The Interplay Between Osteosarcopenia and Intrinsic Capacity: Insights and Associations With All-Cause Mortality in the Toledo Study for Healthy Aging

BACKGROUND: Osteosarcopenia-the coexistence of osteopenia/osteoporosis and sarcopenia-is associated with numerous adverse health outcomes, but its association with intrinsic capacity (IC) remains unknown. We aimed to explore the associations of osteosarcopenia with IC and all-cause mortality in older adults. METHODS: We conducted a cross-sectional analysis of IC and a prospective analysis of all-cause mortality in 1142 participants from the Toledo Study for Healthy Aging (75.1±6.0 years, 53.1% women). Participants were classified as having no musculoskeletal disorders, osteopenia/osteoporosis, sarcopenia, or osteosarcopenia (DXA- and EWGSOP2-based criteria). IC was operationalized as a composite score integrating locomotion, cognition, psychological, vitality, and sensory domains. RESULTS: Older adults with osteosarcopenia exhibited lower total IC (76.6±1.1 points) than those without musculoskeletal disorders (83.7±0.5 points; p<0.001) or with osteopenia/osteoporosis (81.3±0.3 points; p<0.001), with significant differences also found between the latter groups (p<0.001). Specifically, osteosarcopenia was associated with poorer results in the locomotion, cognition, vitality, and sensory domains (all p<0.01), but not in the psychological domain. Over a median 6.2-year follow-up, osteosarcopenia-but not osteopenia/osteoporosis-was associated with higher risk of mortality compared to those without musculoskeletal disorders [HR (95%CI)=1.96 (1.02-3.77); p=0.045]. In joint analyses with IC status (high vs. low, segregated by the median), this association was specifically observed among participants with osteosarcopenia and low IC [HR = 2.55 (1.31-4.96); p=0.004]. CONCLUSIONS: Osteosarcopenia is associated with lower total IC and impairments across most IC domains. This finding is of clinical relevance, as the combination of this condition and low IC is associated with an increased mortality risk.

Authors

Institutions

Publication Details

Journal
The Journals of Gerontology Series A
Published
2026-04-01
DOI
https://doi.org/10.1093/gerona/glag090
Primary Topic
Nutrition and Health in Aging
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

The Interplay Between Osteosarcopenia and Intrinsic Capacity: Insights and Associations With All-Cause Mortality in the Toledo Study for Healthy Aging

Harmehr Sekhon, Nailton José Neto, Fabio A. Quiñónez Bareiro, Óscar Rosas-Carrasco et al.
The Journals of Gerontology Series A
Nutrition and Health in Aging
article

The Interplay Between Osteosarcopenia and Intrinsic Capacity: Insights and Associations With All-Cause Mortality in the Toledo Study for Healthy Aging

Harmehr Sekhon, Nailton José Neto, Fabio A. Quiñónez Bareiro, Óscar Rosas-Carrasco, Andréa Faust, Tiago da Silva Alexandre, Miguel Germán Borda, Ignacio Ara, Lana J. Williams, Pedro L. Valenzuela, Luis M. Alegre, Pierrette Gaudreau, Liang‐Kung Chen, Raman Agnihotram, Ricardo Oliveira Guerra, Guy Hajj-Boutros, Claire Godard-Sebillotte, Julia Chabot, Robinson Ramírez-Vélez, Howard Bergman, Irene Rodríguez-Gómez, L. Rodríguez-Mañas, The Transforming Health and Resilience for Healthy Lives (THRIVE) Project group, Hidenori Arai, Francisco José García-García, Anna Andrianova, Ana Maria Ayala-Copete, Wayne Lok, Emma Connolly, Ivan Baltasa r-Fernandez, Hussein Samhat, Konstantinos Prokoipidis, Marc Sim, Mahdi Imani, Julie Pasco, Alexandra Papaioannou, Gustavo Duque
article en

Abstract

BACKGROUND: Osteosarcopenia-the coexistence of osteopenia/osteoporosis and sarcopenia-is associated with numerous adverse health outcomes, but its association with intrinsic capacity (IC) remains unknown. We aimed to explore the associations of osteosarcopenia with IC and all-cause mortality in older adults. METHODS: We conducted a cross-sectional analysis of IC and a prospective analysis of all-cause mortality in 1142 participants from the Toledo Study for Healthy Aging (75.1±6.0 years, 53.1% women). Participants were classified as having no musculoskeletal disorders, osteopenia/osteoporosis, sarcopenia, or osteosarcopenia (DXA- and EWGSOP2-based criteria). IC was operationalized as a composite score integrating locomotion, cognition, psychological, vitality, and sensory domains. RESULTS: Older adults with osteosarcopenia exhibited lower total IC (76.6±1.1 points) than those without musculoskeletal disorders (83.7±0.5 points; p<0.001) or with osteopenia/osteoporosis (81.3±0.3 points; p<0.001), with significant differences also found between the latter groups (p<0.001). Specifically, osteosarcopenia was associated with poorer results in the locomotion, cognition, vitality, and sensory domains (all p<0.01), but not in the psychological domain. Over a median 6.2-year follow-up, osteosarcopenia-but not osteopenia/osteoporosis-was associated with higher risk of mortality compared to those without musculoskeletal disorders [HR (95%CI)=1.96 (1.02-3.77); p=0.045]. In joint analyses with IC status (high vs. low, segregated by the median), this association was specifically observed among participants with osteosarcopenia and low IC [HR = 2.55 (1.31-4.96); p=0.004]. CONCLUSIONS: Osteosarcopenia is associated with lower total IC and impairments across most IC domains. This finding is of clinical relevance, as the combination of this condition and low IC is associated with an increased mortality risk.

The Journals of Gerontology Series A
Edith Cowan University (AU), University of Liverpool (GB), Deakin University (AU), Universidade Federal de São Carlos (BR), Universidad de Alcalá (ES), Trinity College Dublin (IE), Universidad Iberoamericana (MX), Pontificia Universidad Javeriana (CO), Geelong Hospital (AU), McGill University Health Centre (CA), ProMedica Toledo Hospital (US), Taipei Veterans General Hospital (TW), Universidade Federal do Rio Grande do Norte (BR), National Institute of Biomedical Innovation, Health and Nutrition (JP), Rogaland Training & Education Centre (NO), Stavanger Health Research (Norway) (NO), Hospital Universitario de Getafe (ES), Navarrabiomed (ES), Universidad de la Sierra (MX), Centre for Sustainable Energy (GB), Servicio de Salud de Castilla La Mancha (ES), Centre Hospitalier de l’Université de Montréal (CA), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (ES), National Center for Geriatrics and Gerontology (JP), McGill University (CA), Université de Montréal (CA), University of Castilla-La Mancha (ES), University of Toledo (US), McMaster University (CA)
Good health and well-being
Openalex Percentile: Top 24%
Nutrition and Health in Aging
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.