Sarcopenia

Abstract

Sarcopenia, the loss of muscle mass and function with age, is highly relevant to clinical practice as it has been associated with a wide range of ageing outcomes including disability and shorter survival times. As such it is now a major focus for research and drug discovery. There has been recent progress in the development of consensus definitions for the diagnosis of sarcopenia, taking the form of measurements of muscle mass and strength or physical performance. These definitions form potential inclusion criteria for use in trials, although the optimum choice of outcome measures is less clear. Prevalence estimates using these new definitions vary, although they suggest that sarcopenia is a common (approximately 13% from one study) clinical problem in older people. A range of lifestyle factors have been investigated in regard to the development of this condition, and progressive resistance training is the most well-established intervention so far. There is also marked research interest in the role of diet, although so far the value of supplementation is less clear. Other potential treatments for sarcopenia include the angiotensin-converting enzyme inhibitors, with some evidence that they can improve physical performance in older people. Future research directions include an increased understanding of the molecular and cellular mechanisms of sarcopenia and the use of a life course approach to explore the possibility of earlier intervention and prevention. Arq Bras Endocrinol Metab. 2014;58(5):464-9 Keywords Sarcopenia; muscle mass; physical performance; aging ReSumoA sarcopenia, definida como a perda de função e massa muscular que ocorrem com a idade, é altamente relevante para a prática clínica, pois está associada a vários desfechos negativos, incluindo diminuição da funcionalidade e da sobrevida. Houve recente progresso no desenvolvimento de definições para o diagnóstico da sarcopenia, e estas atualmente se compõem tanto de medidas de massa e força muscular quanto do desempenho físico. Essas definições são potencialmente úteis como critérios de inclusão em pesquisas científicas, todavia a escolha de desfechos é menos clara. As estimativas de prevalência utilizando essas novas definições variam, mas elas sugerem que a sarcopenia é um problema clínico comum (cerca de 13% a partir de um estudo) em pessoas idosas. Uma série de fatores de estilo de vida foi investigada em relação ao desenvolvimento dessa condição, e o treinamento de resistência progressiva é a intervenção mais bem estabelecida até o momento. A intervenção dietética também foi aventada como um fator modificável, embora menos clara que a anterior. Outros tratamentos potenciais para sarcopenia incluem os inibidores da enzima conversora de angiotensina, com alguma evidência de que eles podem melhorar o desempenho físico em idosos. Pesquisas futuras que abordem uma maior compreensão dos mecanismos moleculares e celulares da sarcopenia, além de abordagens precoces que possam vir a modificar o surgimento da sarcopenia, são necessárias. Arq Bras E...

Effects of whey protein supplement in the elderly submitted to resistance training: systematic review and meta-analysis

“…It is highly relevant for clinical practice, since it is associated with various negative outcomes, including decreased functionality and survival [17]. Additionally, elderly go through losses in performing daily activities, resulting in increased risk of falls, fractures, disability, dependence, periodic hospitalizations and increased mortality [2,18].…”

“…In a review about sarcopenia Dodds and Sayer report that three points are essential in dietary treatment for sarcopenia: protein, vitamin D and antioxidants [17]. In a study on the protein intake requirement comparing older and younger men, the authors identified that the daily intake of protein to increase muscle protein synthesis is greater in the elderly than in adults [19].…”

Implications of Sarcopenia in Major Surgery

“…Sarcopenia, defined as the loss of skeletal muscle mass and strength, is associated with frailty, mortality, and poor outcomes in both surgical and nonsurgical patients 1 , 3 – 10 . Patients with sarcopenia are particularly vulnerable in the setting of major physiologic stressors such as major surgery or surgical complications.…”

“…Clinicians use several methods of risk assessment as they recommend a treatment plan. Most often, they identify risk using a subjective assessment of each patient's vigor and physiologic reserve 1 , 2 . Developing techniques to objectively measure the same characteristics that form the gestalt of the “eyeball test” may provide improved means of risk stratification that can be more easily communicated to patients 2 .…”

The role of sarcopenia in the risk of osteoporotic hip fracture

“…DXA is less expensive and can be almost as precise as those other two body image techniques in separating lean tissue from fat and bone keeping the exposure to radiation to a minimum. BIA is a technique that has been frequently used to measure muscle mass, and because it only requires a portable equipment, it constitutes a real alternative to DXA [4]. Anthropometry measures skinfold thickness and member circumferences in order to estimate body fat.…”