Jump Power Predicts Fracture Risk in Older Adults Independent of Sarcopenia and FRAX

Low countermovement jump power is associated with prevalent fracture, osteoporosis, and sarcopenia in older adults. However, whether jump power predicts incident fracture risk remains uninvestigated. Data of 1366 older adults in a prospective community cohort were analyzed. Jump power was measured using a computerized ground force plate system. Fracture events were ascertained by follow‐up interview and linkage to the national claim database (median follow‐up 6.4 years). Participants were divided into normal and low jump power groups using a predetermined threshold (women <19.0 W/kg; men <23.8 W/kg; or unable to jump). Among the study participants (mean age 71.6 years, women 66.3%), low jump power was associated with a higher risk of fracture (hazard ratio [HR] = 2.16 versus normal jump power, p < 0.001), which remained robust (adjusted HR = 1.45, p = 0.035) after adjustment for fracture risk assessment tool (FRAX) major osteoporotic fracture (MOF) probability with bone mineral density (BMD) and Asian Working Group for Sarcopenia (AWGS) 2019 sarcopenia definition. In the AWGS no sarcopenia group, participants with low jump power had a significantly higher risk of fracture than those with normal jump power (12.5% versus 6.7%; HR = 1.93, p = 0.013), comparable to that of possible sarcopenia without low jump power (12.0%). Possible sarcopenia group with low jump power had a similar risk of fracture (19.3%) to sarcopenia group (20.8%). When the definition of sarcopenia was modified with jump power measurement (step‐up approach: no sarcopenia to possible sarcopenia; possible sarcopenia to sarcopenia when low jump power present), jump power–modified sarcopenia improved sensitivity (18%–39.3%) to classify individuals who sustained MOF during follow‐up to high risk compared with AWGS 2019 sarcopenia, while maintaining positive predictive value (22.3%–20.6%). In summary, jump power predicted fracture risk in community‐dwelling older adults independently of sarcopenia and FRAX MOF probabilities, suggesting potential contribution of complex motor function measurement in fracture risk assessment. © 2023 American Society for Bone and Mineral Research (ASBMR).

[1]  S. Cummings,et al.  Association Between Muscle Mass Determined by D3‐Creatine Dilution and Incident Fractures in a Prospective Cohort Study of Older Men , 2022, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[2]  P. Cawthon,et al.  Muscle Strength and Physical Performance Improve Fracture Risk Prediction Beyond Garvan and FRAX: The Osteoporotic Fractures in Men (MrOS) Study , 2021, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[3]  Tuan V. Nguyen,et al.  Mechanography assessment of fall risk in older adults: the Vietnam Osteoporosis Study , 2021, Journal of cachexia, sarcopenia and muscle.

[4]  Yosuke Yamada,et al.  Combination of DXA and BIS Predicts Jump Power Better Than Traditional Measures of Sarcopenia , 2021, JBMR plus.

[5]  P. Capodaglio,et al.  Body composition assessment using bioelectrical impedance analysis (BIA) in a wide cohort of patients affected with mild to severe obesity. , 2021, Clinical nutrition.

[6]  C. Cooper,et al.  Sarcopenia Definitions as Predictors of Fracture Risk Independent of FRAX®, Falls, and BMD in the Osteoporotic Fractures in Men (MrOS) Study: A Meta‐Analysis , 2021, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[7]  D. Felsenberg,et al.  Longitudinal changes in muscle power compared to muscle strength and mass , 2021, Journal of musculoskeletal & neuronal interactions.

[8]  C. Cooper,et al.  Predictive Value of DXA Appendicular Lean Mass for Incident Fractures, Falls, and Mortality, Independent of Prior Falls, FRAX, and BMD: Findings from the Women's Health Initiative (WHI) , 2020, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[9]  N. Binkley,et al.  Defining an international cut-off of two-legged countermovement jump power for sarcopenia and dysmobility syndrome , 2020, Osteoporosis International.

[10]  J. Eisman,et al.  Decline in muscle strength and performance predicts fracture risk in elderly women and men. , 2020, The Journal of clinical endocrinology and metabolism.

[11]  D. Kiel,et al.  Putative Cut‐Points in Sarcopenia Components and Incident Adverse Health Outcomes: An SDOC Analysis , 2020, Journal of the American Geriatrics Society.

[12]  D. Kiel,et al.  Sarcopenia Definition: The Position Statements of the Sarcopenia Definition and Outcomes Consortium , 2020, Journal of the American Geriatrics Society.

[13]  L. Peng,et al.  Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. , 2020, Journal of the American Medical Directors Association.

[14]  J. Cauley,et al.  Associations between novel jump test measures, grip strength, and physical performance: the Osteoporotic Fractures in Men (MrOS) Study , 2019, Aging Clinical and Experimental Research.

[15]  Su Jin Lee,et al.  Cohort profile: Korean Urban Rural Elderly (KURE) study, a prospective cohort on ageing and health in Korea , 2019, BMJ Open.

[16]  J. Kanis,et al.  Appendicular lean mass and fracture risk assessment: implications for FRAX® and sarcopenia , 2019, Osteoporosis International.

