W3: Sarcopenia Flashcards
Whats the muscles function?
Powers human bodily movements
protect internal organs
Accounts for almost half of the body mass
Crucial role in maintaining homeostasis of glucose metabolism
Generates body heat
Describe Sarcopenia
‘poverty of flesh’
Its a process where theres an accelerated loss of muscle mass and function
Commonly occures in older people, underweight people, female and people with other chronic diseases
What are the biological mechanism behind sarcopenia
- Dysfunctional satellite cell
- Dysfunctional mitochondria
- Imblances of protein
- Increased inflammation
- Increased fat andfibrotic infiltration
- Increase in reactive oxygen species
When was sarcopenia classified as a disease? What are the criterions and what does each criterion indicate?
- Low muscle strength
- Low muscle quantity
- Low physical performance
Probable sarcopenia is identified by criterion 1
Diagnosis is confirmed by the additional documentation of 2
And sarcopenia is considered severe when all three are present
What are the tools to identify sarcopenia using case findings, muscle strength, skeletal muscle mass of quality, and physical performance and what are the European cut-off points?
SARC-F
Muscle strength: Grip strength <27kg, <16kg (W); Chair rise test: >15s for 5 (M)
Skeletal muscle mass of quality: DEXA or MRI, CT scan through mid-thigh, Lumbar muscle CT scan: ASM < 20kg or ASM/height^2 < 7kg/m2 (M); <15kg or 5.5kg/m^2 (W)
Physical strength: Gait speed e.g. 4 metre walk gait speed test: ≤0.8m/s; Short physical performance battery: ≤8 points
Timed up and go: ≥20s
400m walk: Incomplete or ≥6 mins
What are the consequences of Sarcopenia?
Lower QoL
Increased risk for cardiac, respiratory diseases, and cognitive impairment
Lower independent living. or need for long-term care replacement
Impaired ability for ADL
Lead to mobility disorder
Increased premature mortality
Increased risk of fall and fractures
What are the financial consequences?
Increased risks of hospitalisation and cost of care.
Those with sarcopenia are 5 times more likely to higher hospital compared to those without
What does the International clinic practice guidelines for Sarcopenia recommend for screening
- Older adults aged ≥65 years should be screened annually after the occurence of a major health event.
- Opportunistic e.g. at annual flu vaccination clinic
What does the catabolic crisis model propose?
Proposed model suggests an age-related muscle loss punctuated by episodes of acute illness or injuries characterised by an accelerated muscles loss and incomplete recovery
What is primary and secondary sarcopenia?
Primary - Age-related sarcopenia
Secondary - Factors other than age such as systemic disease, Physical inactivity and inadequate intake of energy or protein.
What is acute sarcopenia and chronic sarcopenia?
Acute is ones that lasts <6months and usually related to acute illness or condition
Chronic sarcopenia is ones that last >6 months associated
What are some treatments recommended for sarcopenia
Physical activity (Resistance based), protein supplementation,
Some insufficient data - Vitamin D,
Anabolic hormones, Pharmacologic interventions
How can resistance training benefit frail older adults?
10 weeks high-intensity training in frail nursing home residents(Fiaterone, 1994)
Linked to increase in lower body muscle strength (113%) , muscle mass (3% increase in exercise group but 2% decline in non-exercise), gait speed (13%) and climbing power (28%)
What evidence is there that Resistance training benefits healthy older people with sarcopenia?
Chen et al., 2021:
* 14 studies in metaanalysis (n=561 older adults with sarcopenia)
* 1-3 times/week. for 8-36 weeks.
* 11 studies focusing on upper and lower limbs, 3 studies on lower limbs only.
* Interventions include: kettlebell, dumbbells, suspension bands, elastic bands, weight loads, weight machines, body weight
–> Significant effect in gait speed, time up and go, Skeletal muscle mass, leg lean mass, ASMMI, body fat mass, handgrip strength and knee extension (Chen et al., 2021)
It is recommended thatRT should be moderate-high intensity, 3 days/week within 2-3 set of 8-12 reps, Mode should be optimal for the individual.
Study 2:
* RCT
* Intervention - Kettlebell training vs control
* 8 weeks, 60-70% of 1RM, 11 movements 3 sets each with 8-12 reps with duration of 60 minutes
* Used the Asian Working definition for Sarcopenia
Results: Significantly higher left and right hand grip strength, and Sarcopenic Index
Although results didn’t reach the threshold for sarcopenic index, the intervention group was almost there so perhaps it is worth the intervention. (Chen et al., 2018)
How do we prescribe RT to people with sarcopenia? (Not specifics more of the concepts to focus on)
Think about the specificity, overload and gradually increasing the stress applied on the body for the optimal adaptation
