Sarcopenia Flashcards
define sarcopenia
Sarcopenia is the accelerated loss of muscle mass and strength
what are the geriatric giants?
incontinence, instability, immobility and intellectual impairments
what are the symptoms of sarcopenia?
gradual loss of muscle mass, general weakness, less stamina
what is the grip strength test?
patient sits on chair with arm flat on chair arm and holds dynamometer. The test is done for 30s on each hand alternating three times.
what is the male cut off for grip strength test?
less than 27kg
what is the female cut off for grip strength test?
less than 16kg
what are the steps used by the european diagnostics for sarcopenia?
- clinical suspicion
- case finding
- confirming with measurements
what tests are done during initial case finding for sarcopenia?
gait speed, grip test, rise from chair
what is the gait speed cut off for case finding?
0.8m/s, 1.2m/s is needed to cross the road at traffic lights
what measurements are used to confirm sarcopenia case?
- dual energy x ray absorptiometry
- bioelectrical impedance
- CT/ MRI
- D3 creatine
- anthropometry
- potassium levels?
describe dual energy x ray absorpiometry
measures bone loss.
appendicular lean mass is calculated and divided by height^2.
what is bioelectrical impedance?
it is a portable machine that is electrical current to estimate muscle mass, good foer the 80+
what is the function of cross sectional imaging?
eg. CT and MRI to assess the muscle quality
what is D3 creatine dilution?
vast majority of Cr found in muscle. it is deuterium-labelled Cr taken orally. 48-96hrs later D3 Cr is measured in urine
why use potassium as a marker?
98% of potassium is found within cells and 80% of this is within cells that are in muscles
what simple anthropometry tests can be done?
skinfold test - see thickness and limb circumference
how is sarcopenia treated?
- resistance exercise
- having 1-1.2g/kg of protein daily
- myostatin’s - ACE inhib to prevent mitochondrial decline
what can sarcopenia lead to?
disability, lack of independence, increasing risk of falls, fractures, injury, less active and less muscle will lead to more fat and therefore more risk of hypertension, obesity and DM
what ageing research occurs in newcastle?
national institute for health research- NIHR
what sarcopenia research is occurring in NCL?
using biobank in a large prospective epidemiology study.
what did the ncl biobank study find?
- 50.1% with probable sp had 1 or more cardio conditions
2. 64.8% with probable sp had multimorbidities
how many of the 40-70 group have probable sp?
biobank suggests that 5.3% have probable sp
define geriatric medicine
speciality within internal medicine focusing on the complex are of elderly people
the 2014, lit review focused on which diagnostic methods as alternatives?
- D3 cr
- potassium
- anthropometry
- ultrasounds
what year is the study from that discusses alternative and less used diagnostics methods
2014 literature review
what year was the study linking end stage renal disease and sarcopenia?
2021
what is sarcopenia?
a degenerative muscoskeletal disorder involving the loss of muscle mass and function
in 2021, how much sarcopenia cost the USA?
$18.5 billion - linked to increased falls, functional decline, frailty and premature mortality
what is cachexia?
wasting and weakness due to severe chronic illness
what is confounded to sarcopenia?
malnutrition and cachexia
how is CKD a model of accelerated ageing (2021)?
characteristic aberrant changes in muscle mass and function
2021 ref - how many of those with end stage CKD have sarcopenia?
between 15-55%
what does the UK biobank do?
it is a large epidemiological study base that investigates genetics, lifestyle, environmental factor sin health and disease
what are risk factors for sarcopenia?
reduced physical activity, inflammation, lower kidney function and more comorbidities
what are type 2 fast fibres?
sprint - higher glycolic potential, lower oxidative capacity
what are type 1 fatigue resistant fibres?
contain more mitochondrion, capillaries, myoglobin - slow, strength
what type of fibres experience atrophy with age?
type 2
since age causes neuronal loss, how does that link to muscle mass loss?
reduced number of muscle fibres
what is the implication of reduction of GH with age?
less anabolic effects - less muscle and more visceral fat
inflammation links to sarcopenia, how?
there is more TNF-a, IL-6, links to obesity, which there is less muscle strength
what things cause sarcopenia?
- hormones - oestrogen decrease and less GH
- neuronal loss - less muscle fibres
- inflammation
- age
