Targeting Osteosarcopaenia and Multimorbidity for Frailty Prevention

Osteosarcopaenia and multimorbidity have emerged as two key antecedent factors driving the cycle of frailty, leading to adverse outcomes. However, it remains unclear how multimorbidity and/or osteosarcopaenia act singly or in concert to influence the expression and trajectory of the frailty continuum.

OPTIMA-C will develop unifying administrative and data platforms, exploring the feasibility of inclusive screening for sarcopaenia early during rehabilitation hospital stay. Early muscle ultrasound will also be utilised to determine key muscles possibly predictive of rehabilitation functional or global outcomes in the studied populations and their correlation with acute disease outcomes. Digital markers are quantified and correlations are investigated with physical, muscle and bone imaging findings.

Inclusion criteria

• Age ≥ 50y
• Asian ethnicity
• First diagnosis (stroke, Traumatic Brain Injury (TBI), knee osteoarthritis, breast cancer)
• Living in community
• Able to understand 1 step simple commands
• For inpatients: (i) within 12 weeks of disease (stroke/TBI) onset, and (ii) within 2 weeks of rehabilitation ward admission
• For outpatients: (i) >6 months from initial diagnosis of first stroke, TBI, knee osteoarthritis or breast cancer, and (ii) at least standby assistance, modified independent or independent in ambulation with /without walking.

Exclusion criteria

• Nursing home or dormitory resident
• Non-resident status in Singapore (e.g. foreign worker, tourist, temporary visit pass)
• Impairments affecting understanding of questionnaires and tasks: e.g. severe deafness, severe visual impairment and severe /global aphasia,
• Presence of active fractures, dislocations, non-weight bearing status, burns, unhealed wounds, active skin infections/eczema and agitated behaviour or delirium
• Anticipated life expectancy < 1 year
• Presence of tracheostomy, ventilator, renal dialysis, end-organ failure
• Patients with disorders of consciousness.
• Pregnant or lactating participants

For Knee Osteoarthritis patients only:

• Alternative diagnosis to knee OA e.g. Referred pain from hip or spine.
• Other forms of knee arthritis eg. Inflammatory, post traumatic
• Previous knee arthroplasty