Nutrition Mediates the Relationship between Osteosarcopenia and Frailty: A Pathway Analysis
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Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore
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Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore 308433, Singapore
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Department of Continuing and Community Care, Tan Tock Seng Hospital, Singapore 308433, Singapore
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(10), 2957; https://doi.org/10.3390/nu12102957
Received: 29 August 2020
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Revised: 21 September 2020
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Accepted: 23 September 2020
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Published: 27 September 2020
(This article belongs to the Special Issue Nutrients Requirements and Muscle Mass in Older Persons)
Osteosarcopenia is associated with increased risk of adverse outcomes such as falls and fractures. Its association with frailty is less well-described, particularly in independent community-dwelling older adults. Although nutrition plays a crucial role in maintaining bone and muscle health, the complex relationship between osteosarcopenia and nutrition in the pathogenesis of frailty remains to be elucidated. In this cross-sectional analysis of 230 independent, community-dwelling individuals (mean age 67.2 ± 7.4 years), we examined the associations between osteosarcopenia with nutritional status and frailty, and the mediating role of nutrition in the association between osteosarcopenia and frailty. Osteosarcopenia was defined as fulfilling both the Asian Working Group for Sarcopenia 2019 consensus definition (low relative appendicular skeletal muscle mass adjusted for height, in the presence of either of either low handgrip strength or slow gait speed) and T-score ≤ −2.5 SD on bone mineral densitometry. We assessed frailty using the modified Fried criteria and nutrition using the Mini-Nutritional Assessment. We performed multiple linear regression, followed by pathway analysis to ascertain whether nutrition mediates the relationship between osteosarcopenia and frailty. Our study population comprised: 27 (11.7%) osteosarcopenic, 35 (15.2%) sarcopenic, 36 (15.7%) osteoporotic and 132 (57.4%) normal (neither osteosarcopenic, sarcopenic nor osteoporotic). Osteosarcopenia (β = 1.1, 95% CI 0.86–1.4) and sarcopenia (β = 1.1, 95% CI 0.90–1.4) were significantly associated with frailty, but not osteoporosis. Nutrition mediated the association between osteosarcopenia and frailty (indirect effect estimate 0.09, bootstrap 95% CI 0.01–0.22). In conclusion, osteosarcopenia is associated with frailty and poorer nutritional status, with nutrition mediating the association between osteosarcopenia and frailty. Our findings support early nutritional assessment and intervention in osteosarcopenia to mitigate the risk of frailty.
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Keywords:
nutrition; osteosarcopenia; frailty
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MDPI and ACS Style
Chew, J.; Yeo, A.; Yew, S.; Tan, C.N.; Lim, J.P.; Hafizah Ismail, N.; Lim, W.S. Nutrition Mediates the Relationship between Osteosarcopenia and Frailty: A Pathway Analysis. Nutrients 2020, 12, 2957. https://doi.org/10.3390/nu12102957
AMA Style
Chew J, Yeo A, Yew S, Tan CN, Lim JP, Hafizah Ismail N, Lim WS. Nutrition Mediates the Relationship between Osteosarcopenia and Frailty: A Pathway Analysis. Nutrients. 2020; 12(10):2957. https://doi.org/10.3390/nu12102957
Chicago/Turabian StyleChew, Justin, Audrey Yeo, Suzanne Yew, Cai N. Tan, Jun P. Lim, Noor Hafizah Ismail, and Wee S. Lim. 2020. "Nutrition Mediates the Relationship between Osteosarcopenia and Frailty: A Pathway Analysis" Nutrients 12, no. 10: 2957. https://doi.org/10.3390/nu12102957
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