{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T09:27:44Z","timestamp":1782552464525,"version":"3.54.5"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005609","name":"University of Turku","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005609","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Aging Clin Exp Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study assessed osteoporosis, sarcopenia and osteosarcopenia as risk factors for fractures and mortality during 19-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 2506 individuals aged\u2009\u2265\u200955 from the Finnish Health 2000 Survey. Probable sarcopenia was defined as grip strength\u2009&lt;\u200927\u00a0kg for men and &lt;\u200916\u00a0kg for women. Osteoporosis was identified by a bone density T-score &lt; -2,5 via ultrasound or a self-reported diagnosis. Participants were categorized in four groups: reference group with no sarcopenia and no osteoporosis, probable sarcopenia only, osteoporosis only, or osteosarcopenia. Fractures and deaths were identified from national registers until 2019. Four adjustment models were used, adjusting for age, sex, smoking, education, physical activity, and mobility limitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a mean follow-up of 19.1 years, 580 (23.1%) participants sustained a low-energy fracture of any type and 1,375 (54.9%) died. Osteosarcopenia, probable sarcopenia and osteoporosis were all associated with increased risk of any fracture and mortality compared to the reference group. Osteoporosis alone was associated with lower mortality than osteosarcopenia (HR 0.69, 95% CI 0.50\u20130.95), but mortality did not differ between probable sarcopenia and osteosarcopenia (HR 0.79, 95% CI 0.59\u20131.06). No differences in the fracture risk between osteosarcopenia, sarcopenia and osteoporosis were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While both sarcopenia and osteoporosis increase fracture and mortality risks, their combination does not seem to additively elevate fracture risks. Osteoporosis is a stronger predictor for future fractures, whereas probable sarcopenia is more closely linked to mortality. Further research is warranted to determine the best ways to incorporate sarcopenia assessment into comprehensive fracture risk evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40520-025-03229-8","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T14:19:50Z","timestamp":1762438790000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Osteosarcopenia as a risk factor for fractures and mortality \u2013 19-year follow-up of a population-based sample"],"prefix":"10.1007","volume":"37","author":[{"given":"Matias","family":"Blomqvist","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria S.","family":"Nuotio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katri","family":"S\u00e4\u00e4ksj\u00e4rvi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaana","family":"Pentti BSc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seppo","family":"Koskinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sari","family":"Stenholm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"3229_CR1","unstructured":"World Health Organization (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO study group. World Health Organ Tech Rep Ser 843:1\u2013129"},{"key":"3229_CR2","doi-asserted-by":"publisher","DOI":"10.1007\/S11657-013-0136-1","volume":"8","author":"E Hernlund","year":"2013","unstructured":"Hernlund E, Svedbom A, Iverg\u00e5rd M et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden: a report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136. https:\/\/doi.org\/10.1007\/S11657-013-0136-1","journal-title":"Arch Osteoporos"},{"key":"3229_CR3","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1002\/JCSM.12411","volume":"10","author":"SSY Yeung","year":"2019","unstructured":"Yeung SSY, Reijnierse EM, Pham VK et al (2019) Sarcopenia and its association with falls and fractures in older adults: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 10:485\u2013500. https:\/\/doi.org\/10.1002\/JCSM.12411","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"3229_CR4","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1093\/ageing\/afy169","volume":"48","author":"AJ Cruz-Jentoft","year":"2019","unstructured":"Cruz-Jentoft AJ, Bahat G, Bauer J