Osteosarcopenia: beyond age-related muscle and bone loss
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REVIEW
Osteosarcopenia: beyond age‑related muscle and bone loss Gabriela Fagundes Belchior1 · Ben Kirk3,4 · Evela Aparecida Pereira da Silva2 · Gustavo Duque3,4 Received: 2 April 2020 / Accepted: 2 July 2020 © European Geriatric Medicine Society 2020
Key summary points Aim To summarize current evidence on osteosarcopenia. Findings Knowledge on osteosarcopenia as a geriatric syndrome is growing. This will facilitate the development of robust biomarkers and new treatments with dual effect on muscle and bone. Message When assessing older persons for osteoporosis, concomitant assessment for sarcopenia (and vice versa) should be included as an essential part of the comprehensive geriatric assessment. Abstract Purpose Osteosarcopenia is a geriatric syndrome characterized by declines in bone density and microarchitecture and muscle mass and strength, which has gained clinical interest due to its association with falls and fragility fractures. Methods This review discusses the epidemiology of osteosarcopenia including clinical assessment, the pathophysiological aspects leading to the loss of muscle and bone mass, and efficacious therapeutic strategies to combat this syndrome. Results The etiology of osteosarcopenia is thought to include genetic and environmental factors which interact with muscle and bone at the cellular level, reinforcing that these tissues are interconnected not only by mechanical aspects, but also by humoral factors. Osteosarcopenia is identified by low muscle and bone mass and impaired strength of these tissues via imaging and physical performance measures. Conclusion The diagnosis of osteosarcopenia is of clinical importance since early interventions, particularly resistance exercise, and adequate intake of protein, vitamin D and calcium, may delay the onset of individual components (osteopenia/ sarcopenia) of osteosarcopenia. Keywords Osteosarcopenia · Osteoporosis · Sarcopenia · Aging · Geroscience
Introduction Preserving musculoskeletal health across the lifespan has become an important aspect of geriatric research due to age-related diseases such as osteopenia/osteoporosis and * Gustavo Duque [email protected] 1
Albert Einstein Hospital, São Paulo, Brazil
2
Universidade Federal do Estado de São Paulo, Unifesp, São Paulo, Brazil
3
Department of Medicine‑Western Health, Melbourne Medical School, University of Melbourne, St Albans, Melbourne, VIC, Australia
4
Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, 176 Furlong Road, St Albans, Melbourne, VIC 3121, Australia
sarcopenia, which are known to induce substantial socioeconomic burdening [1]. Osteopenia/osteoporosis is characterized by poor bone microarchitecture and low bone density, which predispose to fractures [2], while sarcopenia is defined as the progressive loss of muscle mass, strength and physical functioning [3]. When an older person presents with both conditions, which is increasingly apparent [1], a musculoskeletal syndrome termed osteosarcop
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