We investigated and quantified the predictability of frailty associated with musculoskeletal parameters. This longitudinal study included 287 men aged ≥ 50 yr at baseline (2001–2006) from the Geelong Osteoporosis Study. Baseline musculoskeletal measures included femoral neck bone mineral density (BMD), appendicular lean mass index (ALMI, kg/m²) and whole-body fat mass index (FMI, kg/m²) and lower-limb strength. Frailty at the 15 yr-follow-up (2016–2019) was defined as ≥ 3 and non-frail as < 3, of the following: unintentional weight loss, weakness, low physical activity, exhaustion, and slowness. Binary regression models and AUROC curves quantified the attributable risk of musculoskeletal factors to frailty and their predictive ability. Potential confounders included anthropometry, smoking, alcohol, FMI, socioeconomic status and comorbidities. Forty-eight (16.7%) men were frail at 15 yr-follow-up. Musculoskeletal models were better predictors of frailty compared to the referent (confounders only) model (AUROC for musculoskeletal factors 0.74 vs 0.67 for the referent model). The model with the highest AUROC (0.74; 95% CI 0.66–0.82) included BMD, ALMI and muscle strength (hip abductors) and was better than the referent model that included only lifestyle factors (p = 0.046). Musculoskeletal parameters improved the predictability model as measured by AUROC for frailty after 15 years. In general, muscle models performed better compared to bone models. Musculoskeletal parameters improved the predictability of frailty of the referent model that included lifestyle factors. Muscle deficits accounted for a greater proportion of the risk for frailty than did bone deficits. Targeting musculoskeletal health could be a possible avenue of intervention in regards to frailty.

我们调查并量化了与肌肉骨骼参数相关的虚弱的可预测性。这项纵向研究包括来自吉朗骨质疏松症研究的 287 名基线（2001-2006 年）年龄≥50 岁的男性。基线肌肉骨骼测量包括股骨颈骨矿物质密度 (BMD)、四肢瘦体重指数 (ALMI, kg/m ² ) 和全身脂肪质量指数 (FMI, kg/m ^{2 )}) 和下肢力量。15 年随访（2016-2019 年）的虚弱定义为 ≥ 3，非虚弱定义为 < 3，出现以下情况：无意识的体重减轻、虚弱、体力活动不足、疲惫和行动迟缓。二元回归模型和 AUROC 曲线量化了肌肉骨骼因素导致虚弱的风险及其预测能力。潜在的混杂因素包括人体测量学、吸烟、饮酒、FMI、社会经济地位和合并症。48 名 (16.7%) 男性在 15 年随访时身体虚弱。与参考（仅混杂因素）模型（肌肉骨骼因素的 AUROC 为 0.74 对参考模型的 0.67）相比，肌肉骨骼模型是更好的虚弱预测因子。具有最高 AUROC (0.74；95% CI 0.66–0.82) 的模型包括 BMD、p  = 0.046）。肌肉骨骼参数改善了由 AUROC 测量的 15 年后虚弱的可预测性模型。一般来说，肌肉模型比骨骼模型表现更好。肌肉骨骼参数提高了包括生活方式因素在内的参考模型虚弱的可预测性。与骨骼缺陷相比，肌肉缺陷在虚弱风险中所占的比例更大。针对肌肉骨骼健康可能是一种干预虚弱的可能途径。