Therapeutic approaches to osteosarcopenia: insights for the clinician

Abstract

Osteopenia/osteoporosis and sarcopenia are both age-related conditions. Given the well-defined bone and muscle interaction, when osteopenia and sarcopenia occur simultaneously, this geriatric syndrome is defined as ‘osteosarcopenia’. Evidence exists about therapeutic interventions common to both bone and muscle, which could thereby be effective in treating osteosarcopenia. In addition, there are roles for common nonpharmacological strategies such as nutritional intervention and physical exercise prescription in the management of this condition. In this review we summarize the evidence on current and upcoming therapeutic approaches to osteosarcopenia.

Osteosarcopenia: epidemiology, diagnosis, and treatment—facts and numbers

“…Calcium is the most abundant mineral in bone, and findings from animal models suggest a role of this nutrient in facilitating muscle contractile force via the maintenance of calcium kinetics . Although the benefits of calcium in reducing fracture risk are equivocal, reference guidelines suggest an intake of 1000–1300 mg/day which should be met through supplementation if dietary intake is suboptimal . Despite the recent controversy relating to the proposed risk of calcium supplementation, the most recent cross‐sectional study from UK Biobank showed no association with all‐cause mortality …”

Osteosarcopenia: A case of geroscience

“…With the increasing understanding of the mechanisms of osteosarcopenia, new therapeutic approaches or repurposing of current compounds is translating into phase II and III trials (as summarized in Fatima et al and Zanker and Duque).…”

Nutritional Orthopedics and Space Nutrition as Two Sides of the Same Coin: A Scoping Review

“…The obstacles to early feeding such as the motion sickness exacerbating nausea/vomiting, should be investigated, considering that a diverse combination of medications might be associated with different symptoms [ 7 ]. Patients suffering from osteosarcopenia may benefit from calcium and protein supplements [ 53 ], preparations of vitamin D and iron can optimize cardiac function and iron status [ 27 , 54 ], and the Mediterranean diet may slow down the age-related joint degeneration and subchondral bone deterioration [ 55 , 56 ]. Food preservation methods are crucial for food safety and quality.…”

“…Summary II. A total of 33 references ([ 7 , 10 , 20 , 21 , 22 , 23 , 27 , 45 , 46 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 59 , 60 , 61 , 62 , 63 , 64 , 66 , 67 , 68 , 73 , 76 , 77 , 79 , 82 , 83 , 84 , 85 ]) were used to scope the following nutritional commonalities between post-operative (hospital-based) vs. space station (planetary) issues. The use of single-serving prepackaged meals; the need to establish demand-driven systems that crosstalk and reduce food waste; the importance of guaranteeing food safety and human engagement throughout the process; the need to support the musculoskeletal health; the interest in some nutrients (i.e., proteins, calcium, iron, vitamin D); the need for boosting food flavors to increase appetite, palatability, hedonic appreciation, and food intake.…”

“…The excessive culinary expectations can thus be mediated. Supplements for osteosarcopenia may include diverse molecules of interest, such as β-hydroxy-β-methylbutyrate, vitamin D, calcium, and amino acids [ 53 , 117 ], without assuming the disconnection from other non-pharmacological interventions like daily range-of-motion exercises [ 118 ]. In the near future, most of the orthopedic care pathways will evolve, integrating on-site prescriptions with home-based monitoring after discharge, but the aforementioned hazards will persist at the patient’s home.…”