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Frailty and sarcopenia: definitions and outcome parameters

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Abstract

An operational definition of musculoskeletal decline in older people is needed to allow development of interventions for prevention or treatment, as was developed for the treatment of osteoporosis. Frailty and sarcopenia are linked, but distinct, correlates of musculoskeletal aging that have many causes, including age-related changes in body composition, inflammation, and hormonal imbalance. With the emergence of a number of exciting candidate therapies to retard the loss of muscle mass with aging, the derivation of a consensual definition of sarcopenia and physical frailty becomes an urgent priority. Although several consensual definitions have been proposed, these require clinical validation. An operational definition, which might provide a threshold for treatment/trial inclusion, should incorporate a loss of muscle mass as well as evidence of a decrease in muscle strength and/or physical activity. Evidence is required for a link between improvements in the measures of muscle strength and/or physical activity and clinical outcomes to allow development of interventions to improve clinical outcomes in frail older patients.

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Acknowledgements

WD is an employee and stockholder of Amgen, Inc.; WE is an employee of GlaxoSmithKline; BM is an employee and shareholder of Eli Lilly and Company; YT is an employee of Servier. YR has spoken for and prepared an education module with Nutricia and is on the expert board of Cheisi and Lactalis. SB is senior clinical investigator of the Fund for Scientific Research, Flanders, Belgium (F.W.O.-Vlaanderen) and holder of the Leuven University Chair in Gerontology and Geriatrics. Medical writing assistance was provided by Lucy Hyatt of Amgen (Europe) GmbH, with additional editorial assistance from Lucy Kanan of Bioscript Stirling, funded by Amgen (Europe) GmbH and GlaxoSmithKline.

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Authors and Affiliations

  1. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England, UK

    C. Cooper

  2. Institute of Musculoskeletal Science, University of Oxford, Oxford, UK

    C. Cooper

  3. Amgen Ltd., Uxbridge, UK

    W. Dere

  4. Muscle Metabolism Discovery Unit, GlaxoSmithKline, Research Triangle Park, NC, USA

    W. Evans

  5. WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK

    J. A. Kanis

  6. Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland

    R. Rizzoli

  7. Academic Geriatric Medicine, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK

    A. A. Sayer

  8. Internal Medicine-Geriatrics, Institute for Biomedicine of Aging, Friedrich-Alexander-University, Erlangen-Nürnberg, Germany

    C. C. Sieber

  9. Department of Endocrinology and Laboratory for Hormonology, Ghent University Hospital, Ghent, Belgium

    J.-M. Kaufman

  10. Gérontopôle de Toulouse, Department of Geriatric Medicine, Toulouse University Hospital, INSERM Unit 1027, Toulouse, France

    G. Abellan van Kan & Y. Rolland

  11. Division of Gerontology and Geriatrics, Leuven University, Leuven, Belgium

    S. Boonen

  12. McMaster University, Hamilton, Canada

    J. Adachi

  13. Lilly Research Laboratories, Eli Lilly and Co, Indianapolis, IN, USA

    B. Mitlak

  14. Servier, Paris, France

    Y. Tsouderos

  15. University of Liège, Liège, Belgium

    J.-Y. L. Reginster

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Cooper, C., Dere, W., Evans, W. et al. Frailty and sarcopenia: definitions and outcome parameters. Osteoporos Int 23, 1839–1848 (2012). https://doi.org/10.1007/s00198-012-1913-1

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