{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:12:40Z","timestamp":1792789960316,"version":"4.5.0"},"reference-count":42,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,4,28]],"date-time":"2024-04-28T00:00:00Z","timestamp":1714262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"EFRE.NRW program OsteoSys","award":["EFRE-0800411"],"award-info":[{"award-number":["EFRE-0800411"]}]},{"name":"EFRE.NRW program OsteoSys","award":["EFRE-0800427"],"award-info":[{"award-number":["EFRE-0800427"]}]},{"name":"EFRE.NRW program OsteoSys","award":["LS-1-1-019c"],"award-info":[{"award-number":["LS-1-1-019c"]}]},{"name":"EFRE.NRW program OsteoSys","award":["13GW0338B"],"award-info":[{"award-number":["13GW0338B"]}]},{"name":"noChro","award":["EFRE-0800411"],"award-info":[{"award-number":["EFRE-0800411"]}]},{"name":"noChro","award":["EFRE-0800427"],"award-info":[{"award-number":["EFRE-0800427"]}]},{"name":"noChro","award":["LS-1-1-019c"],"award-info":[{"award-number":["LS-1-1-019c"]}]},{"name":"noChro","award":["13GW0338B"],"award-info":[{"award-number":["13GW0338B"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Osteosarcopenia, the concurrent presence of sarcopenia and osteopenia\/osteoporosis, poses a significant health risk to older adults, yet its impact on clinical outcomes is not fully understood. The aim of this prospective, longitudinal multicentre study was to examine the impact of osteosarcopenia on 3-year mortality and unplanned hospitalizations among 572 older hospitalized patients (mean age 75.1 \u00b1 10.8 years, 78% female). Sarcopenia and low bone mineral density (BMD) were evaluated using Dual Energy X-ray Absorptiometry and the European Working Group on Sarcopenia in Older People (EWGSOP2) and WHO criteria, respectively. Among participants, 76% had low BMD, 9% were sarcopenic, and 8% had osteosarcopenia. Individuals with osteosarcopenia experienced a significantly higher rate of mortality (46%, p &lt; 001) and unplanned hospitalization (86%, p &lt; 001) compared to those without this condition. Moreover, \u201chealthy\u201d subjects\u2014those without sarcopenia or low BMD\u2014showed markedly lower 3-year mortality (9%, p &lt; 001) and less unplanned hospitalization (53%, p &lt; 001). The presence of osteosarcopenia (p = 0.009) increased the 3-year mortality risk by 30% over sarcopenia alone and by 8% over low BMD alone, underscoring the severe health implications of concurrent muscle and bone deterioration. This study highlights the substantial impact of osteosarcopenia on mortality among older adults, emphasizing the need for targeted diagnostic and therapeutic strategies.<\/jats:p>","DOI":"10.3390\/nu16091328","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T04:26:16Z","timestamp":1714364776000},"page":"1328","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Three-Year Mortality of Older Hospitalized Patients with Osteosarcopenia: Data from the OsteoSys Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5486-0765","authenticated-orcid":false,"given":"Maryam","family":"Pourhassan","sequence":"first","affiliation":[{"name":"Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, H\u00f6lkeskampring 40D, 44625 Herne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjoern","family":"Buehring","sequence":"additional","affiliation":[{"name":"Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, 44649 Herne, Germany"},{"name":"Bergisches Rheuma-Zentrum Wuppertal, 42105 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2831-8868","authenticated-orcid":false,"given":"Ulrik","family":"Stervbo","sequence":"additional","affiliation":[{"name":"Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr-University Bochum, 44625 Herne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8536-6065","authenticated-orcid":false,"given":"Sven","family":"Rahmann","sequence":"additional","affiliation":[{"name":"Algorithmic Bioinformatics, Center for Bioinformatics Saar, Saarland University, Saarland Informatics Campus, 66123 Saarbr\u00fccken, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"M\u00f6lder","sequence":"additional","affiliation":[{"name":"Algorithms for Reproducible Bioinformatics, Genome Informatics, Institute of Human Genetics, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany"},{"name":"Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"R\u00fctten","sequence":"additional","affiliation":[{"name":"Center for Orthopedics and Trauma Surgery, St. Anna Hospital, St. Elisabeth Gruppe, 44649 Herne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina Rosa","family":"Neuendorff","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, H\u00f6lkeskampring 40D, 44625 Herne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timm Henning","family":"Westhoff","sequence":"additional","affiliation":[{"name":"Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr-University Bochum, 44625 Herne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Babel","sequence":"additional","affiliation":[{"name":"Center for Translational Medicine and Immune Diagnostics Laboratory, Medical Department I, Marien Hospital Herne, Ruhr-University Bochum, 44625 Herne, Germany"},{"name":"Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7265-0163","authenticated-orcid":false,"given":"Rainer","family":"Wirth","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, H\u00f6lkeskampring 40D, 44625 Herne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2763","DOI":"10.1007\/s00198-013-2413-7","article-title":"Standardising the descriptive epidemiology of osteoporosis: Recommendations from the Epidemiology and Quality of Life Working Group of IOF","volume":"24","author":"Kanis","year":"2013","journal-title":"Osteoporos. Int."