Falls and fracture risk assessment-The role of osteoporosis, obesity, and sarcopenia
Osteosarcopenia is an important shared risk factor for the overlapping geriatric syndromes of falls and fractures. Importantly, the occurrence of falls and fractures frequently sets off a negative cycle of decreased physical activity which further worsens obesity, muscle, and bone quality, increasing risk still further. Screening and treatment for falls and fractures should consider the common risk factors including medications and chronic medical conditions that negatively impact both bone and muscle. Validated risk assessment tools and physical performance tests can be helpful in identifying older adults who need preventive services but have important caveats that must be considered. The overlap between osteosarcopenia, obesity, falls, and fractures open up the possibility of pleiotropic interventions to reduce the risk of all these conditions. Exercise and dietary approaches are currently available. Pharmacologic interventions targeting common cellular pathways are being developed.