Author Identifier (ORCID)
Marc Sim: https://orcid.org/0000-0001-5166-0605
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 < .001) or with osteopenia/osteoporosis (81.3 ± 0.3 points; p < .001), with significant differences also found between the latter groups (p < .001). Specifically, osteosarcopenia was associated with poorer results in the locomotion, cognition, vitality, and sensory domains (all p < .01), but not in the psychological domain. Over a median 6.2-year follow-up, osteosarcopenia—but not osteopenia/osteoporosis—was associated with a higher risk of mortality compared to those without musculoskeletal disorders [HR (95% CI)=1.96 (1.02-3.77); p = .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 = .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.
Keywords
adverse outcomes, bone, healthy aging, muscle, older adults
Document Type
Journal Article
Date of Publication
6-1-2026
Volume
81
Issue
6
PubMed ID
41955333
Publication Title
Journals of Gerontology: Series A
Publisher
Oxford Academic
School
Nutrition and Health Innovation Research Institute
Funding Information
This research was funded with a catalyst grant from the Canadian Institutes of Health Research (CIHR—Grant AC9-200180), the McCall Hutchinson Foundation, and the CIBERFES (CB16/10/00477, CB16/10/00456, and CB16/10/00464), IDISCAM-Instituto de Investigación Sanitaria de Castilla-La Mancha (TEC2022-007), and Plan Propio de Investigación of the University of Castilla-La Mancha and FEDER funds from the European Union (2025-GRIN-38408). It was further funded by grants from the Instituto de Salud Carlos III (PI031558, PI07/90637, PI07/90306, RD 06/0013, and PI18/00972) and the Government of Castilla-La Mancha (Grant No. 03031 and SBPLY/19/180501/000312). P.L.V. is supported by postdoctoral contracts granted by the University of Castilla La Mancha and Fondo Social Europeo Plus (FSE+) (2024-UNIVERS-12850) and Agencia Estatal de Investigación (RYC2024-048275-I).
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Baltasar-Fernandez, I., Valenzuela, P. L., Rodríguez-Gómez, I., Quiñonez-Bareiro, F., Alegre, L. M., Prokopidis, K., Rodriguez-Mañas, L., Ara, I., Rosas-Carrasco, O., Williams, L. J., Ramirez-Vélez, R., Pasco, J. A., Hajj-Boutros, G., Agnihotram, R., Sim, M., Choo, W. L. O., Imani, M., Ayala-Copete, A. M., Chabot, J., . . . Transforming Health and Resilience for Healthy Lives (THRIVE) Project Group. (2026). The interplay between osteosarcopenia and intrinsic capacity: Insights and associations with all-cause mortality in the Toledo Study for Healthy Aging. The Journals of Gerontology: Series A, 81(6). https://doi.org/10.1093/gerona/glag090