Advertisement

The New Science of Musculoskeletal Aging in Bone, Muscle, and Tendon/Ligament

  • Vonda J. WrightEmail author
  • Farah Tejpar
Chapter

Abstract

As the body ages, changes are seen throughout the musculoskeletal system, namely, within bone, muscle, tendons, and ligaments. An age-related decrease in bone mineral density (BMD), or primary osteoporosis, is defined by the World Health Organization as having a hip or spine BMD of at least 2.5 standard deviations below the mean of young, healthy women measured on dual X-ray absorptiometry. Sarcopenia, or age-related muscle loss, begins at approximately 40 years of age and is more prevalent in the sedentary population. Intrinsic and extrinsic factors associated with aging affect tendon and ligament strength, thus leading to more injuries and prolonged healing time. These changes in the musculoskeletal system can lead to significant disability, thus increasing healthcare costs. Prevention is focused on adequate nutrition, supplements, physical activity, and strength training.

Keywords

Osteoporosis Fragility fracture Dual-energy X-ray absorptiometry Sarcopenia Tendinopathy 

References

  1. 1.
    Kanis JA. Diagnosis of osteoporosis and assessment of fracture risk. Lancet. 2002;359:1929–36.CrossRefPubMedGoogle Scholar
  2. 2.
    National Osteoporosis Foundation. Physician’s guide to prevention and treatment of osteoporosis. http://www.nof.org/professionals/Clinicians_Guide.htm. 1 Apr 2014.
  3. 3.
    Kohrt WM, Bloomfield SA, Little KD, Nelson ME, Yingling VR, American College of Sports Medicine. American College of Sports Medicine Position Stand: physical activity and bone health. Med Sci Sports Exerc. 2004;36(11):1985–96.CrossRefPubMedGoogle Scholar
  4. 4.
    Syed F, Hoey K. Integrative physiology of the aging bone: insights from animal and cellular models. Ann N Y Acad Sci. 2010:95–106.CrossRefPubMedGoogle Scholar
  5. 5.
    Carrington JL. Aging bone and cartilage: cross-cutting issues. Biochem Biophys Res Commun. 2005;328:700–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Almeida M, O’Brien C. Basic biology of skeletal aging: role of stress response pathways. J Gerontol A Biol Sci Med Sci. 2013;68:1197–208.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Prevention and management of osteoporosis: report of a WHO Scientific Group. Geneva, Switzerland; 2003. http://whqlibdoc.who.int/trs/WHO_TRS_921.pdf. Accessed 7 Dec 2008.
  8. 8.
    Kanis JA, Gluer CC, for the Committee of Scientific Advisors, International Osteoporosis Foundation. An update on the diagnosis and assessment of osteoporosis with densitometry. Osteoporos Int. 2000;11:192–202.Google Scholar
  9. 9.
    U.S. Department of Health and Human Services. Bone health and osteoporosis: a report of the surgeon general (2004). http://www.surgeongeneral.gov/library/bonehealth/content.html. Accessed 7 Dec 2008.
  10. 10.
    Marcus R, Wong M, Heath H III, Stock JL. Antiresorptive treatment of postmenopausal osteoporosis: comparison of study designs and outcomes in large clinical trials with fracture as an endpoint. Endocr Rev. 2002;23(1):16–37.CrossRefPubMedGoogle Scholar
  11. 11.
    MacLean C, Newberry S, Maglione M, et al. Systematic review: comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis. Ann Intern Med. 2008;148(3):197–213.CrossRefPubMedGoogle Scholar
  12. 12.
    Turner CH, Robling AG. Designing exercise regimens to increase bone strength. Exerc Sport Sci Rev. 2003;31:45–50.CrossRefPubMedGoogle Scholar
  13. 13.
    Leigey D, Irrgang J, Francis K, et al. Participation in high-impact sports predicts bone mineral density in senior olympic athletes. Sports Health. 2009;1:508–13.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    NIH Consensus Conference: Optimal calcium intake: NIH consensus development panel on optimal calcium intake. JAMA. 1994;272:1942–1948.Google Scholar
  15. 15.
    Bischoff-Ferari HA, Willett WC, Wong JB, et al. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA. 2005;293:2257–64.CrossRefGoogle Scholar
  16. 16.
