Frailty as a predictor of vertebral fractures in osteoporosis: A clinical perspective

Abstract

Objectives: This study aims to assess the correlation between vertebral compression fractures (VCFs) and frailty and to identify the possible link between the number of VCFs and frailty intensity in patients with osteoporosis (OP).

Patients and methods: Between January 2025 and February 2025, a total of 204 patients (143 males, 61 females; mean age: 71.8±5.5 years; range, 65 to 89 years) over 65 years who received treatment for OP in the inpatient setting were included. The patients were divided into two groups according to their Clinical Frailty Scale (CFS) scores as the frail group (n=141, CFS ≥4) and the non-frail group (n=63, CFS <4). Demographic and clinical characteristics, geriatric syndromes, and fracture prevalence were recorded.

Results: The handgrip strength was significantly reduced in the frail group (19 kg vs. 21 kg, p=0.004), with a probable sarcopenia rate of 42% (p=0.034). The rate of participants with no fractures, a single fracture, and multiple fractures was 42%, 26%, and 22% in the non-frail group, compared to 57%, 73%, and 77% in the frail group, respectively (p=0.018). This difference was particularly evident in patients with multiple fractures (odds ratio [OR]=2.34, 95% confidence interval [CI]: 1.13-4.87, p=0.023).

Conclusion: Frailty is strongly associated with a higher incidence of VCFs and multiple fractures in older individuals with OP.