Osteosarcopenia: beyond age-related muscle and bone loss

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. 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.