Sarcopenia and Osteoporotic Fractures

Low bone mass is strongly associated with increased fracture risk. However, the importance of low muscle mass and strength—known as sarcopenia—as a risk factor for osteoporotic fractures remains overlooked and sometimes controversial. Bone and muscle are closely interconnected not only anatomically, but also physically, chemically and metabolically. Indeed, a significant proportion of individuals with sarcopenia also suffer from osteopenia/osteoporosis suggesting a link between the two tissues. This subgroup of osteosarcopenic individuals are at higher risk of falls and fractures. Therefore, we suggest that lean mass and muscle strength/function assessments should be an integral part in any fracture prevention protocol. A combination of lean mass quantification by dual-energy X-ray absorptiometry scan and assessment of muscle function by gait velocity could not only confirm the diagnosis of sarcopenia but also optimize any fracture prevention interventions. In the absence of specific therapies for sarcopenia, simple interventions such as resistance (weight-bearing) training, protein supplements and appropriate levels of vitamin D have a dual effect on bone and muscle and could have a significant effect on reducing falls and fractures in this high-risk population.