Early Detection, Timely Care: Taiwan Launches New Initiative to Target Osteoporosis and Sarcopenia
As of December 2024, Chiayi County had a total population of 478,786, of which 111,064 were aged 65 and above. This means older adults account for 23.2% of the population —the highest proportion in Taiwan. This rapid demographic shift poses major healthcare challenges, especially in managing age-related conditions such as osteoporosis and sarcopenia.
Both conditions pose a major threat to older adults’ health and quality of life. Research shows that bone mass begins to decline in both men and women after the age of 40, while muscle mass decreases by about 8% per decade after 30, accelerating to 15% per decade after 70. The combined impact of bone and muscle loss increases the risks of fractures, frailty, disability, and long-term dependence.
To address this urgent issue, the Chiayi County Public Health Bureau launched the “Smart Liaison Care for Osteoporosis and Sarcopenia” programme in April 2023. This localised and community-based initiative aims to identify high-risk individuals early, provide timely interventions, and help residents maintain a good quality of life, supporting the vision of “Peace of mind in Chiayi”.
The programme is spearheaded by the Chiayi County Public Health Bureau in partnership with healthcare organisations, public health centres, academic institutions, technology companies, and mobile medical units. By creating a comprehensive medical and health service network, the initiative has set a benchmark for proactive and preventive elderly care. In recognition of its innovation and effectiveness, it was selected for the Government Service Award in 2025, currently under evaluation.
Dr Ding-Cheng Chan, MD, PhD, Superintendent of National Taiwan University Hospital Bei-Hu Branch and clinical Professor of Department of Internal Medicine, College of Medicine, National Taiwan University, Co-Chair of the Asia Pacific Fragility Fracture Alliance, Capture the Fracture® Mentor stated: “Early detection and proactive management of osteoporosis and sarcopenia are essential for healthy aging. Chiayi’s integrated approach is a model that can inspire similar initiatives globally.”
Another important milestone has been the programme’s success in encouraging hospitals to obtain Fracture Liaison Service (FLS) certification through the Capture the Fracture® programme. This strategy, aligned with efforts to promote international standards, strengthens the quality of care and ensures that high-risk patients receive continuous follow-up to prevent re-fractures. As of August 2025, 18 public health centres have joined the programme, marking a significant step forward in building a coordinated, high-quality fracture prevention network. This momentum not only raises the benchmark for patient care across the region but also sets a model for other healthcare systems aiming to reduce the burden of osteoporotic fractures.
A key element of the programme is the expansion of DXA and sarcopenia screening. To enhance accessibility and participation, the following strategies have been adopted:
- Incorporating DXA and sarcopenia screening into community-based comprehensive health checkups, allowing residents to complete multiple assessments in a single visit.
- Introducing AI-assisted image interpretation and smart management systems to improve efficiency and follow-up accuracy.
- Establishing a referral mechanism to healthcare organizations to ensure individuals with abnormal results receive timely diagnosis and treatment.
- Launching “High-Risk Osteoporosis and Sarcopenia Exercise and Nutrition Classes” that combine physical activity guidance with nutrition education to engage and empower the public.
Despite the initiative’s successes, low public awareness of osteoporosis and sarcopenia remains a major challenge for the region. To address this, the team has made significant efforts to boost awareness through social media campaigns and community events. Another barrier is limited screening participation in remote areas due to transportation difficulties. In response, the team has introduced mobile medical buses equipped with DXA and other screening devices, bringing services directly to communities. The initiative also faced the challenge of integrating diverse resources across sectors. Their current proposal is to develop a unified Osteoporosis and Sarcopenia Liaison Care Platform to standardise data management, streamline referral processes, and ensure consistent follow-up.
Wen-Hua Chao, Deputy Director-General of Chiayi County Health Bureau, noted: “By combining awareness campaigns, mobile screening, and a unified care platform, Chiayi is building a model that not only reaches more people but also ensures they receive continuous, coordinated care.”
Currently, the initiative primarily targets individuals aged 65 and above. However, plans are underway to expand eligibility to include those aged 50 and older, allowing earlier detection of bone and muscle decline. Furthermore, Chiayi’s smart integrated care model is expected to be promoted in other counties and cities, laying the groundwork for a nationwide prevention and care network that can better address the challenges of an aging society.
