BackgroundLean muscle mass and strength decline starting approximately at 40 years of age to become 25% of body weight at 75–80 years old [1]. Within the existing literature, sarcopenia is a highly prevalent condition in older people. The prevalence of sarcopenia increases considerably with age ranging from 5% to 13% in 60 to 70 years, from 11% to 50% for the population aged 80 years and older. In older persons, sarcopenia is related to falls and physical disability leading to reduced quality of life [2]. The prevalence of osteoarthritis increases with age so that 30 to 50% of adults over the age of 65 years suffer from this condition [3]. Age-related factor that contributes includes to the development of OA include a decline in muscle strength. People with lower extremity OA had a two to five times increased incidence of falls than age-matched healthy controls [4].ObjectivesConduct analysis of condition of muscle strength and muscle functioning in older persons with osteoarthritis.MethodsProspective study of 159 patients aged 74±13,3 years was held. Condition of sarcopenia was estimated by lean body mass (LBM) in accordance with criteria of sarcopenia EWGSOP. Muscle strength was estimated by a hand dynamometer and muscle functioning was estimated on the basis of SPPB tests. Amount of pain was estimated by VAS.ResultsSarcopenia was revealed in 31,45% of older persons with ostearthritis. Cases of falls were observed in 28,30% (95% CI 21,5 - 36,0) in patients with osteoartritis with sarcopenia (average number of falls – 1,93) and in 16,98% of patients without sarcopenia (95% CI 11,5 – 23,7) (average number of falls – 0,48). Level of pain in patients with osteoartritis with sarcopenia amounted 3,16 points, in patients without sarcopenia – 3,49 points (p>0,05). Muscle strength in patients with sarcopenia was 14,36 kg, in patients without sarcopenia was significantly higher – 18,53 kg (p<0,05). Common point of SPPB tests in patients with sarcopenia was 6,9, in patients without sarcopenia significantly higher – 7,85 (p<0,05).ConclusionsPatients with sarcopenia in the presence of osteoarthritis were observed to have significant decrease of muscle strength and muscle functioning, increase of frequency of falls which raises risk of repeated falls and their frequency, and consequently, deteriorates condition of musculoskeletal system in older persons.References Ferrucci L., Baroni M., Ranchelli A. et al. Interaction Between Bone and Muscle in Older Persons with Mobility Limitations. Curr Pharm Des. 2014; 20(19): 3178–3197.Morley JE. Sarcopenia: diagnosis and treatment. J Nutr Health Aging. 2008; 12:452–456.Felson DT. Risk factors for osteoarthritis: understanding joint vulnerability. Clinical orthopaedics and related research 2004;(427 Suppl):S16–21.Hoops ML, Rosenblatt NJ, Hurt CP, Crenshaw J, Grabiner MD. Does lower extremity osteoarthritis exacerbate risk factors for falls in older adults? Womens Health (Lond Engl). 2012;8(6):685–96. Disclosure of InterestNone declared

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Objective: to assess the quality of life (QoL) using general and special questionnaires and to identify the relationship between fatigue and sarcopenia (SP) in elderly and senile people.Patients and methods. The cohort study included 230 patients, including 177 women (77%) and 53 men (23%) over 65 years old (median age 75 [68; 79] years). The presence of SP was determined according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2, 2018). QoL was studied using the general questionnaires EQ-5D, SF-36 and a special questionnaire SarQoL, the level of fatigue – using the FACIT-F questionnaire. To assess the possibility of using the FACIT-F scale for SP screening, its sensitivity, specificity, diagnostic accuracy, positive and negative predictive value were determined, a receiver operating characteristic (ROC) curve (ROC analysis) was constructed, and the area under the ROC curve (AUC) was calculated.Results and discussion. The assessment of QoL using the EQ-5D and SF-36 questionnaires did not reveal significant differences between the groups of patients with and without SP (p>0.05). When analyzing the state of health in the study cohort using the special SarQoL questionnaire, the overall indicator was 63.12±18.83 points, while in patients with SP it was significantly lower than in patients without SP (50.65±14.23 and 75,10±14.46 points, respectively; p<0.001). The mean score for all domains was also lower in the presence of SP than in its absence (p<0.001).The level of fatigue on the FACIT-F scale ranged from 10 to 52 points and averaged 32.5 [29.1; 35.3] points, while in patients with SP the overall score was lower than in elderly people without SP (25.1 [22.13; 29.23] and 39.8 [36.4; 42.4] points respectively; p<0.001). In patients with severe fatigue, SP was diagnosed 4.6 times (95% confidence interval, CI 2.80–7.57) more often than in those without it (p<0.001). Fatigue was associated with senile age, underweight, falls in the previous year, weak muscle strength, low SPPB test scores and an appendicular muscle mass index, CRP >10 mg/L (p<0.05).The possibility of using the FACIT-F questionnaire for screening patients with SP was evaluated. Its sensitivity reached 76%, specificity – 73%, positive predictive value – 53%, and negative predictive value – 88%, diagnostic accuracy – 74%. The area under the ROC-curve (AUC) was 0.726 (95% CI 0.627–0.826; p<0.0001).Conclusion. It has been shown that the general questionnaires EQ-5D and SF-36 do not reflect the true QoL impairment in SP. A significant deterioration in the state of health in elderly people with SP can be identified by a special SarQol questionnaire. The FACIT-F fatigue scale can also be used to screening in SP.

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Background: The growing frequency of fractures associated with osteoporosis, the significant costs of their treatment, disability and increased mortality make it an important and urgent task to optimize the diagnosis and treatment of osteoporosis in the Russian Federation.Aim: The aim of this study was analyzed of using modern diagnostic criteria for osteoporosis by specialists when they making a clinical decision to initiate treatment for osteoporosis, including an estimate of the 10-year probability of fractures according to FRAX.Materials and methods: The study was conducted in the city consultative and diagnostic center for the prevention of osteoporosis, St. Petersburg. The register of the osteoporosis center for 2018–2021 was used to select patients for the study. Based on the analysis of registry data, a sample of 362 patients with newly diagnosed osteoporosis was obtained. In the resulting sample, the existing FRAX value was assessed on the therapeutic intervention threshold graph, all of them analyzed the primary medical documentation, as well as the available DXA densitometry data.Results: In this study, we assessed the place of FRAX 10-year risk of major osteoporotic fractures in the clinical decision of an osteoporosis specialist to start anti-osteoporosis therapy, in this case taken as the «gold standard». The study found that a positive FRAX score had a high predictive value of 100%. In contrast, the negative predictive value was very low (19.5%): a FRAX value below the intervention threshold did not guarantee a truly low fracture risk and no need to start osteoporosis treatment.Conclusion: Despite the fact that both densitometry and FRAX have significant limitations in use, and cannot identify all patients with a high risk of fractures, their combined use increases the prognostic value of the methods. FRAX technology in routine practice allows, in addition to clinical and instrumental methods for diagnosing high-risk fractures, to identify candidates for the treatment of osteoporosis, and should be used in accordance with clinical recommendations.