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Musculoskeletal Frailty: A Geriatric Syndrome at the Core of Fracture Occurrence in Older Age

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Abstract

A progressive decline in physiologic reserves inevitably occurs with ageing. Frailty results from reaching a threshold of decline across multiple organ systems. By consequence, frail elderly experience an excess vulnerability to stressors and are at high risk for functional deficits and comorbid disorders, possibly leading to institutionalization, hospitalization and death. The phenotype of frailty is referred to as the frailty syndrome and is widely recognized in geriatric medical practice. Although frailty affects both musculoskeletal and nonmusculoskeletal systems, sarcopenia, which is defined as age-related loss of muscle mass and strength, constitutes one of the main determinants of fracture risk in older age and one of the main components of the clinical frailty syndrome. As a result, operational definitions of frailty and therapeutic strategies in older patients tend to focus on the consequences of sarcopenia.

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Acknowledgments

S. Boonen is senior clinical investigator of the Fund for Scientific Research (FWO-Vlaanderen) and holder of the Leuven University Chair in Gerontology and Geriatrics. This work was supported by Grant G.0488.08 from the Fund for Scientific Research (FWO-Vlaanderen) to S. Boonen and research grants OT-05-53 and OT-09-035 from the KU Leuven to D. Vanderschueren. D. Vanderschueren is a senior clinical investigator of the Leuven University Hospital Clinical Research Fund.

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Authors and Affiliations

  1. Gerontology and Geriatrics Section, Department of Experimental Medicine, KU Leuven, Leuven, Belgium

    E. Gielen, M. Laurent, J. Tournoy, M. Dejaeger & S. Boonen

  2. Research Centre for Musculoskeletal Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium

    S. Verschueren

  3. Arthritis Research UK Epidemiology Unit, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK

    T. W. O’Neill, S. R. Pye & D. M. Lee

  4. Andrology Research Unit, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK

    M. D. L. O’Connell, R. Ravindrarajah & F. C. Wu

  5. Laboratory of Molecular Endocrinology, Department of Molecular Cell Biology, KU Leuven, Leuven, Belgium

    F. Claessens & M. Laurent

  6. Centre for Health Services and Nursing Research, KU Leuven, Leuven, Belgium

    K. Milisen

  7. Experimental Medicine and Endocrinology Section, Department of Experimental Medicine, KU Leuven, Leuven, Belgium

    D. Vanderschueren

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  1. E. Gielen
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Correspondence to S. Boonen.

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E. Gielen and S. Verschueren contributed equally to this article, and both should be considered first author.

The authors have stated that they have no conflict of interest.

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Gielen, E., Verschueren, S., O’Neill, T.W. et al. Musculoskeletal Frailty: A Geriatric Syndrome at the Core of Fracture Occurrence in Older Age. Calcif Tissue Int 91, 161–177 (2012). https://doi.org/10.1007/s00223-012-9622-5

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