Poster Presentation 6th Annual Scientific Meeting of the Australian and New Zealand Society for Sarcopenia and Frailty Research 2024

Women with bipolar disorder are at increased risk of sarcopenia. (#4)

Lana J Williams 1 2 , Amanda L Stuart 1 , Emma C West 1 , Michael Berk 1 2 3 4 5 , Julie A Pasco 1 2 6 7
  1. Deakin University, Geelong, VIC, Australia
  2. Barwon Health, Geelong, VICTORIA, Australia
  3. The University of Melbourne, Parkville, Australia
  4. Florey Institute of Neuroscience and Mental Health, Parkville, Australia
  5. Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Parkville, Australia
  6. Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia
  7. Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia

Background: Bipolar disorder is associated with significant mental and medical comorbidity. Yet little is known about the musculoskeletal health of individuals with bipolar disorder. Thus, we aimed to investigate the association between bipolar disorder and sarcopenia according to the Foundation for the National Institutes of Health (FNIH) and European Working Group on Sarcopenia in Older People (EWGSOP2) algorithms in a group of women aged 20-80 years.

Methods: Women with bipolar disorder (n=106) were recruited from southeastern Australia and age-matched controls (n=300), without bipolar disorder, drawn from the Geelong Osteoporosis Study. Bipolar disorder was identified using a clinical interview (SCID-I/NP). Maximum handgrip strength (HGS) was measured using a handheld Jamar dynamometer, appendicular lean mass (ALM) using a Lunar densitometer and body mass index (BMI, kg/m2) was calculated from height and weight measurements. Low grip strength was considered as <16kg (FNIH and EWGSOP2) and low lean body mass as <0.512m2 (ALM adjusted for BMI; FNIH) and <15kg/m2 (ALM adjusted for height; EWGSOP2). Probable sarcopenia was determined by low grip strength and confirmed sarcopenia by the presence of low grip strength and low lean mass. Socio-economic status (SES) was determined and information on lifestyle factors obtained via questionnaire. Multiple logistic regression models were used to identify associations between bipolar disorder and sarcopenia while testing for potential confounding.

Results: A higher proportion of women with bipolar disorder met criteria for low grip strength [FNIH and EWGSOP2; 15 (14.2%) vs 21 (7.1%), p=0.027] and low lean mass [FNIH; 13 (12.3%) vs 18 (6.0%), p=0.037 and EWGSOP2; 6 (5.7%) vs 7 (2.3%), p=0.09] compared to those without bipolar disorder. Using FNIH and EWGSOP2 criteria, 36 women (8.9%; 34 probable and 2 confirmed) and 46 women (11.4%; 43 probable and 3 confirmed) met criteria for sarcopenia, respectively. Compared to women without bipolar disorder, women with bipolar disorder were twice as likely to have sarcopenia irrespective of criteria used (FNIH; OR 2.24, 95%CI 1.11-4.55, p=0.025 and EWGSOP2; OR 2.78, 95%CI 1.47-5.20, p=0.002). These relationships were independent of age, smoking, physical activity, alcohol consumption and SES.

Conclusion: These data suggest women with bipolar disorder are at increased risk of sarcopenia. Replication and research into underlying mechanisms are next necessary steps.