The social context of osteosarcopenia: Risk factors and social impact

This multidisciplinary chapter discusses the social context of osteosarcopenia: often a neglected area of consideration for this geriatric condition. It begins by discussing the evidence regarding associations between social conditions and lifestyle risk factors for osteosarcopenia. It then argues that lifestyle risk factors during childhood and adolescence may predispose individuals to present with this geriatric condition later in life. The notion of lifecourse accumulation for osteosarcopenia risk is further explored as a conceptual model based on the psychosocial and lifestyle-related exposures beginning in utero and continuing across the lifespan. This social-biological model posits how relationships between social factors, adversity, psychological stress, inflammation, adaptation, and changes to the epigenetic signature over the lifecourse may contribute to the development of osteosarcopenia in later life. Evidence regarding a key role for health literacy in osteosarcopenia risk, prevention, and treatment is presented. Finally, a discussion of the social impact of osteosarcopenia, including identity and social isolation, brings the chapter to a close.