Respiratory Sarcopenia and Sarcopenic Respiratory Disability: Concepts, Diagnosis, and Treatment

Abstract

The condition of muscle fiber atrophy and weakness that occurs in respiratory muscles along with systemic skeletal muscle with age is known as respiratory sarcopenia. The Japanese Working Group of Respiratory Sarcopenia of the Japanese Association of Rehabilitation Nutrition narratively reviews these areas, and proposes the concept and diagnostic criteria. We have defined respiratory sarcopenia as "wholebody sarcopenia and low respiratory muscle mass followed by low respiratory muscle strength and/or low respiratory function." Respiratory sarcopenia can be caused by various factors such as aging, decreased activity, undernutrition, disease, cachexia, and iatrogenic causes. We have also created an algorithm for diagnosing respiratory sarcopenia. Respiratory function decreases with age in healthy older people, along with low respiratory muscle mass and strength. We have created a new term, "Presbypnea," meaning a decline in respiratory function with aging. Minor functional respiratory disability due to aging, such as that indicated by a modified Medical Research Council level 1 (troubled by shortness of breath when hurrying or walking straight up hill), is an indicator of presbypnea. We also define sarcopenic respiratory disability as "a disability with deteriorated respiratory function that results from respiratory sarcopenia." Sarcopenic respiratory disability is diagnosed if respiratory sarcopenia is present with functional disability. Cases of respiratory sarcopenia without functional disability are diagnosed as "at risk of sarcopenic respiratory disability." Functional disability is defined as a modified Medical Research Council grade of 2 or more. Rehabilitation nutrition, treatment that combines rehabilitation and nutritional management, may be adequate to prevent and treat respiratory sarcopenia and sarcopenic respiratory disability.

Post-COVID-19 acute sarcopenia: physiopathology and management

“…A good example of this is the sarcopenic involvement of diaphragm and the intercostal muscles would translate to an impediment to the ventilatory function, this closing the vicious circle [80]. Thus the sarcopenic respiratory disability may be one of the aftermaths of the COVID-19 in older persons [81]. Some insights are given by studies from the pre-COVID-19 era.…”

The Impact of Glucose-Lowering Drugs on Sarcopenia in Type 2 Diabetes: Current Evidence and Underlying Mechanisms

“…The age-related changes involved in sarcopenia not only affect the upper and lower limbs, but rather involve a decline in mass and strength of the respiratory muscles configuring the recent term of "respiratory sarcopenia" [7]. Respiratory sarcopenia is characterized as whole-body sarcopenia with low respiratory muscle mass followed by low respiratory muscle strength and/or deteriorated respiratory function [8]. Various factors may lead to respiratory sarcopenia such as aging, inactivity, undernutrition, diseases, inflammation, and cachexia [8].…”

“…Respiratory sarcopenia is characterized as whole-body sarcopenia with low respiratory muscle mass followed by low respiratory muscle strength and/or deteriorated respiratory function [8]. Various factors may lead to respiratory sarcopenia such as aging, inactivity, undernutrition, diseases, inflammation, and cachexia [8]. The diaphragm is the primary muscle of the respiratory pump, and reduced diaphragm muscle mass impairs inspiratory strength and cough function [8].…”

“…Various factors may lead to respiratory sarcopenia such as aging, inactivity, undernutrition, diseases, inflammation, and cachexia [8]. The diaphragm is the primary muscle of the respiratory pump, and reduced diaphragm muscle mass impairs inspiratory strength and cough function [8]. The reduction in respiratory muscle function in the elderly makes this population more vulnerable to disease and disability [6,9], and contributes to respiratory complications, a common cause of morbidity and mortality in the elderly [10,11].…”

Prospects of Robots in Assisted Living Environment

“…"Movement is life" is a saying used among medical doctors, highlighting the importance of mobility in every patient. Respiratory problems, weakness, muscle atrophy, cachexia, and sarcopenia [5,6] are common pathologies that are worsened due to a lack of movement. This is exacerbated when further restrictions are applied to patient mobility in pandemics, such as with COVID.…”