Addressing muscle and bone health proactively

Proactive prevention and early detection of risk factors and disease are essential in addressing the national burden of osteoporosis, the Irish Osteoporosis Society 2026 Annual Medical Conference heard.

Ms Anne-Marie Seddon, Senior Physiotherapist; and Ms Sinead Shanley, Dietitian Manager, Clontarf Hospital, Dublin, gave a joint presentation entitled ‘Sarcopaenia and bone health: Two sides of the same coin’. They noted how sarcopaenia (loss of muscle mass and strength) and osteoporosis (loss of bone density) form an interconnected ‘bone-muscle unit’.

When both conditions occur together, it is known as osteosarcopaenia. Because contracting muscles physically pull on bones to stimulate strength, weakening muscles directly accelerates bone loss and raises the risk of falls and fractures. So sarcopaenia is not just a falls risk – it is an early warning sign for osteoporosis.

Ms Seddon outlined the details of Clontarf Hospital’s sarcopaenia screening and treatment pathway. It is based on the European Working Group on Sarcopaenia in Older People (EWGSOP) algorithm for case finding, making a diagnosis and quantifying severity in practice. EWGSOP calls for healthcare professionals who treat patients at risk of sarcopaenia to take actions that will promote early detection and treatment in clinical practice.

The pathway in Clontarf Hospital was introduced following a successful pilot carried out in 2024, in which all patients over 65 years were screened for sarcopaenia using the EWGSOP guidelines, and a dietetic and physiotherapy intervention programme was implemented for those found to have sarcopaenia. This pathway is preventative, evidence-based, and cost-saving given the implications for fracture prevention, and is aligned with national bone health priorities, both presenters stressed.

Ms Shanley detailed the use of a higher protein diet for these patients and how the diet was introduced into a setting for older people to fit their tastes and the reality of the foods available.

While the current pathway in Clontarf Hospital is working well, it cannot determine bone mineral density, the presence of osteopaenia or osteoporosis, and the need for anti-resorptive or anabolic therapy. Thus, it is being updated to better address these needs.

“Our sarcopaenia pathway identifies patients at high musculoskeletal risk. And currently we are already treating the muscle. Given the strong epidemiological link between muscle loss and bone loss, probable sarcopaenia should prompt consideration of bone density assessment,” both presenters outlined.

“Early DXA scanning would help us identify osteopaenia or osteoporosis, initiate pharmacological treatment where appropriate, and reduce fractures, mortality, and long-term disability in a high-risk cohort.”