Musculoskeletal integrity in aging – detecting risk and protective factors in bone health and osteoporosis

Osteoporosis is a global concern due to its clinical consequence, fracture, which results in pain, lost mobility and premature death.

This proposal is driven by the challenge to preserve musculoskeletal integrity and function in an ageing population.The questions remain “why do some elderly maintain skeletal integrity and are protected against fracture into old age?

Can protective factors be detected in the young?Our continued emphasis is detection of risk factors for osteoporosis and fragility fractures by exploring common pathogenic mechanisms linking bone, muscle and adipose tissue and delineation of gene-environment interactions to address knowledge gaps from genes to the clinic.We employ an integrated strategy: large, well characterised population-based cohorts of women with more than 10y longitudinal data; women fracture-free into the 90’s and 25yr olds with exceptional BMD; experimental animal models and imaging technology.We search for the missing genetic heritability contributing to skeletal regulation through epigenetics, GWAS & association studies.

We explore in-depth the contribution of sarcopenia and frailty to improve fracture prediction, and biomarkers as cause and consequence.Our studies bridge geriatrics and orthopaedics, to perform translational research whose outcome is practical clinical use and direct patient benefit; evidenced by nation-wide implementation of the person-centered standardized care-pathway for secondary fracture prevention.