},{"key":"ref_2","unstructured":"World Health Organization (1994). Assessment of Fracture Risk and Its Application to Screening for Postmenopausal Osteoporosis: Report of a WHO Study Group [Meeting Held in Rome from 22 to 25 June 1992]."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/j.jamda.2016.06.001","article-title":"Sarcopenia Is Recognized as an Independent Condition by an International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM) Code","volume":"17","author":"Cao","year":"2016","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1007\/s41999-019-00233-w","article-title":"Sarcopenia and health-related outcomes: An umbrella review of observational studies","volume":"10","author":"Veronese","year":"2019","journal-title":"Eur. Geriatr. Med."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Wan, S.N., Thiam, C.N., Ang, Q.X., Engkasan, J., and Ong, T. (2023). Incident sarcopenia in hospitalized older people: A systematic review. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0289379"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Sui, S.X., Holloway-Kew, K.L., Hyde, N.K., Williams, L.J., Tembo, M.C., Leach, S., and Pasco, J.A. (2021). Prevalence of Sarcopenia Employing Population-Specific Cut-Points: Cross-Sectional Data from the Geelong Osteoporosis Study, Australia. J. Clin. Med., 10.","DOI":"10.3390\/jcm10020343"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3178","DOI":"10.2174\/13816128113196660690","article-title":"Interaction between bone and muscle in older persons with mobility limitations","volume":"20","author":"Ferrucci","year":"2014","journal-title":"Curr. Pharm. Des."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1002\/ar.a.10119","article-title":"Bone\u2019s mechanostat: A 2003 update","volume":"275A","author":"Frost","year":"2003","journal-title":"Anat. Rec. Part A Discov. Mol. Cell. Evol. Biol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1038\/nrendo.2012.49","article-title":"Muscles, exercise and obesity: Skeletal muscle as a secretory organ","volume":"8","author":"Pedersen","year":"2012","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Cariati, I., Bonanni, R., Onorato, F., Mastrogregori, A., Rossi, D., Iundusi, R., Gasbarra, E., Tancredi, V., and Tarantino, U. (2021). Role of Physical Activity in Bone-Muscle Crosstalk: Biological Aspects and Clinical Implications. J. Funct. Morphol. Kinesiol., 6.","DOI":"10.3390\/jfmk6020055"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"482940","DOI":"10.1155\/2015\/482940","article-title":"Sarco-Osteoporosis: Prevalence and Association with Frailty in Chinese Community-Dwelling Older Adults","volume":"2015","author":"Wang","year":"2015","journal-title":"Int. J. Endocrinol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.maturitas.2018.04.006","article-title":"High parathyroid hormone levels are associated with osteosarcopenia in older individuals with a history of falling","volume":"113","author":"Suriyaarachchi","year":"2018","journal-title":"Maturitas"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1007\/s00391-019-01553-z","article-title":"Sarcopenia and osteoporosis are interrelated in geriatric inpatients","volume":"52","author":"Reiss","year":"2019","journal-title":"Z. Fur Gerontol. Geriatr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.jamda.2019.09.005","article-title":"The Joint Occurrence of Osteoporosis and Sarcopenia (Osteosarcopenia): Definitions and Characteristics","volume":"21","author":"Phu","year":"2020","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Inoue, T., Maeda, K., Nagano, A., Shimizu, A., Ueshima, J., Murotani, K., Sato, K., Hotta, K., Morishita, S., and Tsubaki, A. (2021). Related Factors and Clinical Outcomes of Osteosarcopenia: A Narrative Review. Nutrients, 13.","DOI":"10.3390\/nu13020291"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"h4183","DOI":"10.1136\/bmj.h4183","article-title":"Calcium intake and bone mineral density: Systematic review and meta-analysis","volume":"351","author":"Tai","year":"2015","journal-title":"BMJ Br. Med. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2213","DOI":"10.1093\/gerona\/glab068","article-title":"Effect of Dietary Protein Intake on Bone Mineral Density and Fracture Incidence in Older Adults in the Health, Aging, and Body Composition Study","volume":"76","author":"Weaver","year":"2021","journal-title":"J. Gerontol. Ser. A Biol. Sci. Med. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1759720X19867009","DOI":"10.1177\/1759720X19867009","article-title":"Therapeutic approaches to osteosarcopenia: Insights for the clinician","volume":"11","author":"Fatima","year":"2019","journal-title":"Ther. Adv. Musculoskelet. Dis."},{"key":"ref_20","first-page":"849","article-title":"Osteosarcopenia: A new geriatric syndrome","volume":"46","author":"Hassan","year":"2017","journal-title":"Aust. Fam. Physician"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1007\/s00198-009-0947-5","article-title":"Osteoporosis and gait and balance disturbances in older sarcopenic obese New Zealanders","volume":"21","author":"Waters","year":"2010","journal-title":"Osteoporos. Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1016\/j.jamda.2020.07.032","article-title":"Osteosarcopenia Predicts Falls, Fractures, and Mortality in Chilean Community-Dwelling Older Adults","volume":"22","author":"Salech","year":"2021","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2173","DOI":"10.1007\/s00198-021-05963-x","article-title":"The analysis of osteosarcopenia as a risk factor for fractures, mortality, and falls","volume":"32","author":"Teng","year":"2021","journal-title":"Osteoporos. Int."