Oral Presentation ANZBMS-MEPSA-ANZORS 2022

What impact have therapeutic advances for musculoskeletal health had on mortality risk – do we see differential relationships for muscle and bone? (#72)

Faidra Laskou 1 , Leo Westbury 1 , Harnish Patel 1 , Cyrus Cooper 1 2 , Elaine M Dennison 1 3
  1. MRC Lifecourse Epidemiology Centre, Southampton University, Southampton, UK
  2. NIHR Oxford Biomedical Research Centre, Oxford, UK
  3. Victoria University of Wellington, Wellington, NEW ZEALAND, New Zealand

Objectives

Historically, several studies have reported associations between either low bone mineral density (BMD) or low grip strength (GS) and mortality risk. However, therapeutic advances in management of osteoporosis (OP) and sarcopenia have occurred at different rates over the last two decades; in this study, we examined relationships between BMD and GS and subsequent all-cause and cause-specific mortality in a UK community-dwelling cohort, considering whether relationships differ between mortality risk and either muscle or bone health.

Material and Methods

Data on GS and mortality were available for 2987 Hertfordshire Cohort Study participants (47% women). Femoral neck BMD was ascertained in 992 participants using DXA; GS was assessed by grip dynamometry in the whole group and deaths were recorded from baseline (1998-2004) until 31st December 2018. Medication use was recorded. Associations between BMD and GS in relation to mortality (all-cause, cardiovascular-related, cancer-related, and other) were examined using sex-specific Cox regression models with adjustment for age.

Results

Mean (SD) baseline age of participants was 65.7 (2.9) years in men and 66.6 (2.7) years in women. Lower GS at baseline was associated with higher all-cause mortality in men (hazard ratio per SD lower grip strength: 1.22 (1.12,1.33), p<0.001) and in women (1.29 (1.17,1.43), p<0.001). Lower GS was associated with increased risk of cardiovascular (1.30 (1.11,1.52), p=0.001 in men; 1.61 (1.30,1.99), p<0.001 in women) and other mortality (1.33 (1.14,1.55), p<0.001 in men; 1.39 (1.18,1.63), p<0.001 in women) in both sexes, but no association was found with cancer mortality (p>0.25). However, lower BMD was not associated with increased risk of all-cause or cause-specific mortality (p>0.09 for all associations).

Conclusions

We report strong relationships between GS and mortality in both sexes after adjustment for age in comparison with BMD. We hypothesize this may reflect better recognition and treatment of low BMD. Further longitudinal studies are required.