title: Frailty, osteoporosis and hip fracture: causes, consequences and therapeutic perspectives.
abstract: OBJECTIVE
  The aim of this review of the literature is to report the factors which both contribute to the frailty syndrome and increase hip fracture risk in the elderly. This work is the fruit of common reflection by geriatricians, endocrinologists, gynecologists and rheumatologists, and seeks to stress the importance of detection and management of the various components of frailty in elderly subjects who are followed and treated for osteoporosis. It also sets out to heighten awareness of the need for management of osteoporosis in the frail elderly.
  
  
  METHODS
  The current literature on frailty and its links with hip fracture was reviewed and discussed by the group.
  
  
  RESULTS
  The factors and mechanisms which are common to both osteoporosis and frailty (falls, weight loss, sarcopenia, low physical activity, cognitive decline, depression, hormones such as testosterone, estrogens, insulin-like growth factor-I (IGF-I), growth hormone (GH), vitamin D and pro-inflammatory cytokines) were identified. The obstacles to access to diagnosis and treatment of osteoporosis in the frail elderly population and common therapeutic pathways for osteoporosis and frailty were discussed.
  
  
  CONCLUSIONS
  Future research including frail subjects would improve our understanding of how management of frailty can can contribute to lower the incidence of fractures. In parallel, more systematic management of osteoporosis should reduce the risk of becoming frail in the elderly population.
authors.affiliation: Inserm U558, F-31073, Université de Toulouse III, France. rolland.y@chu-toulouse.fr
authors.forename: Y
authors.initials: Y
authors.lastname: Rolland
authors.forename: G
authors.initials: G
authors.lastname: Abellan van Kan
authors.forename: A
authors.initials: A
authors.lastname: Bénétos
authors.forename: H
authors.initials: H
authors.lastname: Blain
authors.forename: M
authors.initials: M
authors.lastname: Bonnefoy
authors.forename: P
authors.initials: P
authors.lastname: Chassagne
authors.forename: C
authors.initials: C
authors.lastname: Jeandel
authors.forename: M
authors.initials: M
authors.lastname: Laroche
authors.forename: F
authors.initials: F
authors.lastname: Nourhashémi
authors.forename: P
authors.initials: P
authors.lastname: Orcel
authors.forename: F
authors.initials: F
authors.lastname: Piette
authors.forename: C
authors.initials: C
authors.lastname: Ribot
authors.forename: P
authors.initials: P
authors.lastname: Ritz
authors.forename: C
authors.initials: C
authors.lastname: Roux
authors.forename: J
authors.initials: J
authors.lastname: Taillandier
authors.forename: F
authors.initials: F
authors.lastname: Trémollières
authors.forename: G
authors.initials: G
authors.lastname: Weryha
authors.forename: B
authors.initials: B
authors.lastname: Vellas
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D016330:Frail Elderly; D006620:Hip Fractures / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D009133:Muscular Atrophy / Q000453:epidemiology* / Q000517:prevention & control; D010024:Osteoporosis / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D012307:Risk Factors; D013577:Syndrome; D015431:Weight Loss