Ageing, muscle and bone

G. Fornelli; G.C. Isaia; P. D'Amelio

PDF

Ageing, muscle and bone

G. Fornelli G.C. Isaia P. D'Amelio

Geriatric and Bone Unit, Department of Medical Science, University of Torino, Italy

Sarcopenia Osteoporosis Elderly

Abstract

The ageing process is characterized by a decline in muscle mass and strength, when this process outreaches
pathological levels it is defined sarcopenia. This condition is associated with greater likelihood of recurrent falls
and greater risk of mortality and less consistently associated with risk of hip fracture and functional limitation.
On the other hand, ageing heavily affects bone inducing changes in bone structure – progressive decrease in
trabecular thickness and increase in cortical porosity –, loss of bone mass and increase in bone turnover.
There is an important interplay between muscle and skeletal systems: muscle contractions during anti-gravitational and physical activities apply mechanical stress to bones, influencing bone density, strength and microarchitecture, thus a decrease in muscle function is related to lower bone strength and predisposes to osteoporosis.
Osteoporosis and sarcopenia show multiple common pathogenetic pathways, both systemic and
local: reduction in anabolic hormones, chronic inflammatory condition, inactivity. In particular, several skeletal
muscle-derived cytokines are able to directly influence bone. Vitamin D adequate levels are crucial for both
bone and muscle function. Musculoskeletal impairment causes an important burden of disability and disease
in older patients, a better understanding of pathogenesis and muscle-bone crosstalk could lead to improve
prevention strategies and therapeutic options.