Prevalence and predictors of osteosarcopenia and relationship with physical functionality in rural and urban Indian women

Summary

Age-related bone and muscle impairments lead to osteoporosis and sarcopenia, and their coexistence, osteosarcopenia, causes functional decline but is less studied. We found higher prevalence of osteosarcopenia in rural (13.9%) vs urban women (1.6%), with risk factors including older age, low BMI, tobacco use, low protein, and low socioeconomic status.

Background

With ageing, bone and muscle impairment leading to osteoporosis and sarcopenia often co-exist, increasing risk of falls/fractures, physical disability, and premature mortality. Osteosarcopenia, where osteoporosis and sarcopenia co-exist, and its relationship with physical functionality in older adults is relatively less explored. Hence, we aimed to assess the prevalence, predictors, and physical functionality in urban and rural women with osteosarcopenia.

Methods

We included 397 women > 40 years (182 urban, 215 rural, mean age 52 ± 7) from Pune and nearby villages. Height, weight, BMI, bone density (lumbar spine, femur via DXA), grip strength (JAMAR dynamometer), and muscle function (SPPB) were assessed. Sarcopenia and osteoporosis were diagnosed using AWGS and WHO guidelines, with osteosarcopenia defined as both conditions. Lifestyle factors (diet, physical activity, tobacco use, socioeconomic status) were evaluated by validated questionnaire.

Results

Rural women had higher rates of osteoporosis (42%), sarcopenia (19%), and osteosarcopenia (13.9%) compared to urban women (18%, 3.8%, and 1.6%, respectively). Sarcopenic women had nearly 6 times higher risk (OR = 6.2, 95%CI = 3.2–11.9, p = 0.001) of developing osteoporosis, with the risk remaining significant after adjusting for age and location. Osteosarcopenic women showed impaired physical function and lower bone density, with older age and low BMI as key risk factors.

Conclusion

Rural Indian women showed high rates of osteosarcopenia, osteoporosis, and sarcopenia, with older, low-BMI, postmenopausal women at higher risk. Contributing factors included low socioeconomic status, tobacco use, and poor protein intake. Addressing modifiable risks is important to reduce frailty-related outcomes in rural population.