Role of endocrine-immune dysregulation in osteoporosis, sarcopenia, frailty and fracture risk

Joseph, Cherian; Kenny, Anne M.; Taxel, Pamela; Lorenzo, Joseph; Duque, Gustavo; Kuchel, George A.

doi:10.1016/j.mam.2005.01.004

Cited by 106 publications

(48 citation statements)

References 130 publications

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“…However, there is evidence in literature that frailty and osteoporosis (consequence of low BMD) share risk factors (age group, sarcopenia, sedentarism, low body weight, consumption of tobacco) and physiopathological mechanisms [27,28]. In the latter, alterations in estrogen and growth hormone levels would be related to osteoporosis, as these are involved in the bone remodeling process, and related to frailty because they contribute with loss of muscle mass and strength [27,29,30]. This information presents biological plausibility as in this study, loss of strength in women was the frailty component associated with low BMD.…”

Section: Discussionmentioning

confidence: 99%

Association of Bone Mineral Density with Frailty, Pre-Frailty, and Osteoporosis in Community-Dwelling Elderly: A Prospective Study

Araujo¹

2017

J Geriatr Med Gerontol

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Objectives: To examine the association of Bone Mineral Density (BMD) in the prediction of frailty, pre-frailty, osteoporosis, falls and health conditions in elderly men and women. Methods:A four-year prospective study (2009)(2010)(2011)(2012)(2013) with 106 elderly, both sexes, aged ≥ 60 years, of the city of Goiânia, Brazil. BMD was estimated using dual-energy X ray absorptiometry. Frailty was assessed subjectively, including the following components: unintentional weight loss, fatigue, and low physical activity, reduction of strength and gait speed. Results:Mean age was 70 years of age and Body Mass Index (BMI) was 26.7 kg/m 2 . The mean BMD for women was 1.042 (± 0.11) g/cm 2 while for men, mean BMD was 1.169 (± 0.12) g/cm 2 , (p = 0.000). After adjustments for age and BMI in women, lower BMD values were significantly associated with osteoporosis (p = 0.003), frailty (p = 0.033), and pre-frailty (p = 0.037).Conclusion: BMD was predictive of frailty, pre-frailty and osteoporosis in women. In men, no associations were established. KeywordsBone mineral density, Frailty, Osteoporosis, Muscle strength, Elderly creases in Bone Mineral Density (BMD) are due to the natural ageing process for both sexes, however more prevalent for women [3][4][5][6], with consequences such as increased risk of fractures [3,6], falls and incapacities in the female group [2].Within the last years, the frailty syndrome has been increasingly highlighted due to its complex nature [7], with high prevalence and mortality [8], and its relationship with different health conditions has been investigated [9,10]. The majority of studies has analyzed frailty as a predictor of low BMD and indicate a causal relationship with low BMD [2,3,11]. However, analysis of BMD as a predictor of frailty has not been extensively investigated [12,13]; existing research has presented controversial results. While research finds no association between frailty and BMD in older women, another study observed associations between low BMD and frailty markers such as: low strength and low gait speed in men [12,13].A plausible explanation for the relationship between frailty and low bone mineral density is that the parameters used as frailty markers in the elderly such as advanced age, weight loss, low body weight, sarcopenia, the low level of physical exercise, and impaired mobility, since mechanical crucial is loading to bone mass maintenance [14]. The research presented herein considers the current context of population ageing, as well as the importance of BMD in the general and bone health of elderly. The results presented herein can add relevant RESEARCH ARTICLE

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Section: Discussionmentioning

confidence: 99%

Association of Bone Mineral Density with Frailty, Pre-Frailty, and Osteoporosis in Community-Dwelling Elderly: A Prospective Study

Araujo¹

2017

J Geriatr Med Gerontol

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“…These common age-related changes in skeletal muscle are major causes of impaired physical function in older adults, contributing to impaired mobility, falls and hospitalisation. The causes of sarcopenia are multifactorial and can include muscle disuse, changing endocrine function, chronic diseases, inflammation, insulin resistance and nutritional deficiencies [38]; reductions in testosterone and oestrogen that accompany ageing appear to accelerate its development [39].…”

Section: Sarcopeniamentioning

confidence: 99%

Frailty, Sarcopenia and Falls

Marques

Queirós

2018

Perspectives in Nursing Management and Care for Older Adults

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Research confirms that frailty, sarcopenia and falls are strongly correlated [1] and both are predictors of negative health outcomes such as falls, disability, hospitalisation and death [2]. Interventions are necessary to reverse frailty and treat sarcopenia [3] as it has been estimated that, by the year 2025, around 20% of the population in industrial countries will be aged 65 years and over. As the number of older people increases, their needs will become an increasingly important health issue. Reduction in physical function can lead to loss of independence, need for hospital and longterm nursing home care and premature death. The importance of physical, functional, psychological and social factors in realising a healthy old age is recognised by older people, health-care professionals, policy advisors and decision-makers. This chapter will review the concepts of frailty, sarcopenia and falls as well as the interventions for older people, carried out by nurses and other health-care professionals, that have the potential to positively affect health and functional status and may promote independent functioning of older people with frailty and sarcopenia. Learning OutcomesAt the end of the chapter, and following further study, the nurse will be able to:

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“…First, there are a number of individual physiologic systems that have been identified as dysregulated in association with frailty. As background, there are many data that indicate declines with age in function of multiple functional and regulatory systems in the body, such as circulating levels of specific hormones (e.g., estrogens, testosterone, and insulin-like growth factor 1 [IGF-1]) (Kuchel et al 2001), impaired insulin sensitivity (Davidson 1979;DeFronzo 1981;Shimokata et al 1991;Scheen 2005;Metter et al 2008), along with elevations of markers of inflammation (e.g., interleukin 6 [IL-6] and C-reactive protein [CRP]) with aging (Ershler and Keller 2000;Reuben et al 2002;Cohen et al 2003;Joseph et al 2005). Dynamic interactions between declines in gonadal hormones and increases in inflammatory mediators affect bone mass, as well as mobility (Cappola et al 2003), whereas the impaired insulin sensitivity is predictive of both frailty and diabetes (Kalyani et al 2012b).…”

Section: Mechanisms Underlying the Clinical Syndrome Of Frailtymentioning

confidence: 99%

“…For example, sarcopenia results, in part, both from hormonal deficiency and cytokine excess Morley et al 2005). Postmenopausal declines in serum estrogen and androgen levels contribute to increased bone loss (Joseph et al 2005). Higher serum testosterone in older women is associated with insulin resistance (IR) and metabolic syndrome (Patel et al 2009).…”

Section: Mechanisms Underlying the Clinical Syndrome Of Frailtymentioning

confidence: 99%

“…Further, higher cortisol, DHEA-S ratio, as well as lower levels of DHEA-S and higher white blood cell counts predicted frailty over 10-yr follow-up, indicating interactions between the immune and endocrine axis (Baylis et al 2013). One summary has stated that the "presence of decreased gonadal hormones and IGF-1, combined with unusually high peripheral levels of cytokines, inflammatory mediators, and coagulation markers all enhance risk of sarcopenia and frailty" (Joseph et al 2005).…”

Section: Exercise As An Intervention For Human Frailtymentioning

confidence: 99%

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