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Review
. 2019 Apr 24:10:255.
doi: 10.3389/fendo.2019.00255. eCollection 2019.

Osteoporosis and Sarcopenia Increase Frailty Syndrome in the Elderly

Emanuela A Greco  1 , Peter Pietschmann  2 , Silvia Migliaccio  3
Affiliations
Review

Osteoporosis and Sarcopenia Increase Frailty Syndrome in the Elderly

Emanuela A Greco et al. Front Endocrinol (Lausanne). .

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.

Keywords: aging; diet; frailty syndrome; gender; obesity; osteoporosis; physical activity; sarcopenia.

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Figures

Figure 1
Figure 1
Physiopathological basis of frailty. Aging, reduced physical activity, nutrients intake, hormone imbalance, and chronic inflammation worsen pathological conditions as sarcopenia, obesity, and osteoporosis, which in turn lead to frailty syndrome.
Figure 2
Figure 2
Schematic representation of molecular basis of the complex fat-bone-muscle cross-talk.
Figure 3
Figure 3
MicroCT image of the trabecular structure of a vertebral body of a C57Bl/6J mouse aged 12 month.
See this image and copyright information in PMC

References

    1. Pöllänen E, Ronkainen PH, Horttanainen M, Takala T, Puolakka J, Suominen H, et al. . Effects of combined hormone replacement therapy or its effective agents on the IGF-1 pathway in skeletal muscle. Growth Horm IGF Res. (2010) 20:372–9. 10.1016/j.ghir.2010.07.003 - DOI - PubMed
    1. Anton SD, Woods AJ, Ashizawac T, Barb D, Buford TW, Carter CS, et al. . Successful aging: advancing the science of physical independence in older adults. Ageing Res Rev. (2015) 24:304–27. 10.1016/j.arr.2015.09.005 - DOI - PMC - PubMed
    1. Dawson A, Dennison E. Measuring the musculoskeletal aging phenotype. Maturitas. (2016) 93:13–7. 10.1016/j.maturitas.2016.04.014 - DOI - PMC - PubMed
    1. Walston J, Hadley EC, Ferrucci L, Guralnik JM, Newman AB, Studenski SA, et al. Research agenda for frailty in older adults: toward a better understanding of physiology an etiology: summary from American Geriatrics Society/National Institute on Aging Reaserch Conference on Frailty in Older Adults. J Am Geriatric. (2006) 54:991–1001. 10.1111/j.1532-5415.2006.00745.x - DOI - PubMed
    1. Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty and comorbidity: implications for improved targeting and care. Gerontol A Biol Sci Med. (2004) 59:255–63. 10.1093/gerona/59.3.M255 - DOI - PubMed