Sarcopenia, Weakness

Question 1

3 parameters from European Working Group on Sarcopenia in Older People criteria for diagnosis of sarcopenia? Clinical test to measure each

Answer 1

1. Muscle mass - DXA, CT/MRI
2. Muscle strength - grip strength
3. Physical performance - TUG, SPPB, gait speed

Question 1

What is the only evidence based treatment for sarcopenia?

Answer 1

Exercise

Question 2

What are 3 potential causes for sarcopenia?

Answer 2

1. Malnutrition/malabsorption
2. Inactivity/immobility
3. Chronic disease (COPD, CHF, DM)

Question 3

What is the definition of sarcopenia?

Answer 3

Progressive and generalized accelerated loss of skeletal muscle mass and function

Question 4

Criteria for probable sarcopenia, sarcopenia and severe sarcopenia

Answer 4

Probable = low muscle strength
Sarcopenia = low muscle strength AND low muscle quality/quantity
Severe sarcopenia = low muscle strength, muscle quality/quantity and physical performance

Question 5

What is a screening tool for sarcopenia?

Answer 5

SARC-F
1. How much difficulty lifting and carrying 10 lbs?
2. How much difficulty walking around a room?
3. Transferring from chair or bed?
4. Climbing flight of 10 stairs?
5. How many falls last year?
>4 predictive of sarcopenia

Question 6

What is sarcopenia obesity?

Answer 6

Lean body mass is lost while fat mass may be preserved
Seen in aging, RA, malignancy

Question 7

What is cachexia?

Answer 7

Metabolic syndrome with underlying illness
Loss of muscle +/- loss of fat
Most are sarcopenia, but most sarcopenia individuals are not cachectic

Question 8

Classification of causes of sarcopenia (2 groups)

Answer 8

1. Primary: age related process, influenced by genetic, lifestyle
2. Secondary: malnutrition, disuse, cachexia, endocrine, neurodegenerative, medications causing anorexia

Question 9

What are the causes of sarcopenia?

Answer 9

1. Age associated muscle loss
2. Disease: inflammatory, OA, neurologic disorders, endocrine, cachexia, COPD, CHF, DM
3. Inactivity: sedentary, physical inactivity
4. Malnutrition: undernutrition or malabsorption, medication related anorexia, overnutrition/obesity

Question 10

Treatment of sarcopenia

Answer 10

1. Exercise - resistance training
2. Nutrition - protein intake, leucine/HMB
3. Treat underlying cause

Question 11

Differential diagnosis for proximal muscle weakness

Answer 11

Inflammatory: polymyositis, dermatomyositis,
Rheum: RA, SLE, PMR, fibromyalgia, rotator cuff problem
Metabolic: renal/liver failure, electrolyte disturbance
Drugs: statin, steroid, colchicine

Question 12

What does sarcopenia put patients at increased risk for?

Answer 12

1. Falls
2. Functional decline
3. Frailty
4. Mortality