Osteosarcopenia: The Link Between Bone and Muscle Loss

Take back the power! YOU are in charge of protecting your strength as you age.

Aging gracefully is not just about looking good, aging well is about staying strong, mobile, and independent. Osteosarcopenia, a condition that combines bone loss (osteoporosis or osteopenia) with muscle loss (sarcopenia) can silently undermine your ability to stay strong and active.

YOU are in charge of protecting your strength as you age. While osteosarcopenia is common in older adults, especially postmenopausal women, it is not inevitable. With the right strategy, focused on exercise, nutrition, and early action, you can protect your bone and muscle strength for years to come.

Understanding Osteosarcopenia

Osteosarcopenia happens when two age-related changes occur at the same time.

  • Osteoporosis or osteopenia: Reduced bone mineral density weakens bones, making them more prone to fractures.

  • Sarcopenia: Loss of muscle mass and strength affect balance and mobility.

Because bone and muscle work together – muscles pull on bones to move us – weakness in one accelerates decline in the other. The result is a higher risk of falls, fractures, and loss of independence.

Causes and risk factors affecting osteosarcopenia

Both primary factors (those you cannot change) and secondary risk factors (those you can) play a role in causing loss of bone and muscle.

Genetics: Family history of osteoporosis or hip fracture indicates weakness in bone strength.

Hormonal changes:  Menopause, low testosterone, and reduced growth hormone accelerate bone and muscle loss.

Nutrient deficiencies: Lack of calcium, vitamin D, or protein weakens both systems.

Sedentary lifestyle: Without strength training, bones and muscles lose mass faster.

Chronic conditions: Diabetes, rheumatoid arthritis, and some cancers increase risk.

Medications: Long-term steroid use or certain cancer treatments can affect bone density.

Osteosarcopenia symptoms and early warning signs

Osteosarcopenia develops slowly, often without obvious symptoms. Early detection is key. By the time a fracture occurs, bone loss is already advanced. Look for:

  • Gradual loss of muscle strength

  • Decreased balance and mobility – trouble climbing stairs

  • Bone fractures from minor falls or bumps

  • Posture changes, stooping, or loss of height

  • Fatigue and slower recovery after physical activity

Medical testing and diagnosis of osteosarcopenia

Take action with evidence-based diagnosis and treatment. Know your scores and see how you measure up. Your results drive your action plan.

DEXA scan for bone mineral density

REMS technology (newer, radiation-free option)

Muscle mass measurement (bioelectrical impedance, MRI, CT scan)

Functional strength tests (grip strength, chair rise test)

Osteosarcopenia Action Plan: prevention strategies you can start today

Even small changes, done consistently, can stabilize bone density, improve muscle mass, and protect your independence for decades.

1) Get tested

Schedule a DEXA scan (or REMS if available) to measure your bone density and ask your doctor about muscle strength and balance testing.

2) Move with purpose

Research consistently shows that strength training and weight-bearing activities help both bones and muscles grow stronger. In order to allow them to adapt, use an exercise plan of progressive overload, meaning you gradually increase the weight or impact.

Aim for at least 2-3 strength sessions per week, plus daily walking or other weight-bearing cardio.

  • Step-ups, squats, lunges

  • Resistance band exercises

  • Walking or light jogging for bone impact

3) Fuel your strength

Protein is the powerhouse for muscle; calcium helps mineralize the bone; Vitamin D directs the calcium into the bones.

  • Protein: Incorporate protein at every meal to support muscle repair. Enjoy eggs, dairy, fish, lean meats, legumes.

  • Calcium: 1000-1200 mg/day (from diet and supplements). Think dairy, leafy greens, fortified milk plants.

  • Vitamin D: As recommended by your doctor based on blood levels. Get it from sunlight, fatty fish, and fortified foods.

4) Guard against falls

Many factors can lead to a fall: poor balance, weak muscles, vision problems, alcohol use, and hazards in the home. Improve balance with exercises like stork stance, heel-to-toe walking, yoga, or tai chi. Keep floors clutter-free and ensure good lighting at home.

5) Check in regularly

Reassess your muscle and bone health every 1-2 years. Adjust your exercise and nutrition plan with guidance from a healthcare professional.

Osteosarcopenia is a dual loss of bone and muscle, increasing fall and fracture risk. Exercise and nutrition are two of the strongest tools for prevention and management of this condition. It’s never too early or too late to start taking control. Strength and balance gains are possible at any age, and starting now reduces your future risk of falls and fractures.

Disclaimer: The information presented in this article should not be construed as medical advice. It is not intended to replace consultation with your physician or healthcare provider.

For expert guidance on strength training techniques, step by step photos depicting how to perform the exercises, and a selection of well-rounded workouts please check out the book Strength Training Exercises for Women by Joan Pagano.

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