Nielsen · European geriatric medicine 2018 · systematic review and meta-analysis · n=27 studies (17 in meta-analysis)

Sarcopenia and osteoporosis in older people: a systematic review and meta-analysis.

Cited 154 times in the scientific literature.

Level 3 - non-randomized controlled study

Systematic review and meta-analysis of observational studies

PubMed 34674498 · doi:10.1007/s41999-018-0079-6 · record verified 2026-08-29

What was done

A systematic review and meta-analysis searched literature up to March 10, 2018, to evaluate osteosarcopenia prevalence and associated fracture risk in older adults. Out of 1,105 identified records, 27 original studies met inclusion criteria, with 17 providing data suitable for meta-analysis.

What was found

Osteosarcopenia prevalence ranged from 5% to 37%, influenced by the classification system used for sarcopenia. In low-energy osteoporotic fracture cohorts, sarcopenia prevalence was 7.8–58% in women and 1.3–96.3% in men, with a pooled meta-analytic prevalence of 46% (95% CI 44 to 48%, p < 0.001 across 9 studies). Sarcopenia was associated with an increased relative risk of fracture of 1.37 (95% CI 1.18 to 1.59, p < 0.001; 4 studies). Sarcopenic participants also exhibited significantly lower femoral neck bone mineral density (-0.07 g/cm², 95% CI -0.08 to -0.06; 5 studies) and lower T-scores (-0.34, 95% CI -0.46 to -0.23; 3 studies).

Why it matters

These findings quantify the strong co-occurrence of muscle loss and bone fragility in older adults, showing that sarcopenia significantly compounds fracture risk.

Limits

Prevalence rates varied substantially due to inconsistent diagnostic criteria and operational definitions for sarcopenia across studies. The fracture relative risk estimate was based on only four studies, and the abstract does not report participant demographics, study settings, or potential confounding adjustments.

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