Osteoporosis and Sarcopenia Increase Frailty Syndrome in the Elderly

Abstract

Musculoskeletal aging is a major public health interesting and strain due to the significant demographic modifications in the population, and it is linked to high risk of falls, loss of autonomy in elderly individuals and institutionalization with small health outcomes. Thus, this pathological status is related to high morbidity and health care rates. Bone mass and muscle mass and strength increase during late adolescence and early adulthood but start to reduce noticeably from the fifth decade of life and are closely linked. Bone and muscle tissues were increasingly recognized, as endocrine target organs and endocrine organs themselves, interacting through paracrine and endocrine signals. During growth, bone mineral content closely correlates with muscle mass, and several evidences suggest that osteoporosis and sarcopenia present common pathophysiological factors and show the correlation between low bone mineral density and sarcopenia in both men and women. Then, sarcopenia and osteoporosis, typical features of aging, are often associated with each other and with the frailty syndrome. In particular, sarcopenia and osteoporosis are major contributors to disability and frailty and the common denominators are age-related chronic inflammation, changes in body composition and hormonal imbalance. Frailty syndrome is characterized by a reduced response to stress, triggering the decline of the physiological functioning of the various systems. Frailty syndrome, typical of the older people, is frequently associated with a reduction in the quality of life and mobility. Falls often are the basis of reduced mobility and ability to perform the common functions of daily life and the increase in the number of institutionalizations. Moreover, the reduction of muscle mass, associated with altered muscle composition, fat and fibrous infiltration and alterations in innervations, and the increase in fat mass, have a synergistic effect on the increase in cardiovascular risk. The aim of this review is to analyze the pathophysiological mechanisms underlying the frailty syndrome and its association with sarcopenia and osteoporosis, and investigate possible intervention measures.

The influence of physical Activity on handgrip strength of elderly

“…The loss of skeletal muscle mass can lead to sarcopenic obesity, reduced exercise capacity, chronic heart failure and disability [24,25]. All of the above describes the importance of muscle strength as a potential predictor for the development of chronic conditions and diseases in elderly.…”

Late‐onset Hypogonadism: Bone health

“…As muscle mass depends on serum T and hypogonadism leads to sarcopenia, this indirect effect is of great relevance for bone homeostasis 1,34,35 . Both hypogonadism 19,36 and aging 37 lead to physiological reduction in body muscle masses and sarcopenia in older men, thus promoting bone loss due to mechanical strain 38 and postural instability, thus increasing the risk of fracture due to osteoporosis or increased incidence of falls 38,39 due to altered muscle–bone cross talk 40 …”

“…Apart direct effects, estrogens modulate other hormones and cytokines involved in bone physiology (indirect effects), among them the GH/IGF‐1 network being one of the most important 50 . Finally, estrogens positively modulate the bone response to mechanical strain 51,52 similarly to what androgens 38,40 do.…”

Comprehensive analysis of skeletal muscle- and bone-derived mesenchymal stem/stromal cells in patients with osteoarthritis and femoral neck fracture

“…Age-related OP is commonly accompanied by sarcopenia, a condition that is characterized by muscle weakness, muscle fiber atrophy, and adipose tissue infiltration into muscle [10,11]. Although the precise cause of sarcopenia remains unknown, it has been proposed that a combination of factors are involved, including systemic inflammation, increased oxidative stress, and changes in skeletal muscle stem cell populations [12][13][14].…”