An overview of osteoporosis and frailty in the elderly

Li, Guowei; Thabane, Lehana; Παπαϊωάννου, Αλεξάνδρα; Ioannidis, George; Levine, Mitchell; Adachi, Jonathan D.

doi:10.1186/s12891-017-1403-x

Cited by 155 publications

(140 citation statements)

References 50 publications

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“…Loss of bone mass with age has significant socio-economic and medical implications due to the heightened susceptibility to fractures. Osteoporosis impairs mobility, increases co-morbidities, reduces quality of life and can shorten lifespan, particularly in the elderly (Li et al, 2017). …”

Section: Introductionmentioning

confidence: 99%

Irisin Mediates Effects on Bone and Fat via αV Integrin Receptors

Kim

Wrann²,

Jedrychowski

et al. 2018

Cell

399

431

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Summary Irisin is secreted by muscle, increased with exercise and mediates certain favorable effects of physical activity. In particular, irisin has been shown to have beneficial effects in adipose tissues, brain and bone. However, the skeletal response to exercise is less clear and the receptor for irisin has not been identified. Here we show that irisin binds to proteins of the αV class of integrins and biophysical studies identify interacting surfaces between irisin and αV/β5 integrin. Chemical inhibition of the αV integrins blocks signaling and function by irisin in osteocytes and fat cells. Irisin increases both osteocytic survival and production of sclerostin, a local modulator of bone remodeling. Genetic ablation of FNDC5/irisin completely blocks osteocytic osteolysis induced by ovariectomy, preventing bone loss and supporting an important role for irisin in skeletal remodeling. The identification of the irisin receptor should greatly facilitate our understanding of irisin’s function in exercise and human health.

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Section: Introductionmentioning

confidence: 99%

Irisin Mediates Effects on Bone and Fat via αV Integrin Receptors

Kim

Wrann²,

Jedrychowski

et al. 2018

Cell

399

431

View full text Add to dashboard Cite

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“…It has been ignored by most people because patients with osteoporosis do not have specific symptoms in the clinic, and pathogenesis is very slow (Das et al, 2004; Li et al, 2017). Currently, osteoporosis has become a serious threat to human health and eventually leads to reduced daily activity, lowered quality of life, and increased mortality (Shen et al, 2013; Tabatabaei-Malazy et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Pu-erh Tea Extract Ameliorates Ovariectomy-Induced Osteoporosis in Rats and Suppresses Osteoclastogenesis In Vitro

et al. 2017

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Background and Objective: Tea drinking is associated with positive effects on bone health and may protect against osteoporosis, especially in elderly women. Pu-erh tea has many beneficial effects on human health; however, whether Pu-erh tea has anti-osteoporotic potential remains unclear. Thus, we investigated the effects of Pu-erh tea extract (PTE) on ovariectomy-induced osteoporosis in rats and on osteoclastogenesis in vitro.Methods: Female Wistar rats were divided into six groups: the sham, model, and Xian-Ling-Gu-Bao capsule (XLGB) groups, and the low-, medium-, and high-dose PTE groups. Ovariectomized (OVX) rats were used as an animal model of osteoporosis. The animals were intragastrically administered distilled water, XLGB, or different concentrations of PTE for 13 weeks. Body weight, blood biochemical indicators, relative organ coefficients, femoral bone mineral density (BMD), bone biomechanical properties, and bone microarchitecture were examined and analyzed. Additionally, the in vitro effects of PTE on osteoclastic activities were investigated using the RAW 264.7 cell line as an osteoclast differentiation model. The effects of PTE on osteoclast differentiation and the expression of osteoclast-specific genes and proteins were determined.Results: PTE reduced OVX-induced body weight gain after 6 weeks of treatment, and the high-dose exerted a significant effect. High-dose PTE significantly ameliorated OVX-induced estradiol (E2) deficiency. PTE treatment maintained calcium and phosphorus homeostasis and improved other blood biochemical parameters to various degrees. In addition, PTE treatment improved organ coefficients of the femur, uterus, and vagina and improved femoral BMD and bone biomechanical properties. PTE treatment strikingly ameliorated bone microarchitecture. Moreover, in the in vitro studies, osteoclast differentiation using the differentiation cell model was significantly inhibited by PTE without cytotoxic effects. Additionally, PTE efficaciously suppressed the expression of key osteoclast-specific genes and proteins.Conclusion: PTE can ameliorate ovariectomy-induced osteoporosis in rats and suppress osteoclastogenesis in vitro.

