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BackgroundDysmobility Syndrome (DS) is a novel concept to characterize musculoskeletal (MSK) health. DS includes parameters for osteoporosis, sarcopenia and falls[1]. It has been associated with fractures and mortality in community dwelling older adults[2-4]but has never been applied to patients with rheumatic and musculoskeletal diseases (RMD).ObjectivesTo study the prevalence of DS and the association of DS with frailty and major osteoporotic fractures (MOF) in patients with inflammatory and non-inflammatory RMD.MethodsPatients with inflammatory and non-inflammatory RMD aged 65 and older were recruited at a tertiary rheumatology hospital. DS was defined using published cut-offs[1, 2]of the following parameters: Osteoporosis (DXA T-score ≤ -2.5), obesity (DXA % body fat > 30% in men; > 40% in women), low appendicular lean mass (ALM/height2<7.26 kg/m2in men; < 5.45 kg/m2in women), low grip strength (< 30kg in men; < 20kg in women), slow gait speed (< 1.0 m/s) and falls (history of one or more falls within last year). A score of ≥ 3 was defined as having DS. The FRAIL-scale5was used to quantify frailty. Historical data on MOF as defined by FRAX (https://frax.shef.ac.uk/frax/) was collected.Results141 patients (103 women/38 men) were included in the analysis. Mean age was 73 years. Of the total population, 80% had an inflammatory RMD (of those 45% had Rheumatoid Arthritis) as their primary diagnosis. Patients with non-inflammatory diseases had either degenerative spine and/or joint disease and/or fibromyalgia. Mean disease duration was 5 years. Mean DS score was 2.8 (for more demographic data see Table 1). 81/141 (57.5%) participants met DS criteria. DS was more common in women compared to men (63.1 vs. 42.1%, p= 0.0252) and in inflammatory RMD compared to non-inflammatory (61,1 vs. 42.9%, p=0.0811). Patients with DS reported fractures twice as often as those without DS (33,3 vs. 16.6%, p=0.0261). The frequency of individuals with a history of MOF increased with DS score (see Figure 1). Additionally, there was a significant association between DS and FRAIL scores in a univariate linear regression analysis (R2=0,22, p<0.001).ConclusionThis primary study to explore the prevalence of DS in patients with RMD showed that more than half of participants met DS criteria. Similar to studies of community dwelling older adults, fractures were more common in patients with DS. Importantly, a positive association of frailty and DS was seen. Further studies are needed to examine whether DS can be used clinically to better characterize overall MSK health in patients with RMD and whether a standardized management of DS will improve outcomes in these patients.References[1]Binkley N. Osteoporos Int. 2013;24(12):2955-9.[2]Buehring B. J Bone Miner Res. 2018;33(9):1622-9.[3]Hong N. Arch Osteoporos. 2018;13(1):86.[4]Looker AC. Osteoporos Int. 2015;26(1):93-102.[5]Morley JE. J Nutr Health Aging. 2012;16(7):601-8.Table 1.Study demographicsVariableTotaln = 141Femalesn = 103Malesn = 38p-value% Inflammatory RMD80.177.786.80.226Age [years] (SD)72.9(5.2)73.0(5.1)72.7(5.6)0.737Height [cm] (SD)165.3(9.0)161.5(6.2)175.6(6.9)< 0.001Weight [kg] (SD)77.9(15.1)76.1(15.5)82.8(12.9)0.019ALM/height2[kg/m2](SD)6.99(1.17)6.79(1.07)7.51(1.28)0.001Body fat [%] (SD)41.5(7.91)44.7(6.40)33.0(4.72)< 0.001Lowest BMD T-score (SD)-1.6(1.16)-1.7(1.21)-1.4(1.01)0.227Grip strength [kg] (SD)19.0(10.2)14.8(6.79)30.3(9.38)< 0.001Gait speed [m/s] (SD)0.95(0.31)0.89(0.27)1.110.36< 0.001Dysmobility Score (SD)2.8(1.30)2.9(1.30)2.5(1.25)0.054Simple Frail Score (SD)2.6(1.35)2.7(1.28)2.3(1.49)0.085Figure 1.Frequency of individuals with history of MOF by Dysmobility Syndrome (DS) Score. The frequency of individuals with a history of MOF increased with the DS Score (p=0.0509). Note: Only 3 individuals had a DS score of 0 and only 2 had a DS score of 6.AcknowledgementsThe OsteoSys Study was funded by grants EFRE.NRW.(EFRE-0800411, EFRE-0800427, LS-1-1-019c) and noChro.(13GW0338B) - PI Prof. Nina Babel.Disclosure of InterestsBjoern Buehring Speakers bureau: Alexion, Biogen, Boehringer-Ingelheim, Gilead/ Galapagos, MSD,Sanofi Genzyme, UCB, Consultant of: Amgen, Gilead/ Galapagos, Theramex, UCB, Roshnak Parvaee: None declared, Celina Mueller: None declared, Ioana Andreica: None declared, David Kiefer: None declared, Uta Kiltz: None declared, Styliani Tsiami: None declared, Maryam Pourhassan: None declared, Timm Westhoff: None declared, Rainer Wirth: None declared, Xenofon Baraliakos: None declared, Nina Babel: None declared, Juergen Braun: None declared.