Association of frailty trajectories with osteoporosis and hip fracture in an older female population.

UNLABELLED: This study explores the association between frailty trajectories and osteoporosis and hip fractures. Using data from two prospective longitudinal studies-the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA), it finds that frailty status is significantly associated with both osteoporosis and hip fracture.

BACKGROUND: Frailty is associated with a variety of chronic diseases, yet there is a lack of research on the association of frailty trajectories with osteoporosis and hip fracture.

METHODS: This study used data from two prospective longitudinal cohorts: the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA), with biennial follow-up from 2014 to 2018. A frailty index (FI) was used to measure frailty status, and group-based trajectory modeling was applied to identify four distinct frailty trajectories. Osteoporosis and hip fracture were defined based on self-reported physician diagnosis. Logistic regression models were used to examine associations between frailty trajectories and the two outcomes, with odds ratios (ORs) and 95% confidence intervals (CIs) reported.

RESULTS: A total of 10,207 participants were included (6816 from HRS and 3391 from ELSA). Four groups of frailty trajectories were identified: the "stable robust trajectory" (n = 4949, 48.3%), the "pre-frailty trajectory" (n = 2717, 26.6%), the "moderate frailty trajectory" (n = 1937, 19.0%), and "severe frailty trajectory" (n = 624, 6.1%). Compared to the stable robust trajectory group, the association with osteoporosis was stronger in the multivariate-adjusted pre-frailty trajectory group (OR 1.91, 95% CI 1.69-2.15), the moderate frailty trajectory group (OR 3.02, 95% CI 2.6-3.52), and severe frailty trajectory group (OR 5.39, 95% CI 4.1-7.07), and in the moderate frailty trajectory (OR 2.55, 95% CI 1.68-3.87), and stronger association with hip fracture in the severe frailty trajectory group (OR 6.03, 95% CI 3.2-11.36).

CONCLUSION: These results suggest that frailty status is closely associated with the risk of osteoporosis and hip fracture, with poorer frailty status correlating with a higher risk of osteoporosis and hip fracture.