Populations are ageing and obesity rates are increasing in developed nations. Obesity is associated with higher muscle and bone mass, but poorer muscle function and quality. As we age, muscle and bone mass decline alongside physical function, leading to increased rates of osteoporosis and sarcopenia. Age-related body composition and musculoskeletal changes have important implications for numerous public health issues, including falls and fall-related injuries, fractures, type 2 diabetes and cardiovascular disease.
Several pharmacological interventions are effective in treating osteoporosis, although none have been approved for treating sarcopenia. The most effective lifestyle interventions for improving musculoskeletal health include exercise, particularly progressive resistance training and weight-bearing impact exercise, and consuming a well-balanced diet containing adequate amounts of protein, vitamin D and calcium, which may also be achieved through multi-supplement interventions. Primary management of obesity generally includes weight loss through caloric restriction, which can be facilitated by pharmacological interventions (e.g., incretin mimetics) and endoscopic bariatric therapies. Clinically meaningful weight loss results in significant loss of muscle and bone mass and has been associated with an increased incidence of fractures in older adults.
Engaging in resistance and impact training programs, while ensuring adequate intakes of key nutrients during caloric restriction, can reduce weight loss-related declines in muscle and bone mass and therefore potentially minimising subsequent fracture risk. Our research has also shown that performing resistance and impact training during caloric restriction is effective at increasing physical performance in older adults with obesity.
This presentation will highlight how obesity and weight loss can contribute to poor musculoskeletal health in older adults and discuss established and emerging evidence-based interventions for managing these risks.