Levels of Physical Performance and Physical Activity in Older Attendees at a Bone Health Clinic

Introduction: Osteoporosis and sarcopenia are two common conditions seen in community dwelling older adults. Clear links between both are emerging regarding pathophysiology, shared risk factors and clinical assessment, with the more recent designation of a single syndrome ‘osteosarcopenia’. However, more studies are needed to better understand the factors associated with osteosarcopenia and its effect on clinical outcomes compared to its component conditions alone. In Ireland, limited information on physical performance and activity exists in older adults at risk of osteosarcopenia.

Aim and objectives: The aim of this study was to examine levels of physical performance and physical activity in patients attending a bone health clinic.

Methods: A cross sectional study was conducted. Community dwelling older adults attending a bone health clinic in an acute Irish hospital were invited to participate. Primary outcome measures for physical performance and activity were; grip strength, the Short Physical Performance Battery (SPPB), the Timed Up and Go test (TUG) and the International Physical Activity Questionnaire (IPAQ). Secondary outcomes included; Bone Mineral Density T-scores, diagnosis of probable sarcopenia, osteosarcopenia, frailty, fractures and falls history.

Results: A total of 104 participants took part in the study. Median age was 76 (IQR 12), ranging from 65 to 91 years. Females accounted for the majority (88.5%) of recruited participants. Osteoporosis was present in 63% and osteopenia in 31%. Low levels of physical activity were identified in 29%. Probable Sarcopenia ranged from 17 to 37%. Osteosarcopenia was identified in 9 to 33% depending on four possible definitions. The most common associations with osteosarcopenia were with frailty and low BMI. Physical performance (grip strength, SPPB and TUG) and physical activity (IPAQ) were negatively associated with increased age, comorbidities, frailty and falls.

Conclusion: A high proportion of participants were classified as having osteoporosis, probable sarcopenia and osteosarcopenia. A range of factors were associated with osteosarcopenia including physical performance and physical activity, highlighting common factors shared in both osteoporosis and sarcopenia in older adults. Physical performance and activity measures were easily assessed in this setting and could provide useful information to clinicians about patients and their potential risks/deficits.