The relationship between sarcopenia and fragility fracture—a systematic review

  • R. M. Y. Wong
  • H. Wong
  • N. Zhang
  • S. K. H. Chow
  • W. W. Chau
  • J. Wang
  • Y. N. Chim
  • K. S. Leung
  • W. H. CheungEmail author
Review Article


Sarcopenia is a common geriatric syndrome characterized by progressive decrease of muscle mass and function leading to an increased risk of physical disability, poor quality of life, and mortality. Increasing evidence shows that sarcopenia is related with fragility fractures. This systematic review aimed to summarize the following: (1) the prevalence of sarcopenia in patients with fragility fracture and (2) the associated risk factors for fragility fracture in patients with sarcopenia. Literature search was conducted in PubMed and Cochrane databases. Studies with the prevalence of sarcopenia in elderly patients with fragility fracture and associated risk factors in patients with sarcopenia were included. A total of 15 papers were included, with 10 reporting sarcopenia prevalence, and 5 on fracture risk in patients with sarcopenia. The prevalence of sarcopenia after fracture ranged from 12.4 to 95% in males and 18.3 to 64% in females. The prevalence of sarcopenia in elderly patients with fragility fracture was high, especially in men. Two studies showed that sarcopenia was a risk factor for fragility fracture when associated with low bone mineral density (BMD) but only in men. Caution should be taken for male patients with sarcopenia and low BMD, which is related to significantly increased risk of fractures. There is a pressing need for further research on sarcopenia and its risk on fragility fracture to better understand the relationship, pathophysiology, and mechanisms, which may shed light on potential interventions to improve clinical outcomes.


Fracture risk Fragility fracture Prevalence Sarcopenia Systematic review 


Funding information

This study was partially supported by General Research Fund (Reference: 14113018).

Compliance with ethical standards

Conflicts of interest


Supplementary material

198_2018_4828_MOESM1_ESM.pdf (1.2 mb)
ESM 1 (PDF 1208 kb)


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2019

Authors and Affiliations

  1. 1.Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong KongHong KongChina
  2. 2.The CUHK-ACC Space Medicine Centre on Health Maintenance of Musculoskeletal SystemThe Chinese University of Hong Kong Shenzhen Research InstituteShenzhenPeople’s Republic of China

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