What’s in a name revisited: should osteoporosis and sarcopenia be considered components of “dysmobility syndrome?”

Abstract

Sarcopenia and osteoporosis are age-related declines in the quantity and quality of muscle and bone respectively, with shared pathogeneses and adverse health consequences. Both absolute and relative fat excess, i.e., obesity and sarcopenic obesity, contribute to disability, falls, and fractures. Rather than focusing on a single component, i.e., osteoporosis, sarcopenia, or obesity, we realized that an opportunity exists to combine clinical factors, thereby potentially allowing improved identification of older adults at risk for disability, falls, and fractures. Such a combination could be termed dysmobility syndrome, analogous to the approach taken with metabolic syndrome. An arbitrary score-based approach to dysmobility syndrome diagnosis is proposed and explored in a small cohort of older adults. Further evaluation of such an approach in large populationbased and prospective studies seems warranted.

Синдром Дисмобільності: Зміна Парадигми В Царині Профілактики Переломів

“…Nonetheless, an accumulating body of evidence finds dysmobility to be associated with adverse health outcomes. For example, in our initial editorial proposing the concept [39], we found dysmobility syndrome in 97 older adults, mean age 81 years, to be associated with a higher falls prevalence than proposed consensus sarcopenia definitions. Similarly, Edwards et al in 398 older adults in the Herfordshire calculator used to estimate 10-year fracture probability.…”

“…Instead, those interested in reducing fractures should focus on the multitude of diseases/conditions that lead to the ultimate adverse outcome of fragility fracture. Nonetheless, the "what's in a name" publication [9] provide dincentive and direction to bring forward our suggestion that fragility fractures be considered part of a larger syndrome, that we suggested be named "dysmobility syndrome" and encompasses osteoporosis, sarcopenia, obesity and other fracture risk factors as an approach to improve identification and ultimately treatment of older adults to reduce their risk for falls and fractures [39]. The term "dysmobility", i.e., impairment of or difficulty with walking, was selected, but it is acknowledged that other terminology for this concept could well be equally, or even more, descriptive of this concept.…”

“…As an initial approach to this, our group proposed [39] a simple score based system in which slow gait speed (< 1 m/sec), a BMD T-score ≤ -2.5, low appendicular lean mass as measured by DXA (4.45 and 7.26 kg/m 2 for women and men respectively), history of falls within the last year, low grip strength (< 20 kg; female and < 30 kg; male) and high total body fat mass were considered with each risk factor receiving one point with dysmobility arbitrarily being diagnosed if the composite store was ≥ three.…”

Calcium intake: good for the bones but bad for the heart? An analysis of clinical studies

“…Moreover, such food sources result in the minimization of the risk of nephrolithiasis (33), which is known to be increased by medicinal calcium supplementation (34), and these food sources can provide other nutrients, such as proteins, which are useful in maintaining bone mass in adults (35,36) and can minimize the risks of malnutrition and sarcopenia, which are indirectly related to bone quality and the risk of fractures (37). Thus, calcium intake from dietary sources should be a priority, and supplements should be reserved for patients who are at a real risk of osteoporotic fractures and who cannot achieve their daily nutritional needs.…”

Physical Function, Cognitive Function, and Depressive Symptoms in Elderly Women with Dysmobility Syndrome

“…Dysmobility was defined as having at least three of the following six conditions: high body fat, osteoporosis, low muscle mass, low muscle strength, slow gait speed, and risk of falling [2]. According to a study that examined the relationship between dysmobility and mortality among adults over the age of 50 according to age, sex, and race or ethnicity using 1999-2002 data of the National Health and Nutrition Examination Survey (NHANES) [1], higher mortality was associated with dysmobility syndrome, age over 70 years, female gender, and deficiency in physical activities according to age and gender.…”