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Effects of Aging on Skeletal Fragility

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Osteoporotic Fracture and Systemic Skeletal Disorders

Abstract

Although bone loss is a natural accompaniment to aging in both men and women, most older people who fracture are not osteoporotic. Part of this is because of the nonlinear relationship between mass and strength; strength and stiffness decline faster than bone mass at any given age. However, the weakness of bone that develops with age also suggests there are many more facets to skeletal fragility than simply bone mass alone. The distribution of bone (its cortical geometry and cancellous architecture) can either partially offset the effects of bone loss (as in the case of periosteal apposition) or exacerbate it (as in the case of lower trabecular connectivity). Additionally, bone tissue changes with age in ways that make it less elastic and more brittle, and this in combination with increased porosity contributes to bone fragility, especially in cases of impact such as those that occur in a fall. Consequently, bone is at greater risk of fracture as one ages, even to some degree independent of bone mass. Unfortunately, techniques to measure these changes outside of bone mineral density are not well developed and cannot readily be used clinically. Given that, a health care worker should take care to consider both bone mineral density and the age of the patient in developing a treatment plan.

The present invited review was completed and submitted to the publisher on 09-May-19. 

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Authors and Affiliations

  1. Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN, USA

    David B. Burr

  2. Department of Biomedical Engineering, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA

    David B. Burr

  3. Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, IN, USA

    David B. Burr

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Editors and Affiliations

  1. Niigata Bone Science Institute, Niigata Rehabilitation Hospital, Niigata, Japan

    Hideaki E. Takahashi

  2. Department of Anatomy, Cell Biology and Physiology, Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, IN, USA

    David B. Burr

  3. Niigata Bone Science Institute, Niigata Rehabilitation Hospital, Niigata, Japan

    Noriaki Yamamoto

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Burr, D.B. (2022). Effects of Aging on Skeletal Fragility. In: Takahashi, H.E., Burr, D.B., Yamamoto, N. (eds) Osteoporotic Fracture and Systemic Skeletal Disorders. Springer, Singapore. https://doi.org/10.1007/978-981-16-5613-2_3

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