Abstract :
Objective: The aim of this review of the literature is to report the factors which both contribute to the
frailty syndrome and increase hip fracture risk in the elderly. This work is the fruit of common reflection by
geriatricians, endocrinologists, gynecologists and rheumatologists, and seeks to stress the importance of detection
and management of the various components of frailty in elderly subjects who are followed and treated for
osteoporosis. It also sets out to heighten awareness of the need for management of osteoporosis in the frail
elderly. Design: The current literature on frailty and its links with hip fracture was reviewed and discussed by the
group. Results: The factors and mechanisms which are common to both osteoporosis and frailty (falls, weight
loss, sarcopenia, low physical activity, cognitive decline, depression, hormones such as testosterone, estrogens,
insulin-like growth factor-I (IGF-I), growth hormone (GH), vitamin D and pro-inflammatory cytokines) were
identified. The obstacles to access to diagnosis and treatment of osteoporosis in the frail elderly population and
common therapeutic pathways for osteoporosis and frailty were discussed. Conclusion: Future research including
frail subjects would improve our understanding of how management of frailty can can contribute to lower the
incidence of fractures. In parallel, more systematic management of osteoporosis should reduce the risk of
becoming frail in the elderly population