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1007\/s00223-023-01181-1","article-title":"Osteosarcopenia: Prevalence and 10-Year Fracture and Mortality Risk\u2014A Longitudinal, Population-Based Study of 75-Year-Old Women","volume":"114","author":"Paulin","year":"2024","journal-title":"Calcif. Tissue Int."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Pourhassan, M., Buehring, B., Stervbo, U., Rahmann, S., M\u00f6lder, F., R\u00fctten, S., Trampisch, U., Babel, N., Westhoff, T.H., and Wirth, R. (2021). Osteosarcopenia, an Asymmetrical Overlap of Two Connected Syndromes: Data from the OsteoSys Study. Nutrients, 13.","DOI":"10.3390\/nu13113786"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J. Biomed. Inform."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s12603-012-0084-2","article-title":"A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans","volume":"16","author":"Morley","year":"2012","journal-title":"J. Nutr. Health Aging"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1002\/jcsm.12048","article-title":"SARC-F: A symptom score to predict persons with sarcopenia at risk for poor functional outcomes","volume":"7","author":"Malmstrom","year":"2016","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"M85","DOI":"10.1093\/geronj\/49.2.M85","article-title":"A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission","volume":"49","author":"Guralnik","year":"1994","journal-title":"J. Gerontol."},{"key":"ref_30","unstructured":"Dachverband Osteologie (2024, April 25). DVO Leitlinie Osteoporose (Kurzfassung und Langfassung). Available online: https:\/\/www.dv-osteologie.org\/uploads\/Leitlinie%202014\/DVO-Leitlinie%20Osteoporose%202014%20Kurzfassung%20und%20Langfassung%20Version%201a%2012%2001%202016.pdf."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4158\/GL-2020-0524SUPPL","article-title":"American association of clinical endocrinologists\/american college of endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis-2020 update","volume":"26","author":"Camacho","year":"2020","journal-title":"Endocr. Pract."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"110974","DOI":"10.1016\/j.exger.2020.110974","article-title":"Prevalence of muscle dysfunction concomitant with osteoporosis in a home-dwelling Danish population aged 65\u201393 years\u2014The Copenhagen Sarcopenia Study","volume":"138","author":"Nielsen","year":"2020","journal-title":"Exp. Gerontol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1007\/s12603-021-1640-4","article-title":"Osteosarcopenia: A Geriatric Giant of the XXI Century","volume":"25","author":"Duque","year":"2021","journal-title":"J. Nutr. Health Aging"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"29","DOI":"10.11005\/jbm.2014.21.1.29","article-title":"Interaction between Muscle and Bone","volume":"21","author":"Kaji","year":"2014","journal-title":"J. Bone Metab."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2781","DOI":"10.1007\/s00198-017-4151-8","article-title":"Osteosarcopenia: Where bone, muscle, and fat collide","volume":"28","author":"Hirschfeld","year":"2017","journal-title":"Osteoporos. Int."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.jocd.2009.06.004","article-title":"Beyond FRAX: It\u2019s time to consider \u201csarco-osteopenia\u201d","volume":"12","author":"Binkley","year":"2009","journal-title":"J. Clin. Densitom"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.bone.2015.02.029","article-title":"Bone muscle interactions and vitamin D","volume":"80","author":"Gunton","year":"2015","journal-title":"Bone"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1002\/jcsm.13392","article-title":"Global epidemiological features and impact of osteosarcopenia: A comprehensive meta-analysis and systematic review","volume":"15","author":"Chen","year":"2024","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.archger.2019.01.015","article-title":"Prospective associations of osteosarcopenia and osteodynapenia with incident fracture and mortality over 10 years in community-dwelling older adults","volume":"82","author":"Balogun","year":"2019","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Huang, T., Li, C., Chen, F., Xie, D., Yang, C., Chen, Y., Wang, J., Li, J., and Zheng, F. (2023). Prevalence and risk factors of osteosarcopenia: A systematic review and meta-analysis. BMC Geriatr., 23.","DOI":"10.1186\/s12877-023-04085-9"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/j.tem.2012.03.008","article-title":"Estrogen and the skeleton","volume":"23","author":"Khosla","year":"2012","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.archger.2010.02.002","article-title":"Prevalence of sarcopenia and its association with osteoporosis in 313 older women following a hip fracture","volume":"52","author":"Vallero","year":"2011","journal-title":"Arch. Gerontol. Geriatr."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/9\/1328\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:35:29Z","timestamp":1760106929000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/9\/1328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,28]]},"references-count":42,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["nu16091328"],"URL":"https:\/\/doi.org\/10.3390\/nu16091328","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,28]]}}}