et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48:16\u201331. https:\/\/doi.org\/10.1093\/ageing\/afy169","journal-title":"Age Ageing"},{"key":"3229_CR5","doi-asserted-by":"publisher","first-page":"3424","DOI":"10.1007\/S00586-015-3805-5","volume":"25","author":"T Hida","year":"2016","unstructured":"Hida T, Shimokata H, Sakai Y et al (2016) Sarcopenia and sarcopenic leg as potential risk factors for acute osteoporotic vertebral fracture among older women. Eur Spine J 25:3424\u20133431. https:\/\/doi.org\/10.1007\/S00586-015-3805-5","journal-title":"Eur Spine J"},{"key":"3229_CR6","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1016\/J.JAMDA.2014.07.011","volume":"15","author":"R Yu","year":"2014","unstructured":"Yu R, Leung J, Woo J (2014) Sarcopenia combined with FRAX probabilities improves fracture risk prediction in older Chinese men. J Am Med Dir Assoc 15:918\u2013923. https:\/\/doi.org\/10.1016\/J.JAMDA.2014.07.011","journal-title":"J Am Med Dir Assoc"},{"key":"3229_CR7","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1159\/000517099","volume":"68","author":"J Xu","year":"2022","unstructured":"Xu J, Wan CS, Ktoris K et al (2022) Sarcopenia is associated with mortality in adults: a systematic review and meta-analysis. Gerontology 68:361\u2013376. https:\/\/doi.org\/10.1159\/000517099","journal-title":"Gerontology"},{"key":"3229_CR8","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1093\/ageing\/afaa123","volume":"50","author":"E Lunt","year":"2021","unstructured":"Lunt E, Ong T, Gordon AL et al (2021) The clinical usefulness of muscle mass and strength measures in older people: a systematic review. Age Ageing 50:88\u201395. https:\/\/doi.org\/10.1093\/ageing\/afaa123","journal-title":"Age Ageing"},{"key":"3229_CR9","doi-asserted-by":"publisher","first-page":"253","DOI":"10.12968\/hmed.2018.79.5.253","volume":"79","author":"J Paintin","year":"2018","unstructured":"Paintin J, Cooper C, Dennison E (2018) Osteosarcopenia. Br J Hosp Med 79:253\u2013258. https:\/\/doi.org\/10.12968\/hmed.2018.79.5.253","journal-title":"Br J Hosp Med"},{"key":"3229_CR10","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-021-05963-x","author":"Z Teng","year":"2021","unstructured":"Teng Z, Zhu Y, Teng Y et al (2021) The analysis of osteosarcopenia as a risk factor for fractures, mortality, and falls. Osteoporos Int. https:\/\/doi.org\/10.1007\/s00198-021-05963-x","journal-title":"Osteoporos Int"},{"key":"3229_CR11","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/J.ARCHGER.2019.01.015","volume":"82","author":"S Balogun","year":"2019","unstructured":"Balogun S, Winzenberg T, Wills K (2019) Prospective associations of osteosarcopenia and osteodynapenia with incident fracture and mortality over 10 years in community-dwelling older adults. Arch Gerontol Geriatr 82:67\u201373. https:\/\/doi.org\/10.1016\/J.ARCHGER.2019.01.015","journal-title":"Arch Gerontol Geriatr"},{"key":"3229_CR12","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1093\/GERONA\/GLY162","volume":"74","author":"D Scott","year":"2019","unstructured":"Scott D, Seibel M, Cumming R et al (2019) Does combined osteopenia\/osteoporosis and sarcopenia confer greater risk of falls and fracture than either condition alone in older men? The concord health and ageing in men project. The Journals of Gerontology: Series A 74:827\u2013834. https:\/\/doi.org\/10.1093\/GERONA\/GLY162","journal-title":"The Journals of Gerontology: Series A"},{"key":"3229_CR13","unstructured":"Heistaro S (2008) Methodology report: Health 2000 Survey"},{"key":"3229_CR14","unstructured":"Aromaa A, Koskinen S (2004) Health and functional capacity in Finland. Baseline results of the Health 2000 health examination survey"},{"key":"3229_CR15","unstructured":"Kanis JA, on behalf of the World Health Organization Scientific Group (2007) (2007) Assessment of osteoporosis at the primary health-care level. Technical Report"},{"key":"3229_CR16","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1161\/01.CIR.38.6.1104","volume":"38","author":"B Saltin","year":"1968","unstructured":"Saltin B, Grimby G (1968) Physiological analysis of middle-aged and old former athletes. Comparison with still active athletes of the same ages. Circulation 38:1104\u20131115. https:\/\/doi.org\/10.1161\/01.CIR.38.6.1104","journal-title":"Circulation"},{"key":"3229_CR17","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1080\/01621459.1999.10474144","volume":"94","author":"JP Fine","year":"1999","unstructured":"Fine