A Multifactorial Approach for Sarcopenia Assessment: A Literature Review

Abstract

Sarcopenia refers to a progressive and generalized weakness of skeletal muscle as individuals age. Sarcopenia usually occurs after the age of 60 years and is associated with a persistent decline in muscle strength, function, and quality. A comparison of the risk factors associated with sarcopenia based on the European Working Group on Sarcopenia (1 and 2) in Older People, the Asian Working Group for Sarcopenia (1 and 2), the International Working Group on Sarcopenia, and the Foundation for the National Institutes of Health revealed no consistent patterns. Accordingly, the identification of a single risk factor for sarcopenia is unpredictable due to its “multifactorial” pathogenesis, with the involvement of a multitude of factors. Therefore, the first aim of this review was to outline and propose that the multiple factors associated with sarcopenia need to be considered in combination in the design of new experimentation in this area. A secondary aim was to highlight the biochemical risk factors that are already identified in subjects with sarcopenia to assist scientists in understanding the biology of the pathophysiological mechanisms affecting the old people with sarcopenia. We also briefly discuss primary outcomes (physical) and secondary outcomes (social and financial) of sarcopenia. For future investigative purposes, this comprehensive review may be useful in considering important risk factors in the utilization of a panel of biomarkers emanating from all pathways involved in the pathogenesis of this disease. This may help to establish a uniform consensus for screening and defining this disease. Considering the COVID-19 pandemic, its impact may be exacerbated in older populations, which requires immediate attention. Here, we briefly suggest strategies for advancing the development of smart technologies to deliver exercise in the COVID-19 era in an attempt regress the onset of sarcopenia. These strategies may also have an impact on sarcopenia’s primary and secondary outcomes.

Home-Based Physical Activity as a Healthy Aging Booster before and during COVID-19 Outbreak

“…Sarcopenia . When the health status of older adults during the COVID-19 outbreak, characterized by sedentary behaviors, is taken into account, it puts older adults at higher risk of sarcopenia [ 90 ]. Regular levels of PA have been associated with reducing the detrimental effects of sarcopenia.…”

Strength training in elderly: An useful tool against sarcopenia

“…This condition mainly results from adaptive changes after a decrease in the physical activity level and may subsequently be counteracted by improving physical fitness (Fielding et al, 2017 ); however, senescence and genetic-related individual responses should not be omitted (Singh and Gasman, 2020 ). Thus, risk factors that determine this condition are multifactorial in nature and include genetic factors, sex, age, medical history, comorbidities, social factors and physical activity level (Supriya et al, 2021 ). This condition is aggravated if at the same time there is overweight or obesity.…”

“…It is worth noting that Fritzen et al ( 2020 ) showed how the ability to respond to strength exercise is comparable in young and older adults, with the deconditioning followed a similar time course. The general recommendations regarding physical activity are addressed to prevent mobility decline and involve a combination of resistance training and cardiovascular activities (Cruz-Jentoft et al, 2019 ; Fritzen et al, 2020 ; Singh and Gasman, 2020 ; Supriya et al, 2021 ). In the case of resistance training, the American College of Sport Science (ACSM) (Chodzko-Zajko et al, 2009 ) has suggested a training frequency ranging between 2 and 4 days weekly and a low training volume [60–80% of one-repetition maximum (1RM)] for major muscle groups, that it could be a good starting point but it should be “personalized” and if possible increased in intensity, volume and frequency.…”

Biomarkers of Frailty: miRNAs as Common Signatures of Impairment in Cognitive and Physical Domains

“…The identification of the above biological hallmarks has driven the research on the identification of circulating biomarkers whose screening, in association with a complete geriatric assessment, including cognitive and physical tests, can be helpful for a primary frailty diagnosis of the patient. Figure 3 [ 33 , 34 , 35 , 36 , 37 ] resumes the most common identified blood and biochemical markers of frailty covering different sets of physiological parameters, which includes inflammatory markers [ 38 ] oxidative markers [ 39 , 40 ], nutritional and metabolic markers, hematological markers, endocrine and immune markers [ 36 ].…”