Prävention und Behandlung der Kachexie

Background Peak oxygen uptake (peak VO 2 ) is known not only as an index of aerobic fitness but also one of an index of life expectancy. Frailty, sarcopenia, and cachexia are associated with a poor prognosis and high mortality. The purpose of this study was to determine the relationships of peak VO 2 with the features of sarcopenia, frailty, and cachexia, to provide insight into which might mediate the poor prognosis. Methods The first group of participants was 175 community-dwelling older Japanese outpatients (58 men and 117 women; mean age 77.6 ± 6.4 years), in whom we assessed the features of sarcopenia, frailty, and cachexia, and measured peak VO 2 during cardiopulmonary exercise. To confirm the relationships, we analysed another group of 162 participants (77.3 ± 5.5 years). Results There were significant correlations between peak VO 2 and the features of sarcopenia, frailty, and cachexia, with the exception of high sensitivity C-reactive protein. Multiple linear regression analysis for the prediction of peak VO 2 (mL/min) identified following formula: predicted peak VO 2 = À11.6 × age (years) + 25.5 × haemoglobin concentration (g/dL) + 114.2 × skeletal muscle mass index (kg/m 2 ) + 8.9 × hand grip strength (kg) + 226.4 × usual walking speed (m/s) À 65.8 × fatiguability (absence 0, presence 1) À 177.4 × chronic heart failure (absence 0, presence 1) + 437.1 (R 2 = 0.627, P < 0.001). The validity of the formula was confirmed with another group (r = 0.78, P < 0.001). Conclusions This study has identified the features of sarcopenia, frailty, and cachexia that are related to peak VO 2 in an older population.

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Sarcopenia

Keller

2018

Wien Med Wochenschr

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Sarcopenia is a very common, but frequently overlooked and undertreated geriatric syndrome comprising pronounced muscle mass and strength/performance loss. Estimated prevalence is between 5 and 40% in the general population, accompanied by an exponential incline with increasing age. Sarcopenia is connected to atrophy and loss of muscle fibers and motor units, affecting primarily the fast-twitch muscle fibers und their motor units. Fast-twitch muscle fibers seem to be more prone to failure of function and loss over time. Main causes for the development of sarcopenia are hormonal changes (reduced release of testosterone, estrogen, and growth hormone), nutritional deficiencies, chronic inflammation, and particularly a decrease in physical activity due to sedentary lifestyle with advancing age. Treatment options for sarcopenia comprise an active lifestyle with physical activity and exercise training, modifications of nutritional intake, and pharmacological therapies. Strength training and an adequate nutritional intake form the basis of successful sarcopenia treatment.

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Prävention und Behandlung der Kachexie

Cited by 3 publications

References 41 publications

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Peak oxygen uptake correlates with indices of sarcopenia, frailty, and cachexia in older Japanese outpatients

Sarcopenia

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