Sarcopenia and Frailty are two age-related syndromes. Both of them in their uniqueness are related with negative outcomes for the individual – in physical and mental aspect. Through the daily clinical practice, many health professionals encounter a provocative resemblance between the two –undeniably- geriatric syndromes. But the essence of the question that is set to be answered is if it’s so important to discriminate between those two syndromes, since they share several common features. Following there is a description of the fundamental characteristics ofthe syndromes - “building” a certain phenotype, and a series of related evaluations for the identification of these characteristics. The segregation between the two syndromes might be difficult to be understood but the attempt for perceiving the concept of sarcopenia and frailty is the keystone for a substantial diagnosis and a successfully designed therapeutic approach.

The incidence of falls is increasing proportionally with age and is related with high rates of disability and frailty. Falls are considered the leading cause of death in the elderly and are often multifactorial in origin. They are also linked with older adults losing their confidence and independency. Furthermore they are associated with increased funding spent for hospital extended stays, carer time and absence from work. Taking into account that the population is ageing, thus the number of people older than 65 will increase considerably in the near future, it is easy to understand that costs are really likely to increase further. It is therefore important to address that problem and instead of focusing especially on treatment to concentrate on prevention as well.

Hip fractures are serious fractures in the upper quarter of the femur bone. The underlying cause of most of them is osteoporosis. Biphosphonates are the most commonly prescribed drugs used to treat osteoporosis worldwide. However, there are concerns as to whether their use can cause problems with the healing of hip fractures and if so, is the timing of their initiation and the duration of their application important? The purpose of this systematic review was to answer the above questions. A literature search was conducted, with the use of the PubMed, Google Scholar and Cochrane databases. The abstracts of all potentially relevant studies, were extensively examined. All of them referred to the biphosphonate treatment, the duration of healing and/or the non-union rates of hip fractures, were included to the study. Biphosphonates, were found to affect hip fracture healing, when applied prior to the fracture and to have no effect on healing process, when applied after the fracture event. There was no statistically significant correlation between treatment duration and union time. There is a need of additional studies to investigate the effects of biphosphonates on hip fracture healing. These studies need to be focused on healing time, non-union rates and the duration of treatment.

Being given the characterization of the two sides of the same coin, sarcopenia and frailty, represent two geriatric syndromes that concern a great number of elder population. The impact of these pathological states on the health status of the individual is well-established through associated scientific papers and is encountered by health professionals through their daily clinical practice. Given that fact that both geriatric syndromes target both physical and mental aspects of an individual, the need for improving the treating methodologies of sarcopenia and frailty, is of great importance. The following paper provides key pointers to the reader regarding the effects an individual will have, after the adherence to a program including a variety of physical activities.

Purpose: The influence of regular exercise on bone properties is not well defined. Frail subjects have limitations to perform exercise with skeletal impact. This study aims to analyze whole-bone vibration treatment (WBV) as an enhancer of bisphosphonate effects in postmenopausal frail women with osteopenia/osteoporosis. Methods: Fiftythree postmenopausal sedentary osteopenic women were treated during 12 months with a drinkable alendronate (ALN) formulation. By randomization, 21 of them underwent a WBV (15-min sessions, 3 days per week) as an additional treatment. The serum C-terminal telopeptide of type I collagen (CTx) and total alkaline phosphatase (TAP) were determined at 0, 6 and 12 months of ALN therapy. In subgroups of 19/13 women, peripheral quantitative computerized tomography (pQCT) was applied at the tibia mid shaft to determine the volumetric BMD of cortical bone (CtBMDv) and the polar strain-strength index (SSIp). Results: CTx levels fell significantly deeper in the WBV subgroup (-39.3% and -30.3%, respectively, p<0.01), suggesting that in these women WBV promotes a greater effect of ALN on bone resorption inhibition. Basal CtBMDv and SSIp values were similar in both groups and were weakly (negatively) associated with basal CTx values. After treatment, the correlation between CtBMDv or SSIp values with CTx values were also weak and negative in the Sedentary subgroup but become positive and closer in the WBV subgroup. Conclusions: Vibration treatment enhanced the ALN-induced inhibition of bone resorption and may affect positively bone properties. Protracted treatments should show whether this trend is maintained as to effectively reduce the incidence of falls and skeletal fractures in frail subjects.

The cortical bone is a hierarchically organised biocomposite tissue ranging from the nanoscopic to the macroscopic scale. The present paper is concerned with the new morphological observations of human femoral cortical bone at the nanostructural/submicrostructural levels of older patients. The objective of this study is to verify and refine the descriptions of nanostructures and submicrostructures in selected localities of the human femoral diaphyses by the scanning electron microscope - Quanta 450 with the ETD detector. The great interest has been focused on identifying the orientations of basic structural domains of bones at each of their structural levels. The bearing structural domains are composed and oriented not only to effectively resist localized mechanical stresses/strains, but to promote uniform dissipations of energy of deformation into lower structural levels of tissue. As the domains of the 2^nd structural level are mineralized nanofibrils, then dominant domains of the 3^rd structural level are layered nanoshalls, creating the mineralized cylindrical columns, i.e. mineralized microfibres. Each mineralized nanoshell is composed of parallel oriented mineralized nanofibrils (nanorods). The nano/substructural elements are formed (during the bone remodeling) under the influence of the dominant biomechanical effects as are torsional micromoments, microforces in tension and/or in compression.

The surgical procedure of total hip replacement is one of the most successful operations in the medical field today. Being introduced back in 1960, THR represents the eradication of the present degradation. Post-surgically, there are some functional precautions that should be followed during the RHB plan as well an increased danger of occurrence of falling incidence. During the RHB plan, which should be followed after the total hip replacement operation, the inclusion of a diagnostic as well therapeutic intervention regarding fallings is of major importance.

Objective: Corridor tests (CT) are validated tools used to measure the effects of rehabilitation interventions in frail elderly subjects. Recently the six-minute walk test (6MWT) was introduced in the assessment of frail individuals. The purpose of this study was to investigate the use of the 6MWT as a tool for measurement the functional capacity and mobility in different frail populations with chronic heart failure (CHF). Methods: In this study 6MWT was applied in seventy-five (n=75) individuals randomized into two training groups for a 12^th week period; group A (n=38) performed high-intensity aerobic interval training (HIAIT), while group B (n=37) fulfilled moderate intensive continuous training (MICT), for measuring the impact in the effectiveness in two different intensity cardiac rehabilitation (CR) interventions in patients with CHF. Results: The data indicate that the average six-minute walk distance (6MWD) in both groups (HIAIT and MICT) before the start of the CR programs was no statistically significant between them (p>0.05). A significant increase in the 6MWD in both CR groups was found after the final of 12-week of CR program (p<0.001). The increase obtained in HIAIT group was higher than the increase observed in MICT group (14.53% vs. 10.6%, respectively). Conclusion: The 6MWT is a safe tool for assessing the effectiveness of CR interventions on functional capacity and mobility in different frail populations with CHF.