Consenso sarcopenia IA Flashcards
What is sarcopenia?
A progressive and generalised skeletal muscle disorder associated with increased likelihood of adverse outcomes including falls, fractures, physical disability and mortality.
What are the main health risks associated with untreated sarcopenia?
- Increased risk of falls and fractures
- Impaired ability to perform activities of daily living
- Associated with cardiac disease
- Associated with respiratory disease
- Associated with cognitive impairment
- Leads to mobility disorders
- Contributes to lowered quality of life
- Loss of independence or need for long-term care placement
- Increased mortality
How does sarcopenia affect healthcare costs?
Sarcopenia increases risk for hospitalisation and raises the cost of care during hospitalisation.
How much more likely are older adults with sarcopenia to incur higher hospital costs compared to those without?
More than 5-fold more likely.
What are the key insights from EWGSOP2 regarding sarcopenia?
- Development of sarcopenia begins earlier in life
- Sarcopenia is now considered a muscle disease (muscle failure)
- Low muscle strength is a principal determinant
- Muscle mass and quality are mainly used in research, not clinical practice
- Sarcopenia is often overlooked and undertreated in mainstream practice
What is the primary parameter for diagnosing sarcopenia according to EWGSOP2?
Low muscle strength.
What criteria must be met to diagnose sarcopenia as severe?
- Low muscle strength
- Low muscle quantity or quality
- Low physical performance
What is the SARC-F questionnaire used for?
To elicit self-reports from patients on signs characteristic of sarcopenia.
What is the recommended method for case-finding in clinical practice for sarcopenia?
Use of the SARC-F questionnaire.
What are the three criteria for identifying probable sarcopenia?
- Low muscle strength
- Low muscle quantity or quality
- Low physical performance
True or False: Sarcopenia is primarily a condition associated only with older adults.
False.
What are the implications of identifying sarcopenia earlier in life?
It opens up opportunities for interventions that can prevent or delay the development of sarcopenia.
What factors contribute to the complexity of diagnosing sarcopenia?
- Determining what variables to measure
- How to measure them
- What cut-off points guide diagnosis and treatment
- Evaluating effects of therapeutic interventions
What does the term ‘muscle quality’ refer to in the context of sarcopenia?
Micro- and macroscopic aspects of muscle architecture and composition.
What are the recommended tools for measuring muscle strength in clinical practice?
- Grip strength test
- Chair stand test
What is the significance of muscle strength in predicting adverse outcomes related to sarcopenia?
Muscle strength is recognized as a better predictor of adverse outcomes than muscle mass.
Fill in the blank: Sarcopenia is often overlooked and ______ in mainstream practice.
undertreated
What are the potential drivers of disability in activities of daily living (ADL) associated with sarcopenia?
- Lower gait speed
- Chair stand performance
What is the aim of the EWGSOP2 updates regarding sarcopenia?
- Build a sarcopenia definition reflecting recent advances
- Identify variables that best detect sarcopenia
- Advise cut-off points for measured variables
- Recommend an updated screening and assessment pathway
What is the advantage of using the Ishii screening test?
It estimates the probability of sarcopenia using an equation-derived score based on age, grip strength, and calf circumference.
How does low physical performance relate to sarcopenia?
Detection of low physical performance predicts adverse outcomes and is used to identify the severity of sarcopenia.
What is the role of the European Geriatric Medicine Society (EuGMS) concerning EWGSOP2?
Organized EWGSOP2 and included experts to update sarcopenia definitions and diagnostic characteristics.
What is SARC-F?
A self-reported screening tool reflecting patient perceptions of adverse outcomes
SARC-F is used in multiple languages to assess the risk of sarcopenia.
What is the Ishii screening test used for?
To estimate the probability of sarcopenia using age, grip strength, and calf circumference
It is a more formal case-finding instrument preferred in clinical settings.
Why is grip strength an important measure?
It predicts poor patient outcomes such as longer hospital stays and increased functional limitations
Low grip strength is associated with poor health-related quality of life and death.
What equipment is commonly used to measure grip strength?
The Jamar dynamometer
Other brands are being explored but Jamar is widely validated.
What does the chair stand test measure?
Strength of leg muscles, specifically the quadriceps muscle group
It assesses the time taken to rise from a seated position multiple times.
How can muscle quantity be estimated?
Using techniques like MRI, CT, DXA, and BIA
Muscle quantity can be reported as total body Skeletal Muscle Mass (SMM) or Appendicular Skeletal Muscle Mass (ASM).
