Fractures due to osteoporosis in older adults are very common and often associated with increased illness and mortality. MACH Care of the Ageing Network’s Professor Gustavo Duque and colleagues are working on a range of research considering the impact of bone and muscle health in older adults.
Currently osteoporosis (bone loss) and sarcopenia (muscle loss) affect two in three older Australians. By 2022, it is anticipated that approximately 6.2 million Australians over the age of 50 will have osteoporosis or osteosarcopenia (bone and muscle loss).
How do older adults look after their bone and muscle health?
Prof. Duque explains we should look after our musculoskeletal health as we age, as this will have a significant impact on our quality of life.
Firstly, it is very important to keep active. Walking is good, but ideally older adults should try to incorporate some resistance activities (such as weights) and balance activities (such as yoga) into their exercise regime. Resistance and balance activities increase strain on muscle and bone, and help to build strength.
Secondly, Prof Duque recommends that those over 65 years of age who do not have any symptoms of osteosarcopenia such as reduced mobility, or a history of falls and fractures, should request a bone density scan from their general practitioner (GP). This painless 10-15 minute assessment involves a patient lying on their back while bone minerals such as calcium are measured. The initial scan provides a baseline for further measures to be compared against.
Thirdly, osteosarcopenia can have a heredity component. If a family member has a history of fractures, Prof Duque recommends consulting a GP about precautionary ways to protect bone and muscle health.
About the research
In this recent study, Prof. Duque and colleagues consider the link between ageing, and bone and muscle health, and the impact fat infiltration into bone has on these two factors. The research indicated that increased fat cells in bone marrow meant less bone formation. Less bone formation means decreased bone density and strength, and therefore an increased risk of fractures.
There is increased interest in the role fat plays in metabolism and ageing, with fats having a strong link to bone health, however a lot of research is still being undertaken in the area.
When discussing with Prof Duque if we should reduce fat in our diet he stated that “fat cells in bone marrow, are independent to the fat we metabolise”; meaning fat in our bone marrow is not based on what we eat. He goes on to explain that fat cells in bone, and fat cells in muscle, are very similar, and an increase in sarcopenic muscle and osteoporotic bone develop independently of the body mass index and of the amount of other fats in the body.
However it must be stressed that taking care of our diets is still an important factor for bone and muscle health as well as general well-being, especially as we age.
So what does impact on bone and muscle health? According to Prof Duque Vitamin D, calcium, exercise and diet are all important factors.
Bringing this research to life
Prof. Duque and colleagues are currently working with GPs to assist with the diagnosis of osteoporosis, through the Integrating Osteoporosis in Primary Care: The Osteoporosis Risk and Management (ORMA) Project.
The project aims to increase GPs awareness, diagnosis and treatment of osteoporosis in the community, as currently there is a gap for people who are identified and receive treatment for osteoporosis.
This innovative method does not place any extra burden onto a GP’s work load, as osteoporosis identification is embedded in medical software already used. It facilitates access to information, such as when to order osteoporosis diagnostic tests, and when to treat someone who is showing signs of osteoporosis. The aim is for GPs to examine their own practice and become more informed into how they manage and treat osteoporosis.
16 GPs across Western Melbourne are involved in the study and approximately 120,000 people access these GPs annually with approximately 12% of the population over 60 years of age.
Patient outcomes are at the forefront of this project by targeting how osteoporosis is diagnosed. This will in turn have positive impacts on the health and well-being of individuals and the community through the prevention of fractures.