OBJECTIVE: The aim of this review of the literature is to report the factors which both contribute to the frailty syndrome and increase hip fracture risk in the elderly. This work is the fruit of common reflection by geriatricians, endocrinologists, gynecologists and rheumatologists, and seeks to stress the importance of detection and management of the various components of frailty in elderly subjects who are followed and treated for osteoporosis. It also sets out to heighten awareness of the need for management of osteoporosis in the frail elderly. DESIGN: The current literature on frailty and its links with hip fracture was reviewed and discussed by the group. RESULTS: The factors and mechanisms which are common to both osteoporosis and frailty (falls, weight loss, sarcopenia, low physical activity, cognitive decline, depression, hormones such as testosterone, estrogens, insulin-like growth factor-I (IGF-I), growth hormone (GH), vitamin D and pro-inflammatory cytokines) were identified. The obstacles to access to diagnosis and treatment of osteoporosis in the frail elderly population and common therapeutic pathways for osteoporosis and frailty were discussed. CONCLUSION: Future research including frail subjects would improve our understanding of how management of frailty can can contribute to lower the incidence of fractures. In parallel, more systematic management of osteoporosis should reduce the risk of becoming frail in the elderly population.
OBJECTIVE: The aim of this review of the literature is to report the factors which both contribute to the frailty syndrome and increase hip fracture risk in the elderly. This work is the fruit of common reflection by geriatricians, endocrinologists, gynecologists and rheumatologists, and seeks to stress the importance of detection and management of the various components of frailty in elderly subjects who are followed and treated for osteoporosis. It also sets out to heighten awareness of the need for management of osteoporosis in the frail elderly. DESIGN: The current literature on frailty and its links with hip fracture was reviewed and discussed by the group. RESULTS: The factors and mechanisms which are common to both osteoporosis and frailty (falls, weight loss, sarcopenia, low physical activity, cognitive decline, depression, hormones such as testosterone, estrogens, insulin-like growth factor-I (IGF-I), growth hormone (GH), vitamin D and pro-inflammatory cytokines) were identified. The obstacles to access to diagnosis and treatment of osteoporosis in the frail elderly population and common therapeutic pathways for osteoporosis and frailty were discussed. CONCLUSION: Future research including frail subjects would improve our understanding of how management of frailty can can contribute to lower the incidence of fractures. In parallel, more systematic management of osteoporosis should reduce the risk of becoming frail in the elderly population.
Authors: Gustavo Duque; Louise Mallet; Ayanna Roberts; Serge Gingrass; Richard Kremer; Louis-Georges Sainte-Marie; Douglas P Kiel Journal: J Am Med Dir Assoc Date: 2006-07-07 Impact factor: 4.669
Authors: Heike A Bischoff-Ferrari; Walter C Willett; John B Wong; Edward Giovannucci; Thomas Dietrich; Bess Dawson-Hughes Journal: JAMA Date: 2005-05-11 Impact factor: 56.272
Authors: Douglas P Kiel; Jay Magaziner; Sheryl Zimmerman; Linda Ball; Bruce A Barton; Kathleen M Brown; Judith P Stone; Dawn Dewkett; Stanley J Birge Journal: JAMA Date: 2007-07-25 Impact factor: 56.272
Authors: L M Donini; L J Dominguez; M Barbagallo; C Savina; E Castellaneta; D Cucinotta; A Fiorito; E M Inelmen; G Sergi; G Enzi; C Cannella Journal: J Nutr Health Aging Date: 2011-11 Impact factor: 4.075