Sarcopenia: assessment of disease burden and strategies to improve outcomes

Abstract

Life expectancy is increasing worldwide, with a resultant increase in the elderly population. Aging is characterized by the progressive loss of skeletal muscle mass and strength – a phenomenon called sarcopenia. Sarcopenia has a complex multifactorial pathogenesis, which involves not only age-related changes in neuromuscular function, muscle protein turnover, and hormone levels and sensitivity, but also a chronic pro-inflammatory state, oxidative stress, and behavioral factors – in particular, nutritional status and degree of physical activity. According to the operational definition by the European Working Group on Sarcopenia in Older People (EWGSOP), the diagnosis of sarcopenia requires the presence of both low muscle mass and low muscle function, which can be defined by low muscle strength or low physical performance. Moreover, biomarkers of sarcopenia have been identified for its early detection and for a detailed identification of the main pathophysiological mechanisms involved in its development. Because sarcopenia is associated with important adverse health outcomes, such as frailty, hospitalization, and mortality, several therapeutic strategies have been identified that involve exercise training, nutritional supplementation, hormonal therapies, and novel strategies and are still under investigation. At the present time, only physical exercise has showed a positive effect in managing and preventing sarcopenia and its adverse health outcomes. Thus, further well-designed and well-conducted studies on sarcopenia are needed.

Association of timed up and go test outcomes with future incidence of cardiovascular disease and mortality in adults aged 66 years: Korean national representative longitudinal study over 5.7 years

“…Physical performance has been shown to be associated with markers of CV disease. Additionally, sarcopenia, which is important physiology of physical frailty, is related to disability, hospitalization, and death [19]. Some CV markers, such as carotid artery intima media thickness [20] and serum concentrations of homocysteine [21] and high-density lipoprotein cholesterol [22], are associated with walking speed.…”

Hemojuvelin is a novel suppressor for Duchenne muscular dystrophy and age‐related muscle wasting

“…Muscle wasting occurs in response to a variety of physiological and pathological conditions and is highly detrimental to the human body . For example, elderly people are known to undergo a progressive loss of muscle mass, which is associated with reduced muscle force, decreased physical activity, insulin resistance, and increased risk of fracture . Progressive muscle wasting and weakness also occur in Duchenne muscular dystrophy (DMD), an inherited X‐linked recessive disorder caused by a mutation in the dystrophin gene.…”

“…2 For example, elderly people are known to undergo a progressive loss of muscle mass, which is associated with reduced muscle force, decreased physical activity, insulin resistance, and increased risk of fracture. 3,4 Progressive muscle wasting and weakness also occur in Duchenne muscular dystrophy (DMD), an inherited X-linked recessive disorder caused by a mutation in the dystrophin gene. The lack of dystrophin results in increased sarcolemma fragility, leading to chronic inflammation, ongoing degeneration, and regeneration cycles as well as fibrosis.…”

Systematic review with meta‐analysis: Nutritional screening and assessment tools in cirrhosis

“…They can be broadly classified into one of four categories: (a) bedside single measure nutritional assessment tools (NATs) (ie) mid‐arm muscle circumference (MAMC), hand grip strength (HGS), etc (b) bedside global NATs (ie) subjective global assessment (SGA), Royal Free Hospital‐Global Assessment (RFH‐GA), (c) non‐cross‐sectional imaging‐based body composition assessment tools (ie) bioelectrical impedance analysis (BIA) and (d) cross‐sectional imaging‐based sarcopenia assessment (ie) L3 skeletal index via computed tomography (CT) or magnetic resonance imaging (MRI). The information provided by NATs is supplemented by additional dietitian input, thus leading to an evaluation including food intake, barriers to intake and the stress associated with disease or illness in order to formulate a personalised nutritional plan …”

“…10,11 They can be broadly classified into one The information provided by NATs is supplemented by additional dietitian input, thus leading to an evaluation including food intake, barriers to intake and the stress associated with disease or illness in order to formulate a personalised nutritional plan. 9,12,13 Although clearly associated with prognosis, in cirrhosis, the definition of malnutrition and the processes for nutrition screening and assessment are in evolution, without a clearly accepted standard. 8,9 A synthesis of this literature is seen as an important step on the way to evaluate the breadth of knowledge that is already available and moving towards standardisation in both clinical practice and research.…”