The Association Between Malnutrition, Sarcopenia, and Fracture Risk in Older Adults with Osteoporosis

Objectives: The objective of this study is to examine the association between nutritional status and the incidence of fractures in elderly patients with osteoporosis, while also evaluating other clinical, anthropometric, and biochemical factors related to these outcomes.
Methods: Geriatric patients diagnosed with osteoporosis presenting to the outpatient clinic were included from January 2016 to December 2019. In addition to demographic, clinical, anthropometric, and laboratory data, we examined bone mineral density (via DEXA), nutritional status, sarcopenia assessment, and the presence and types of fractures. Nutritional status was assessed using multiple validated tools including the Geriatric Nutritional Risk Index (GNRI).
Results: A total of 181 patients (79% females), with a mean age of 78.12 ± 6.65 years, were included in the study. The fracture incidence recorded during follow-up was 40.88% (n = 74). The mean age of the fracture group was significantly higher than that of the non-fracture group. GNRI, with a cut-off value of ≤100.6, could significantly distinguish patients without fracture. Sarcopenia was present in 57.46% of patients, with no significant difference between fracture and non-fracture groups (p = 0.642). Multivariable logistic regression indicated that older age (OR: 1.090, 95% CI: 1.022 - 1.162, p = 0.009), fewer medications (OR: 0.868, 95% CI: 0.791 - 0.953, p=0.003) and low DEXA vertebra T-score (OR: 0.436, 95% CI: 0.285 - 0.668, p<0.001) were independently associated with fracture likelihood.
Conclusion: Malnutrition is correlated with an elevated fracture risk among older adults with osteoporosis, while sarcopenia prevalence was high but not independently associated with fractures.