E-Poster Presentation 30th Australian and New Zealand Bone and Mineral Society Annual Scientific Meeting 2020

Risk factors for incident falls and fractures in older men with and without type 2 diabetes mellitus: the concord health and ageing in men project (#108)

Jakub Mesinovic 1 , David Scott 1 2 3 , Markus J Seibel 4 , Robert G Cumming 5 6 7 , Vasi Naganathan 6 , Fiona M Blyth 6 , David G Le Couteur 6 8 , Louise M Waite 6 , David J Handelsman 9 , Vasant Hirani 6 10
  1. Department of Medicine, Monash University, Melbourne, Victoria, Australia
  2. Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne, Victoria, Australia
  3. Department of Medicine and Australian Institute of Musculoskeletal Science, University of Melbourne, Melbourne, Victoria, Australia
  4. Endocrinology and Metabolism, University of Sydney, Sydney, New South Wales, Australia
  5. School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  6. Centre for Education and Research on Ageing and Alzheimer’s Institute, University of Sydney, Sydney, New South Wales, Australia
  7. The Australian Research Council Centre of Excellence in Population Ageing Research, University of Sydney, Sydney, New South Wales, Australia
  8. ANZAC Research Institute and Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
  9. Department of Andrology, University of Sydney, Sydney, New South Wales, Australia
  10. School of Life and Environmental Sciences, University of Sydney, Sydney, New South Wales, Australia

Background: Type 2 diabetes mellitus (T2DM) increases falls and fracture risk. Our objective was to compare falls and fracture incidence in community-dwelling older men with and without T2DM, and to determine whether known risk factors affect falls and fractures differently in these individuals.

Methods: A total of 1,705 men (471 with T2DM; 1234 without T2DM) aged >70 years from the Concord Health and Ageing in Men Project (CHAMP) were assessed at baseline (2005–2007) and 5 years later (2010–2013). At both time-points, measurements included fat mass, appendicular lean mass (ALM), handgrip strength, upper-limb muscle quality and gait speed. Men were contacted every 4 months for 6.0 + 2.2 years to ascertain incident falls and fractures. Hip fractures were ascertained via data linkage (follow up: 8.8 + 3.6 years). Risk factors for falls and fractures included physical activity and function, body composition, medications and vision.

Results: Men with T2DM had lower handgrip strength, upper-limb muscle quality and gait speed than men without T2DM (P<0.05). Over five years, men with T2DM lost more ALM (-0.34kg [95%CI: -0.533, -0.152]), but had similar fat mass losses (-0.40kg [95%CI: -0.938, 0.144]) compared to men without T2DM. Men with T2DM had similar falls (IRR: 0.90 [95%CI: 0.69, 1.17]) and fracture (HR: 0.86 [95%CI: 0.56, 1.32]) rates compared to men without T2DM after adjustment for significant risk factors. Interaction terms demonstrated that increases in ALM over 2 years was independently associated with lower 2-year falls rates (IRR: 0.66 [95%CI:0.52, 0.83]), and better contrast sensitivity was independently associated with lower fracture rates (HR: 0.14 [95%CI:0.02, 0.85]) in men with T2DM compared to men without T2DM.

Conclusion: Older men with T2DM lose more lean mass than men without T2DM. Maintaining muscle mass and improving vision may reduce fracture risk in older men with T2DM.