Inserm UMR-S 1132 Bioscar, Université Paris Cité - Hôpital Lariboisiere, Paris, F-75010, France.
Clin Interv Aging. 2022 May 4;17:717-732. doi: 10.2147/CIA.S357501. eCollection 2022.
Aging represents a major concern, with a two-fold increase in individuals >65 years old by 2040. Older patients experience multiple declines in condition, with overlapping concerns. Fractures, frailty and falls remain underestimated events in routine practice. They are shared by numerous conditions and diseases, such as osteoporosis, sarcopenia and undernutrition, which mostly feature low evolution and are silent. In this review, we focused on musculoskeletal decline in older individuals who also have chronic kidney disease (CKD), which promotes fractures and falls. We aimed to highlight the need for a global approach for musculoskeletal and kidney aging. Although strategies limiting falls remain controversial, the need for an early diagnosis can limit these declines and allow for specific treatment of bone fragility in addition to non-pharmacological approaches. The emergence of senolytic agents offers new hope for preventing musculoskeletal disorders. This scoping review describes these overlapping silent diseases, provides evidence for their global understanding and management, and sheds light on new therapeutic directions.
老龄化是一个主要关注点,到 2040 年,65 岁以上的人口将增加一倍。老年患者的病情会出现多种衰退,且重叠问题较多。骨折、虚弱和跌倒在常规实践中仍然被低估。这些问题与许多疾病和病症有关,如骨质疏松症、肌肉减少症和营养不良,这些病症的进展通常较为缓慢,且悄无声息。在这篇综述中,我们重点关注患有慢性肾脏病(CKD)的老年患者的肌肉骨骼衰退,因为 CKD 会导致骨折和跌倒。我们的目的是强调需要对肌肉骨骼和肾脏衰老采取全面的方法。尽管限制跌倒的策略仍存在争议,但早期诊断的必要性可以限制这些衰退,并允许除了非药物治疗之外,还可以对骨脆弱性进行特异性治疗。衰老细胞清除剂的出现为预防肌肉骨骼疾病带来了新的希望。本范围综述描述了这些重叠的无声疾病,为其全球认识和管理提供了证据,并为新的治疗方向提供了启示。