What are gold standards for non-invasive assessment of muscle quantity?
MRI and CT
They are high-cost and require trained personnel, limiting their use in primary care.
What does DXA measure?
Total body lean tissue mass or appendicular skeletal muscle mass non-invasively
DXA results can vary between brands, affecting consistency.
What is bioelectrical impedance analysis (BIA) used for?
To estimate total or appendicular skeletal muscle mass based on body electrical conductivity
BIA is affordable and portable but requires careful calibration.
What does muscle quality refer to?
Micro- and macroscopic changes in muscle architecture and function per unit of muscle mass
It is assessed using imaging tools and strength-to-mass ratios.
What is the creatine dilution test?
A method to estimate whole-body muscle mass using deuterium-labelled creatine
It correlates well with MRI measures of muscle mass.
What is the significance of gait speed in assessing sarcopenia?
It is a reliable predictor of adverse outcomes related to sarcopenia such as disability and mortality
A cut-off speed of ≤0.8 m/s indicates severe sarcopenia.
What does the Short Physical Performance Battery (SPPB) assess?
Gait speed, balance, and chair stand performance
A score of ≤8 points indicates poor physical performance.
What is the purpose of the Timed-Up and Go test (TUG)?
To evaluate physical function through a series of movements
The test involves rising from a chair, walking to a marker, and sitting down.
What is the role of specific biomarkers in diagnosing sarcopenia?
To identify and monitor the condition through markers related to muscle function and inflammation
A panel of biomarkers may be more effective than a single biomarker due to the complexity of sarcopenia.
What is the advantage of using ultrasound for muscle assessment?
It provides reliable measures of muscle quantity and quality
Ultrasound can detect changes in muscle thickness and cross-sectional area efficiently.
What does calf circumference predict in older adults?
Performance and survival
A calf circumference cut-off point of <31 cm is significant.
What does muscle strength correlate with?
Strength in other body compartments
Grip strength serves as a surrogate for more complicated strength measures.
What is the disadvantage of DXA?
It is not portable for community use
DXA measurements can also be influenced by patient hydration status.
What is sarcopenia?
A muscle disease rooted in adverse muscle changes that accrue across a lifetime
What is the main indicator of probable sarcopenia according to EWGSOP2?
Low strength
How is sarcopenia categorized based on duration?
Acute (<6 months) and chronic (≥6 months)
What does the SarQoL tool assess?
Patients’ perception of physical, psychological, and social aspects of health
What are the three parameters defining sarcopenia?
- Muscle strength
- Muscle quantity/quality
- Physical performance
Which questionnaire is recommended for finding individuals with probable sarcopenia?
SARC-F questionnaire
What is the recommended pathway for sarcopenia case-finding?
Find-Assess-Confirm-Severity (F-A-C-S)
What is the relationship between aging and muscle mass?
Muscle mass generally increases in youth, is maintained in midlife, and decreases with aging
What factors can contribute to the development of sarcopenia?
- Aging
- Inadequate energy or protein intake
- Physical inactivity
- Systemic diseases
What type of studies are needed to validate the sensitivity of SarQoL?
Longitudinal studies
What are the EWGSOP2 recommendations for cut-off points based on?
European populations and normative references
What is sarcopenic obesity?
Reduced lean body mass in the context of excess adiposity
What is the distinction between primary and secondary sarcopenia?
- Primary: Age-related with no other specific cause
- Secondary: Due to other causes, such as systemic disease
True or False: Sarcopenia can occur due to malnutrition.
True
What is the significance of grip strength in sarcopenia assessment?
It is a key measure of muscle strength
Fill in the blank: Sarcopenia is defined by low levels of muscle strength, muscle ______, and physical performance.
quantity/quality
What should be done to prevent or delay sarcopenia?
Maximize muscle in youth, maintain muscle in middle age, minimize loss in older age
What are some suggested areas for further research in sarcopenia?
- Influences causing sarcopenia
- Identification of high-risk individuals
- Validated cut-off points
- Muscle quality indicators
What is frailty characterized by?
Cumulative decline in multiple body systems or functions
What overlap exists between frailty and sarcopenia?
Low grip strength and slow gait speed
What are the current EWGSOP2 cut-off points for grip strength in men?
<27 kg
What is one of the primary goals of the updated recommendations by EWGSOP2?
Facilitate early detection and better treatment of sarcopenia
What is a challenge in the research and development of sarcopenia?
Lack of consistency due to disputes over cut-off points
