Frailty as a Predictor of Low-Energy Fractures in Older People with Osteoporosis: A Retrospective Study

Abstract

This study aims to elucidate the relationship between bone mineral density and frailty in older people with osteoporosis, as well as to assess the predictive value of frailty for low-energy fractures within this demographic. A retrospective analysis was conducted on clinical data from older people with osteoporosis admitted between January 2020 and January 2022. Frailty was evaluated using the Fried Frailty Phenotype, and data on demographics, medical history, lifestyle factors, and bone mineral density were collected. All patients were followed for three years post-enrollment to document the occurrence of low-energy fractures, thereby investigating the association between frailty status (frail, pre-frail, non-frail) according to the Fried Frailty Phenotype and fracture risk. A total of 129 patients were included in the study, with 115 completing the follow-up. The bone mineral density in frail patients was significantly lower than that in both pre-frail and non-frail participants, while pre-frail patients also exhibited significantly lower bone mineral density compared to non-frail individuals. The incidence of low-energy fractures was markedly higher in frail patients compared to their pre-frail and non-frail counterparts (72.4% vs. 40.4% vs. 20.5%). Multivariate logistic regression analysis identified frailty status (frail, pre-frail, non-frail) according to the Fried Frailty Phenotype and cardiovascular disease as independent risk factors for fractures. Frailty status (frail, pre-frail, non-frail) according to the Fried Frailty Phenotype is an independent predictor of low-energy fractures in older people with osteoporosis, indicating the need for its incorporation into comprehensive fracture risk management strategies.