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“…80 In a systematic review, Kojima analyzed six studies involving 96,564 community-dwelling older people to determine the relationship between frailty and fractures. 80 In a systematic review, Kojima analyzed six studies involving 96,564 community-dwelling older people to determine the relationship between frailty and fractures.…”

Section: Explanationmentioning

confidence: 99%

“…Recent evidence suggests that frailty is associated with an increased risk of osteoporosis and osteoporotic fractures. 80 In a systematic review, Kojima analyzed six studies involving 96,564 community-dwelling older people to determine the relationship between frailty and fractures. He found that those who were frail or pre-frail were significantly more likely to experience fractures; the pooled OR was 1.…”

Section: Explanationmentioning

confidence: 99%

Chapter 4 Frailty and specific diseases

Sugimoto

Rakugi

Kojima

et al. 2020

Geriatrics Gerontology Int

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CQ18: What is the relationship of frailty with orthostatic hypotension and orthostatic intolerance? Summary • Orthostatic hypotension and orthostatic intolerance are more prevalent among frail individuals than non-frail individuals, and these conditions worsen frailty outcomes (evidence level: E-2). ExplanationOrthostatic hypotension and orthostatic intolerance, both of which are risk factors for falls, are reported to be associated with frailty. O'Connell et al. examined the relationship between orthostatic hypotension, orthostatic intolerance and frailty using data from 5692 individuals aged ≥50 years who participated in the Irish Longitudinal Study on Aging (TILDA). Of these participants, 6.1% had orthostatic hypotension, 6.7% had orthostatic intolerance and 4.3% were identified as frail, and 34.5% participants were identified as pre-frail under the Cardiovascular Health Study (CHS) criteria. Both orthostatic hypotension and orthostatic intolerance were more prevalent in frail participants (8.9% and 14.3%) than they were in robust participants (5.0% and 5.7%). In a multivariate analysis, orthostatic intolerance was found to be independently associated with frailty (odds ratio [OR] 1.80, 95% CI 1.13-2.87), although orthostatic hypotension was not. 1 Similarly, Freud et al. examined associations between orthostatic hypotension and mortality using data of patients who were regularly assessed in the outpatient Comprehensive Geriatric Assessment Unit. These patients were aged ≥65 years (mean age 83.7 years), and 32.1% were diagnosed with orthostatic hypotension. They found that orthostatic hypotension was associated with increased mortality (over the follow-up period, 30.2% and 22.3% of those with and without orthostatic hypotension died, respectively), but a multivariate analysis did not show orthostatic hypotension to be independently associated with increased mortality. 2 These studies suggest that orthostatic hypotension and orthostatic intolerance are more prevalent in frail individuals, and that they worsen frailty outcomes.Romero-Ortuno et al. analyzed a sample of older individuals (average age of 72, 6.1% with orthostatic hypotension, 6.7% with orthostatic intolerance) who did not have dementia or risk factors for autonomic neuropathy. They arranged the participants into non-frail, pre-frail and frail groups, and found that the baseline heart rate decreased across the groups in that order. They also found that the delta heart rate (maximum heart rate within 30 s after standing minus baseline heart rate) increased across the groups in that order. It was reported that 30 s after standing, 98% of the non-frail participants, 95% of the pre-frail participants and 92% of the frail participants recovered to their baseline heart rate. 3 These findings suggest that frailty worsens hypostatic problems that occur when standing.CQ19: What is the relationship of frailty with antihypertensive treatment? Summary • Antihypertensive treatment prevents cardiovascular events whether or not the patient is frail. Intensive anti...

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An overview of osteoporosis and frailty in the elderly

Cited by 155 publications

References 50 publications

Irisin Mediates Effects on Bone and Fat via αV Integrin Receptors

Irisin Mediates Effects on Bone and Fat via αV Integrin Receptors

Pu-erh Tea Extract Ameliorates Ovariectomy-Induced Osteoporosis in Rats and Suppresses Osteoclastogenesis In Vitro

Chapter 4 Frailty and specific diseases

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