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PREVALENCE OF FRAILTY AND ITS DETERMINANTS IN ELDERLY PATIENTS WITH OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES
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Abstract
Background: Vertebral compression fractures (VCFs) are among the most serious clinical consequences of osteoporosis. They are associated with chronic pain, reduced mobility and functional decline, and an increased prevalence of frailty in older adults. In Vietnam, however, contemporary data on frailty among patients with VCFs—as well as evaluations of the relationship between fracture characteristics and functional status—remain limited. Accordingly, this study was undertaken to determine the prevalence of frailty and to analyze factors associated with frailty among older patients with osteoporotic VCFs. Methods: This cross-sectional descriptive study enrolled 187 patients aged ≥60 years diagnosed with osteoporotic vertebral compression fractures (VCFs) at the musculoskeletal/ rheumatology outpatient clinic of the University Medical Center Ho Chi Minh City, from September 2024 to June 2025. Frailty was assessed using the Clinical Frailty Scale (CFS), and thoracolumbar spine radiographic characteristics and related factors were recorded. Results: The median age was 74 years (IQR 68–80), with a female-to-male ratio of 9:1. The prevalence of frailty (CFS ≥5) was 62%. In multivariable analysis, factors associated with frailty included having fractures in ≥3 vertebrae (OR 3.61; 95% CI 1.06–12.26; p=0.04), Genant grade-3 (severe) vertebral fractures (OR 4.58; 95% CI 1.67–12.54; p<0.001), age ≥80 years (“oldest-old”) (OR 17.57; 95% CI 4.06–75.85; p<0.001), history of falls (OR 3.97; 95% CI 1.58–9.96; p=0.003), and polypharmacy (OR 3.57; 95% CI 1.31–9.69; p=0.013). Conclusions: Frailty is highly prevalent among older adults with osteoporotic VCFs. Severe vertebral fracture grade, multiple-level involvement, oldest-old age (≥80 years), a prior history of falls, and polypharmacy are independently associated with frailty in this population. Clinicians should prioritize systematic evaluation and management of frailty in these patients to improve outcomes.
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Keywords
Vertebral fractures, elderly osteoporosis, frailty.
References
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