JP, Gray RJ (1999) A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc 94:496\u2013509. https:\/\/doi.org\/10.1080\/01621459.1999.10474144","journal-title":"J Am Stat Assoc"},{"key":"3229_CR18","doi-asserted-by":"publisher","DOI":"10.1007\/S40520-024-02785-9","author":"N Veronese","year":"2024","unstructured":"Veronese N, Ragusa FS, Sabico S et al (2024) Osteosarcopenia increases the risk of mortality: a systematic review and meta-analysis of prospective observational studies. Aging Clin Exp Res. https:\/\/doi.org\/10.1007\/S40520-024-02785-9","journal-title":"Aging Clin Exp Res"},{"key":"3229_CR19","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1002\/JBMR.4483","volume":"37","author":"D Alajlouni","year":"2022","unstructured":"Alajlouni D, Tran T, Bliuc D et al (2022) Muscle strength and physical performance improve fracture risk prediction beyond Garvan and FRAX: the osteoporotic fractures in men (MrOS) study. J Bone Min Res 37:411\u2013419. https:\/\/doi.org\/10.1002\/JBMR.4483","journal-title":"J Bone Min Res"},{"key":"3229_CR20","doi-asserted-by":"publisher","first-page":"293","DOI":"10.23736\/S0022-4707.23.15417-X","volume":"64","author":"A De Sire","year":"2024","unstructured":"De Sire A, Marotta N, Prestifilippo E et al (2024) Influence of hand grip strength test and short physical performance battery on FRAX in post-menopausal women: a machine learning cross-sectional study. J Sports Med Phys Fitness 64:293\u2013300. https:\/\/doi.org\/10.23736\/S0022-4707.23.15417-X","journal-title":"J Sports Med Phys Fitness"},{"key":"3229_CR21","doi-asserted-by":"publisher","DOI":"10.1186\/S12966-020-01041-3","author":"C Sherrington","year":"2020","unstructured":"Sherrington C, Fairhall N, Kwok W (2020) Evidence on physical activity and falls prevention for people aged 65\u2009+\u2009years: systematic review to inform the WHO guidelines on physical activity and sedentary behaviour. Int J Behav Nutr Phys Act. https:\/\/doi.org\/10.1186\/S12966-020-01041-3","journal-title":"Int J Behav Nutr Phys Act"},{"key":"3229_CR22","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1007\/S00198-011-1817-5","volume":"23","author":"A Moayyeri","year":"2012","unstructured":"Moayyeri A, Adams JE, Adler RA et al (2012) Quantitative ultrasound of the heel and fracture risk assessment: an updated meta-analysis. Osteoporos Int 23:143\u2013153. https:\/\/doi.org\/10.1007\/S00198-011-1817-5","journal-title":"Osteoporos Int"},{"key":"3229_CR23","doi-asserted-by":"publisher","first-page":"832","DOI":"10.7326\/0003-4819-144-11-200606060-00009","volume":"144","author":"S Nayak","year":"2006","unstructured":"Nayak S, Olkin I, Liu H et al (2006) Meta-analysis: accuracy of quantitative ultrasound for identifying patients with osteoporosis. Ann Intern Med 144:832\u2013841. https:\/\/doi.org\/10.7326\/0003-4819-144-11-200606060-00009","journal-title":"Ann Intern Med"}],"container-title":["Aging Clinical and Experimental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40520-025-03229-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40520-025-03229-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40520-025-03229-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T14:19:51Z","timestamp":1762438791000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40520-025-03229-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,6]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3229"],"URL":"https:\/\/doi.org\/10.1007\/s40520-025-03229-8","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-6662182\/v1","asserted-by":"object"}]},"ISSN":["1720-8319"],"issn-type":[{"value":"1720-8319","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,6]]},"assertion":[{"value":"14 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 September 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 October 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 November 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"M.S.N. has been part of advisory board for Amgen. M.B., K.S., J.P., S.K. and S.S. state no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}},{"value":"The study protocol of the survey was approved by the Epidemiology Ethics Committee of the Helsinki and Uusimaa Hospital District (407\/E3\/2000). All participants signed an informed consent before participating in the survey.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval."}}],"article-number":"319"}}