title: More than osteoporosis: age-specific issues in bone health.
abstract: OBJECTIVE
  The interaction between fall and fracture risk factors is an area of increasing clinical relevance, but little information is known about the age-specific issues in bone health unique to HIV-infected adults. The present review will focus on what is known about falls and fall risk factors among HIV-infected adults, and then review the association between decreased muscle, increased adiposity, and frailty with both low bone mineral density (BMD) and falls.
  
  
  RESULTS
  The rate of falls among middle-aged HIV-infected adults is similar to that of HIV-uninfected adults 65 years and older. Many of the clinical factors that contribute to low BMD overlap with risk factors for falls, resulting in a high risk of a serious fall among older adults with the greatest risk for a fracture. Low muscle mass, increased adiposity and metabolic syndrome, physical function impairment and frailty, common among older HIV-infected adults, contribute to an increased risk for low BMD and falls, and subsequently, may increase the risk of fracture among HIV-infected older adults.
  
  
  CONCLUSIONS
  Interventions with dual benefit on reducing fall risk and improving BMD are likely to have the greatest impact on fracture prevention in the older, HIV-infected adult.
authors.affiliation: aUniversity of Colorado, Aurora, Colorado, USA bUniversity of Modena and Reggio Emilia, Modena, Italy cMcGill University, Montreal, Quebec, Canada.
authors.forename: Kristine M
authors.initials: KM
authors.lastname: Erlandson
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
authors.forename: Julian
authors.initials: J
authors.lastname: Falutz
mesh_terms: D000058:Accidental Falls; D050154:Adiposity; D000368:Aged; D000369:Aged, 80 and over; D050723:Fractures, Bone / Q000453:epidemiology*; D015658:HIV Infections / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D009133:Muscular Atrophy / Q000150:complications*; D010024:Osteoporosis; D012307:Risk Factors