# Frailty and lived experiences in older adults with osteoporosis: protocol for a convergent mixed-methods study

## TL;DR

This study explores how frailty and osteoporosis together affect older adults, combining surveys and interviews to understand both clinical and personal impacts.

## Contribution

The study introduces a convergent mixed-methods approach to holistically examine frailty and osteoporosis in older adults.

## Key findings

- Frailty and osteoporosis together increase the risk of functional decline in older adults.
- Quantitative and qualitative data will be integrated to provide a comprehensive understanding of patient experiences.
- Risk factors for frailty will be identified through logistic regression analysis.

## Abstract

Older adults is characterized by an age-related decline in bone mineral density. Frailty-a distinct age-associated geriatric syndrome-further exacerbates this condition. The concomitance of osteoporosis and frailty in older adults markedly heightens the risk of functional decline, with attendant profound psychosocial sequelae. A mixed-methods study design is essential to achieve a comprehensive, patient-centered understanding of this phenomenon.

This study will adopt a convergent mixed-methods design comprising three primary phases: (1) Quantitative phase: a cross-sectional survey will be conducted among older adults diagnosed with osteoporosis. Data collection will include demographic variables, scores from the Edmonton Frail Scale, Activities of Daily Living assessments, Nutritional Risk Screening assessments, and the Hospital Anxiety and Depression Scale. In addition, handgrip strength will be measured, alongside relevant laboratory parameters. Data will undergo descriptive analysis, followed by univariate analyses and multivariate binary logistic regression to identify factors associated with frailty. (2) Qualitative phase: semi-structured, face-to-face interviews will be performed with participants classified as frail according to their frailty assessment scores, enabling an in-depth exploration of their subjective perceptions and experiences of frailty within the context of osteoporosis. (3) Integration phase: key findings from both quantitative and qualitative components will be analyzed and synthesized to generate a comprehensive understanding of the phenomenon.

This study aims to explore the prevalence and clinical characteristics of frailty among older adults with osteoporosis. It also seeks to identify associated risk factors and to explore patients' subjective experiences of living with frailty in the context of osteoporosis.

This trial has been registered with the Chinese Clinical Trial Registry (ChiCTR2500097059).