Osteosarcopenia is suggested to be on the causal pathway to frailty; however, data on this topic is scarce, and it is unclear if osteosarcopenia is associated with frailty risk. To investigate if osteosarcopenia is associated with frailty risk in community-dwelling older adults.

Retrospective analysis of a prospective cohort study. I-Lan Longitudinal Aging Study (ILAS). 1779 older adults (≥50 years) at baseline, and 998 participants at follow-up.

Frailty was defined based on the Fried criteria. Osteosarcopenia was defined by the coexistence of osteopenia or osteoporosis (WHO definition) and sarcopenia (Asian Working Group definition).

Multinomial logistic regression models were employed to examine the association of osteosarcopenia (at baseline) with frailty risk (at eight years), adjusted for demographic and clinical factors. Out of 1779 adults (mean age 63.9 ± 9.2 SD, women 53.1 %), 998 (mean age 67.1 ± 7.6 SD, women 52.6 %) completed a follow-up at eight years.

At baseline, osteosarcopenia was more prevalent in the frail group (27.5 %) compared to the pre-frail (10.8 %) and non-frail groups (0 %). However, neither osteosarcopenia (Odds Ratio [OR] 2.67, 95 %CI 0.85-8.40, p = 0.094) nor its components (sarcopenia (OR 3.13, 95 %CI 0.64-15.21, p = 0.158); osteopenia (OR 1.33, 95 %CI 0.70-2.53, p = 0.386); osteoporosis (OR 1.71, 95 %CI 0.64-4.59, p = 0.287)) were associated with frailty risk at eight years.

Neither osteosarcopenia nor its components were associated with frailty risk. However, a greater number of older adults with osteosarcopenia and extended follow-up are needed to re-evaluate whether osteosarcopenia is associated with frailty risk.