Osteosarcopenia increases risk of falls in patients with rheumatoid arthritis

Osaka, Japan: Osteoporosis and sarcopenia are frequently diagnosed in elderly people and lead to frailty due to functional disability and weakness in activities of daily living. Osteosarcopenia is defined as osteoporosis with sarcopenia. The prevalence of sarcopenia was 25% for those with osteopenia and 50% for those with osteoporosis in postmenopausal women. Osteoporosis and sarcopenia are independent risk factors for fractures and falls, respectively.

A prospective, observational study was conducted by M. Tada, Y. Yamada, K. Mandai et al. from 2016 to identify correlations of sarcopenia, locomotive syndrome, and RA disease activity, as the correlation research of sarcopenia, skeletal muscle and disease activity in rheumatoid arthritis (CHIKARA) study. Sarcopenia was defined according to the Asia Working Group for Sarcopenia (AWGS) 2014 criteria. Osteoporosis was defined according to the Japanese Guidelines for Prevention and Treatment of Osteoporosis 2011.

The patients were divided into 4 groups by their baseline status:

• no sarcopenia and no osteoporosis (SP-OP-)

• only sarcopenia (SP + OP-)

• only osteoporosis (SP-OP+)

• both sarcopenia and osteoporosis (SP + OP+).

Survival rates and Cox hazard ratios were analyzed using falls and fractures as endpoints, adjusted by age, sex, and body mass index.

Results:

• A total of 100 RA patients (SP-OP-: 44%, SP + OP-: 17%, SP-OP+: 28%, and SP + OP+: 11%) were enrolled.

• 37 patients had falls, and 19 patients had fractures.

• The fall-free and fracture-free survival rates were significantly lower in SP + OP+ (36.4%, 54.5%) than in SP-OP- (75.0%, 86.4%).

• The hazard ratio of falls was significantly increased in SP + OP+, by 3.32-fold (95%CI: 1.01e10.9), whereas in SP + OP- and SP-OP+, there were no differences compared to SP-OP-.

The authors concluded that the survival rates with the endpoints of falls and fractures in RA patients with osteosarcopenia were lower during 4-year follow-up. The risk of falls increased with the synergistic effect of osteoporosis and sarcopenia

Key Words: Osteosarcopenia, Sarcopenia, Osteoporosis, fall, Rheumatoid arthritis

Further reading:

Osteosarcopenia synergistically increases the risk of falls in patients with rheumatoid arthritis

Masahiro Tada , Yutaro Yamada , Koji Mandai , Yoshinari Matsumoto, Noriaki Hidaka

Osteoporosis and Sarcopenia 7 (2021) 140- 145

https://doi.org/10.1016/j.afos.2021.11.002