LAUSR

OBJECTIVES We investigated whether the locomotive syndrome (LS) severity affects future fragility fractures in osteoporosis patients. METHODS In this retrospective cohort study, 315 women with osteoporosis (mean follow-up period, 2.8 years) were reviewed, of whom 244 were included in the analysis. At baseline, we obtained medical information, bone mineral density of the lumbar spine and femoral neck, and sagittal vertical axis (SVA). Additionally, LS risk was assessed using the two-step, stand-up, and 25-question geriatric locomotive function scale (GLFS) scores. The LS risk test results were used to classify LS severity, which was rated on a 4-point scale from stage 0 (robust) to 3 (worsening). Cox proportional hazards regression analysis was used to determine the association of the severity with future fragility fracture. RESULTS Fragility fractures occurred in 37 of 315 participants (11.8%). This study showed that SVA (hazard ratio [HR]=1.014, 95% confidence interval [CI] 1.005-1.023, p-value=0.003) and LS severity (HR =1.748, 95% CI 1.133-2.699, p=0.012) were independent risk factors for incidence of fragility fracture. CONCLUSIONS This study revealed the LS severity to predicted fragility fractures. We suggested that the progression of LS associated with osteoporosis increases the fracture risk.