[17]  D. Schoeller,et al.  Combination of DXA and BIS body composition measurements is highly correlated with physical function—an approach to improve muscle mass assessment , 2018, Archives of Osteoporosis.

[18]  C. Cooper,et al.  Measures of Physical Performance and Muscle Strength as Predictors of Fracture Risk Independent of FRAX, Falls, and aBMD: A Meta‐Analysis of the Osteoporotic Fractures in Men (MrOS) Study , 2018, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[19]  J. Cauley,et al.  Normative Values of Muscle Power using Force Plate Jump Tests in Men Aged 77–101 Years: The Osteoporotic Fractures in Men (MrOS) Study , 2018, The journal of nutrition, health & aging.

[20]  C. O. Kim,et al.  Low peak jump power is associated with elevated odds of dysmobility syndrome in community-dwelling elderly individuals: the Korean Urban Rural Elderly (KURE) study , 2018, Osteoporosis International.

[21]  D. Kiel,et al.  Lower Lean Mass Measured by Dual-Energy X-ray Absorptiometry (DXA) is Not Associated with Increased Risk of Hip Fracture in Women: The Framingham Osteoporosis Study , 2018, Calcified Tissue International.

[22]  C. Cooper,et al.  Falls Predict Fractures Independently of FRAX Probability: A Meta‐Analysis of the Osteoporotic Fractures in Men (MrOS) Study , 2017, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[23]  S. Lemeshow,et al.  Assessing the Calibration of Dichotomous Outcome Models with the Calibration Belt , 2017 .

[24]  R. Kolamunnage-Dona,et al.  Time-dependent ROC curve analysis in medical research: current methods and applications , 2017, BMC Medical Research Methodology.

[25]  Dong Sook Kim,et al.  Towards Actualizing the Value Potential of Korea Health Insurance Review and Assessment (HIRA) Data as a Resource for Health Research: Strengths, Limitations, Applications, and Strategies for Optimal Use of HIRA Data , 2017, Journal of Korean medical science.

[26]  C. O. Kim,et al.  Lower Jump Power Rather Than Muscle Mass Itself is Associated with Vertebral Fracture in Community-Dwelling Elderly Korean Women , 2017, Calcified Tissue International.

[27]  S. Cummings,et al.  Evaluation of the Usefulness of Consensus Definitions of Sarcopenia in Older Men: Results from the Observational Osteoporotic Fractures in Men Cohort Study , 2015, Journal of the American Geriatrics Society.

[28]  B. Heiderscheit,et al.  Reproducibility of jumping mechanography and traditional measures of physical and muscle function in older adults , 2015, Osteoporosis International.

[29]  Yvonne Vergouwe,et al.  Towards better clinical prediction models: seven steps for development and an ABCD for validation. , 2014, European heart journal.

[30]  C. O. Kim,et al.  The Korean urban rural elderly cohort study: study design and protocol , 2014, BMC Geriatrics.

[31]  S. Boonen,et al.  Official Positions for FRAX® clinical regarding falls and frailty: can falls and frailty be used in FRAX®? From Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®. , 2011, Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry.

[32]  F. Rauch,et al.  Reproducibility of jumping mechanography in healthy children and adults. , 2010, Journal of musculoskeletal & neuronal interactions.

[33]  Rebecca Hardy,et al.  Is chair rise performance a useful measure of leg power? , 2010, Aging clinical and experimental research.

[34]  Bjoern Buehring,et al.  Jumping mechanography: a potential tool for sarcopenia evaluation in older individuals. , 2010, Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry.

[35]  J. Eisman,et al.  Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. , 2009, JAMA.

[36]  S. Cummings,et al.  Physical Performance and Risk of Hip Fractures in Older Men , 2008, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[37]  J. Eisman,et al.  Risk of subsequent fracture after low-trauma fracture in men and women. , 2007, JAMA.

[38]  P. Heagerty,et al.  Survival Model Predictive Accuracy and ROC Curves , 2005, Biometrics.

[39]  Dieter Felsenberg,et al.  Reproducibility of the Jumping Mechanography As a Test of Mechanical Power Output in Physically Competent Adult and Elderly Subjects , 2004, Journal of the American Geriatrics Society.

[40]  A. Monsch,et al.  Identifying a cut-off point for normal mobility: a comparison of the timed 'up and go' test in community-dwelling and institutionalised elderly women. , 2003, Age and ageing.

[41]  S. Cummings,et al.  Fracture risk reduction with alendronate in women with osteoporosis: the Fracture Intervention Trial. FIT Research Group. , 2000, The Journal of clinical endocrinology and metabolism.

[42]  P. Royston,et al.  Regression using fractional polynomials of continuous covariates: parsimonious parametric modelling. , 1994 .

[43]  F. Harrell,et al.  Prognostic value of a treadmill exercise score in outpatients with suspected coronary artery disease. , 1991, The New England journal of medicine.

[44]  Diane Podsiadlo,et al.  The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons , 1991, Journal of the American Geriatrics Society.