Sarcopenia: From definition to treatment

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH

The process of aging is associated with various structural and functional changes in the body. During aging, loss of muscle tissue and muscle mass make the individual bed bound and physically disabled. The term "sarcopenia" refers to loss of muscle mass, strength and function in older subjects. There are many theories like mitochondrial dysfunction, hormonal changes, decline in neural function, reduced satellite cell function, chronic inflammation support the process of sarcopenia in later life. Though, still the proper pathophysiology remains unclear in sarcopenia. There are various groups of criteria for defining sarcopenia like European Working Group on Sarcopenia Older People (EWGSOP), International Working Group on Sarcopenia (IWGS) and European Society for Clinical Nutrition and Metabolism-Special Interest Group (ESPEN-SIG), Asian Working Group for Sarcopenia (AWGS). Among these, AWGS criteria are mainly used for screening of Asian patients. Various non imaging and imaging techniques are also available for diagnosing sarcopenia. Mainly diet, nutrition and physical healthy lifestyle are needed to prevent sarcopenia. In physical therapy aerobic training, resistance training, group therapy, whole body vibration therapy are available for sarcopenia patients. Among these therapies, a combination of diet (protein, amino acids supplements) and endurance training are useful approach. The pathophysiology and diagnostic criteria could be useful to do early detection of the disease in geriatric populations. To reduce severity and avoid further progression of the disease proper treatment options are needed. Further researches are required to develop effective exercise regime for the treatment of sarcopenia.

The Aging Male, 2014

Geriatric Care, 2019

Sarcopenia is a major contributor to the risk of physical frailty, functional decline, poor health-related quality of life and premature death in older people. Sarcopenia can be considered a geriatric syndrome. The term sarcopenia indicates the loss of muscle mass that accompanies aging. Muscle mass declines with aging process with differences between subjects in relation to the presence of chronic diseases, to lifestyles habits (mainly diet and physical activity), to cognitive status. Sarcopenia in the elderly is associated with poor health outcomes, such as falls, disability, loss of independence, and mortality; however, it is potentially treatable if recognized and intervened early. The prevalence of sarcopenia rates between 5% and 13% in community-dwelling older people aged 65 years and over, and is higher in those 80 years and older (20-25%). The cause of sarcopenia is generally thought to be multifactorial, with environmental causes, disease triggers, inflammatory pathway acti...

Mechanisms of Ageing and Development, 2020

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Balneo and PRM Research Journal, 2022

Sarcopenia or degeneration of skeletal muscle tissue with aging, is responsible for functional de-cline and loss of independence in older adults. The purpose of this article is to review the current definitions of sarcopenia, its potential causes, clinical consequences and the potential for prop-hylactic and curative intervention. Sarcopenia is recognized as a major clinical problem for the elderly, and the research in this area is growing exponentially. One of the most important recent developments has been convergence in the operational definition of sarcopenia that combines muscle mass, strength and muscle function. In 2010, the European Working Group on Sarcopenia in Oder People (EWGSOP) published a definition of sarcopenia aimed at promoting progress in the identification and care of the elderly. In early 2018 (EWGSOP2) he met again to update the original definition to reflect the scientific and clinical evidence that has been built over the past decade. The cause of sarcopenia...

Turkish Journal of Geriatrics-Turk Geriatri Dergisi, 2013

ÖZ Kaslarda yaflla iliflkili olarak kitle, güç, kalite ve fonksiyon azalmas› olarak tan›mlanabilen sarkopeni multifaktöryel ve kompleks bir tablodur. Araflt›rmalar devam etmekte olup, sarkopeniye neden olan primer neden henüz tan›mlanamam›flt›r. Sarkopeni tan›s› için; kas kütlesi, kas gücü ve fiziksel performans›n de¤erlendirilmesi gerekmektedir. Sarkopeni olan hastalar› belirlemek için tan› kriterlerinin olmamas›, potansiyel tedavi seçeneklerini aksatmaktad›r. Moleküler fizyoloji alan›ndaki geliflmelerle birlikte iskelet kas›nda de¤ifliklik oluflturabilecek potansiyel ilaçlar tan›mlanmaya bafllam›flt›r. Ancak literatürdeki moleküller gerek yan etkileri gerekse kan›t eksiklikleri nedeniyle maalesef henüz beklentilerimizi karfl›layacak nitelikte de¤ildir. Farmakolojik tedavilerin mekanizmas›, etkinli¤i ve güvenli¤i ile ilgili veriler yetersizdir. Dirençli egzersizler ve nutrisyonel destek önleme ve tedavi aç›s›ndan faydal› olmaktad›r. Bu nedenle kifliye özel, gere¤inde toplum bazl›, ...

Chest, 1999

With aging, the heart, kidneys, liver, lungs, and brain lose mass. While not inherently impaired, the reserve capacity of the older individual to compensate for stress, metabolic derangement, and drug metabolism is increasingly limited. Functional disability occurs faster and takes longer to remediate, necessitating early preventive interventions.

Age and Ageing, 2010

The European Working Group on Sarcopenia in Older People (EWGSOP) developed a practical clinical definition and consensus diagnostic criteria for age-related sarcopenia. EWGSOP included representatives from four participant organisations, i.e. the European Geriatric Medicine Society, the European Society for Clinical Nutrition and Metabolism, the International Association of Gerontology and Geriatrics-European Region and the International Association of Nutrition and Aging. These organisations endorsed the findings in the final document. The group met and addressed the following questions, using the medical literature to build evidence-based answers: (i) What is sarcopenia? (ii) What parameters define sarcopenia? (iii) What variables reflect these parameters, and what measurement tools and cut-off points can be used? (iv) How does sarcopenia relate to cachexia, frailty and sarcopenic obesity? For the diagnosis of sarcopenia, EWGSOP recommends using the presence of both low muscle mass + low muscle function (strength or performance). EWGSOP variously applies these characteristics to further define conceptual stages as 'presarcopenia', 'sarcopenia' and 'severe sarcopenia'. EWGSOP reviewed a wide range of tools that can be used to measure the specific variables of muscle mass, muscle strength and physical performance. Our paper summarises currently available data defining sarcopenia cut-off points by age and gender; suggests an algorithm for sarcopenia case finding in older individuals based on measurements of gait speed, grip strength and muscle mass; and presents a list of suggested primary and secondary outcome domains for research. Once an operational definition of sarcopenia is adopted and included in the mainstream of comprehensive geriatric assessment, the next steps are to define the natural course of sarcopenia and to develop and define effective treatment.

Age and Ageing, 2013

Journal of Applied Pharmaceutical Science