A clinical guide to the pathophysiology, diagnosis and treatment of osteosarcopenia. (October 2020)

• Record Type: Journal Article
• Authors: Kirk, Ben; Miller, Sarah; Zanker, Jesse; Duque, Gustavo
• Is Part Of: Maturitas. Volume 140(2020)
• Page Start: 27
• Page End: 33
• Publication Date: 2020-10
• Subjects: ALM appendicular lean mass -- BMD bone mineral density -- MSC mesenchymal stem cell -- SARC-F strength, assistance in walking, rise from a chair, climb stairs, falls -- FRAX fracture risk assessment tool -- SPPB Short Physical Performance Battery -- TUG Timed Up and Go test -- DXA dual-energy X-ray Absorptiometry -- QCT quantitative computed tomography -- QUS quantitative ultrasound -- MRI magnetic resonance imaging -- BIA bioimpedance analysis -- IMAT intramuscular adipose tissue -- RE resistance exercise -- FDA food and drug administration; Osteosarcopenia -- Osteoporosis -- Sarcopenia -- Osteokines -- Adipokines -- Myokines -- Vitamin D; Climacteric -- Periodicals; Menopause -- Periodicals; Climacteric -- Periodicals; Geriatrics -- Periodicals; Menopause -- Periodicals; Middle Aged -- Periodicals; Climatère -- Périodiques; Ménopause -- Périodiques; Climacterium; Climacteric; Menopause; Electronic journals; Periodicals; 612.66
• DOI: 10.1016/j.maturitas.2020.05.012
• Languages: English
• ISSNs: 0378-5122

Abstract

Highlights: The pathophysiology of osteosarcopenia is multifactorial. Diagnosis requires a combination of imaging techniques and physical and geriatric assessments. Resistance and balance exercises along with osteoporosis medications are the primary treatments. Increasing protein, vitamin D, calcium and creatine may complement primary treatments. At present, no diagnostic biomarkers or pharmaceutical treatments with an effect on both muscle and bone are available. Abstract: Advances in medicine have paved the way for older persons to live longer, but with more years spent living with disability and dependency. Many older persons are living with comorbidities such as osteoporosis (loss of bone mass) and sarcopenia (loss of muscle mass and function), two diseases that, when concurrent, form osteosarcopenia, a newly identified musculoskeletal syndrome. Osteosarcopenia impedes mobility and diminishes independence and thus quality of life. Evidence suggests the pathology of this syndrome comprises genetic polymorphisms, alterations in mechanotransduction, and localized or systemic crosstalk between growth factors and other proteins (myokines, osteokines, adipokines). As a direct result of an aging society, health outcomes such as falls and fractures will rise as the prevalence of osteosarcopenia increases. Two major risk factors for osteosarcopenia (other than age itself) are physical inactivity and poor nutrition. Addressing these modifiable risk factors can prevent, or at least delay, the onset of osteosarcopenia. Pharmaceutical treatments for osteosarcopenia are currently unavailable, although research trials are underway. This review provides an update from basic and clinical sciences on the biology, epidemiology (prevalence, risk factors and diagnosis) and treatments for osteosarcopenia, and recommends future research priorities to improve health outcomes for those living with or at risk of osteosarcopenia.