Osteoporosis International

, Volume 23, Issue 7, pp 1839–1848

Frailty and sarcopenia: definitions and outcome parameters


    • MRC Lifecourse Epidemiology UnitUniversity of Southampton
    • Institute of Musculoskeletal ScienceUniversity of Oxford
  • W. Dere
    • Amgen Ltd.
  • W. Evans
    • Muscle Metabolism Discovery UnitGlaxoSmithKline
  • J. A. Kanis
    • WHO Collaborating Centre for Metabolic Bone DiseasesUniversity of Sheffield
  • R. Rizzoli
    • Rehabilitation and GeriatricsGeneva University Hospitals
  • A. A. Sayer
    • Academic Geriatric Medicine, MRC Lifecourse Epidemiology UnitUniversity of Southampton
  • C. C. Sieber
    • Internal Medicine-Geriatrics, Institute for Biomedicine of AgingFriedrich-Alexander-University
  • J.-M. Kaufman
    • Department of Endocrinology and Laboratory for HormonologyGhent University Hospital
  • G. Abellan van Kan
    • Gérontopôle de Toulouse, Department of Geriatric MedicineToulouse University Hospital
  • S. Boonen
    • Division of Gerontology and GeriatricsLeuven University
  • J. Adachi
    • McMaster University
  • B. Mitlak
    • Lilly Research LaboratoriesEli Lilly and Co
  • Y. Tsouderos
    • Servier
  • Y. Rolland
    • Gérontopôle de Toulouse, Department of Geriatric MedicineToulouse University Hospital
  • J.-Y. L. Reginster
    • University of Liège

DOI: 10.1007/s00198-012-1913-1

Cite this article as:
Cooper, C., Dere, W., Evans, W. et al. Osteoporos Int (2012) 23: 1839. doi:10.1007/s00198-012-1913-1


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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© International Osteoporosis Foundation and National Osteoporosis Foundation 2012