SAT-779 - Impact of A Prior Osteoporosis Diagnosis on Physical Performance in Community-Dwelling Older Adults

Introduction:  Osteoporosis is the most common bone disease in the US and is associated with increased fracture risk and functional decline. The aim of this study is to assess the relationship between osteoporosis diagnosis and change in physical performance among community-dwelling older adults.  

Methods: We conducted a retrospective cohort study using publicly available data from the National Health and Aging Trends Study (NHATS). Baseline data from 2011 were compared to follow-up assessments at 1 year (2012) and 5 years (2016). Of 6,731 baseline participants, we excluded those who were non–community-dwelling or had memory impairment (n=1,496). Of the remaining 5,235 participants, 2,633 had complete outcome data and were included in the analysis. The primary predictor was self-reported osteoporosis diagnosis (yes or no). The outcome variable was physical function score, defined by the NHATS Expanded Short Physical Performance Battery (SPPB) and grip strength, and scored from 4 to 16. We assessed differences in demographic factors, subjective measures (e.g., fear of falling), and injury characteristics (e.g., inpatient admission and hip fracture). Categorical variables were analyzed using chi-squared and Fisher’s exact tests, while continuous variables were compared using Wilcoxon rank-sum tests.

Results: Of the 2,633 study participants, 534 (20%) had osteoporosis at baseline. Participants with osteoporosis were more likely to be female (92% vs 49%, p < 0.001), use mobility devices (28% vs 16%, p < 0.001), report arthritis (70% vs 51%, p < 0.001), and have a history of hip fracture (6% vs 2%, p < 0.001) or other fractures (36% vs 16%, p < 0.001). At baseline, participants with osteoporosis had lower physical function scores compared to those without osteoporosis (8.56 ± 3.41 vs 10.13 ± 3.50, p < 0.001). At 1-year follow-up, changes in physical function scores did not differ significantly between groups. By 5 years, participants with osteoporosis showed a smaller decline in physical function scores on univariate analysis (-0.90 ± 2.81 vs -1.20 ± 2.79, p = 0.028) compared to those without osteoporosis.

Conclusions: Community-dwelling older adults with a prior osteoporosis diagnosis had lower baseline physical function scores than those without osteoporosis. However, over five years, they experienced smaller declines in physical function scores. Lower physical function at baseline may create a floor effect with lower risks of comparable deterioration than those with better baseline function. These findings also may reflect increased clinical attention to mobility and exercise promotion in patients with osteoporosis. Future analysis will assess the impact of a new osteoporosis diagnosis on the trajectory of physical function.

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