Hip Fractures in Elderly Stroke Patients - The Role of Sarcopenia and Osteoporosis

Abstract

Both hip fractures and stroke are common in elderly patients and hip fractures are especially prevalent in elderly stroke patients. This literature review is an attempt to explore the evidence for strategies to reduce hip fractures in stroke patients, the role of sarcopenia and osteoporosis in causing them and current and potential management strategies. A narrative approach was adopted in reviewing the evidence available on hip fractures in stroke patients, with regard to their incidence and prevalence, the role of sarcopenia and osteoporosis in their genesis and the evidence available for hip fracture prevention in stroke patients. I also attempt to explore the potential role of targeting muscle and bone as one unit in future therapeutic strategies. Although there are encouraging results from clinical trials on therapeutic interventions to prevent hip fractures in stroke patients, larger, more robustly designed studies are needed to validate many of the findings. Some evidence exists that suggest that hip fractures risk can be reduced in stroke patients but the findings need validation in larger more robust trials. Moreover it is clear that sarcopenia and osteoporosis are implicated in hip fractures in stroke and non-stroke elderly patients. A consensus on the definition of sarcopenia would also aid clarification of findings from studies.