for fractures, disability, frailty and mortality, are not well-defined. Therefore, more sensitive and specific methodologies are required to diagnose osteosarcopenia and detect its progression with ageing. Assessment of sarcopenia using mid-thigh slice of whole-body DXA is a potential low-radiation, accessible alternative to CT scanning of older patients2. We hypothesised that compared to conventional indices and regions of interest (ROIs), mid-thigh muscle and bone masses are better correlated with age; and are also better predictors of synchronic changes in muscle strength and bone mineral density (BMD) in older persons.

Methods:Men and women (n=303), aged 54-95 (78.8±7.3) with at least one fall (mean=3.3±3.7) within last 6 month were studied. Using whole-body DXA scans, at the mid-thigh of both legs, in a 1.3 cm thick ROI, bone and muscle masses were correlated with age and conventional bone and muscle mass/strength indicators.

Results:Three-quarters (76.7%) of the cohort had low bone mass (38.7%), muscle mass (7.7%) or both (32.3%). Right and left (R&L) mid-thigh muscle masses had stronger association with age, compared to appendicular lean muscle mass/height2 (ALM/h2; rs=-0.464&-0.417, p<0.001, vs. -0.193, p=0.011). Age-associated decline in R&L mid-femoral BMD was comparable to the femoral neck BMD reduction(rs=-0.263&-0.219, p=0.009&0.070, vs. -0.250, p=0.002); while lumbar spine and whole-body BMDs did not decline significantly with age.

Compared to ALM/h2, R&L mid-thigh muscle masses had 20.5±6% (12.8-32.7%)stronger correlations with grip strength and BMD in various ROIs (Table), except for whole-body BMD.

Conclusion:Compared to conventional indices, mid-thigh ROI has a greater potential to detect age-associated decline in bone and muscle mass. Furthermore, muscle mass in this ROI shows better correlations with strength and BMD.Longitudinal studies are warranted.

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  1. Huo, Y. R., et al. (2014). J Am Med Dir Assoc 16(4): 290-295.
  2. Hansen, R. D., et al. (2007). Am J Clin Nutr 86(4): 952-958.