    Mitchell WK, Williams J, Atherton P, et al. Sarcopenia, dynapenia, and the impact of advancing age on the human skeletal muscle size and strength; a quantitative review. Front Physiol. 2012;3:260.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Janssen I, Shepard DS, Katzmarzyk PT, et al. The health care cost of sarcopenia in the United States. J Gerontol. 2004;52:80–5.Google Scholar
  18. 18.
    Faulkner JA, Larkin LM, Claflin DR, et al. Age-related changes in the structure and function of skeletal muscles. Clin Exp Pharmacol Physiol. 2007;34:1091–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Horstman AM, Dillon EL, Urban RJ, et al. The role of androgens and estrogens on healthy aging and longevity. J Gerontol. 2012;67:1140–52.CrossRefGoogle Scholar
  20. 20.
    Larsson L, Karlsson J. Isometric and dynamic endurance as a function of age and skeletal muscle characteristics. Acta Physiol Scand. 1978;104:129–36.CrossRefPubMedGoogle Scholar
  21. 21.
    Siparsky P, Kirkendall D, Garrett W. Muscle changes in aging: understanding sarcopenia. Sports Health. 2014;6:36–40.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Cesari M, Fielding R, Pahor M, et al. Biomarkers of sarcopenia in clinical trials- recommendations from the international working group on sarcopenia. J Cachexia Sarcopenia Muscle. 2012;3:181–90.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Goodpaster BH, Parks SW, Harris TB, et al. The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. J Gerontol. 2006;61:1059–64.CrossRefGoogle Scholar
  24. 24.
    Castaneda C, Charnley JM, Evans WJ, et al. Elderly women accommodate to a low-protein diet with losses of body cell mass, muscle function, and immune response. Am J Clin Nutr. 1995;62:30–9.CrossRefPubMedGoogle Scholar
  25. 25.
    Fiatarone MA, Marks EC, Ryan ND, et al. High-intensity strength training in nonagenarians. Effects on skeletal muscle. JAMA. 1990;263:3029–34.CrossRefPubMedGoogle Scholar
  26. 26.
    Frontera WR, Meredith CN, O’Reilly KP, et al. Strength and conditioning in older men: skeletal muscle hypertrophy and improved function. J Appl Physiol. 1988;64:1038–44.CrossRefPubMedGoogle Scholar
  27. 27.
    American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc. 1998;30:975–91.Google Scholar
  28. 28.
    Frizziero A, Vittadini F, Gasparre G. Impact of oestrogen deficiency and aging on tendon: concise review. Muscles Ligaments Tendons J. 2014;4:324–8.PubMedPubMedCentralGoogle Scholar
  29. 29.
    McCarthy M, Hannafin J. The mature athlete: aging tendon and ligament. Sports Health. 2014;6:41–8.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Shwartz Y, Blitz E, Zelzer E. One load to rule them all: mechanical control of the musculoskeletal system in development and aging. Differentiation. 2013;86:104–11.CrossRefPubMedGoogle Scholar
  31. 31.
    Chard MD, Cawston TE, Riley GP, et al. Rotator cuff degeneration and lateral epicondylitis: a comparative histological study. Ann Rheum Dis. 1994;53:30–4.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Fu SC, Chan BP, Wang W, et al. Increased expression of matrix metalloproteinase 1 (MMP1) in 11 patients with patellar tendinosis. Acta Orthop Scand. 2002;73:658–62.CrossRefPubMedGoogle Scholar
  33. 33.
    Lavagnino M, Arnoczky SP. In vitro alterations in cytoskeletal tensional homeostasis control gene expression in tendon cells. J Orthop Res. 2005;23:1211–8.CrossRefPubMedGoogle Scholar
  34. 34.
    Hasegawa A, Otsuki S, Pauli C, et al. Anterior cruciate ligament changes in the human knee joint in aging and osteoarthritis. Arthritis Rheum. 2012;64:696–704.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Woo SL, Hollis JM, Adams DJ, et al. Tensile properties of the human femur-anterior cruciate ligament-tibia complex. The effects of specimen age and orientation. Am J Sports Med. 1991;19:217–25.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryUniversity of Pittsburgh, UPMC Lemieux Sports ComplexPittsburghUSA
  2. 2.Cleveland ClinicWestonUSA

Personalised recommendations