SARCOPENIA

SARCOPENIA:
definition 2003

Causes
Atrophy and loss
of
individual muscle cells
linked to diminished:
- synthesis of muscle proteins
- function of mitochondria
GREENLUND LJ et al Mech Ageing Dev 2003; 124: 287

SARCOPENIA: definition 2006

Consequences
Age-associated
loss of skeletal muscle mass,
postulated to be a major factor in
the strength decline with ageing
Moreover, sarcopenia is related to:
- functional impairment
- disability
- falls
- loss of independence
GOODPASTER BH et al

J Gerontol Med Sci

2006; 61A: 1059-64

Risk factors of Sarcopenia

Constitutional
factors
Female gender
Low birth rate
Genetic susceptibility

Living habits
Malnutrition
Low protein intake
Alcohol abuse
Smoking
Physical inactivity

Living
conditions
Starvation
Bed rest /immobility
/deconditioning
Weightlessness

Ageing process
Increased muscle turnover
Catabolic stimuli
. Protein degradation
. Subclinical inflammation
Anabolic stimuli
. Protein synthesis
Reduced number of muscle cells
Myostatin ( recruitment)
Apoptosis
Hormonal deregulation
Testosterone, DHEA production
Estrogen production
1-25 (OH)2 vitamin D
Thyroid function
Growth hormone, IGF-1
Insulin resistance
Changes in nervous system
CNS input (loss of -motor
neurons)
Neuro-muscular disjunction
Mitochondrial dysfunction
Peripheral vascular flow

Chronic health
conditions
Cognitive impairment
Mood disturbances
Diabetes mellitus
Heart failure
Liver failure
Renal failure
Respiratory failure
Osteoarthritis
Chronic pain
Obesity
Catabolic effects of
drugs
Cancer ?
Chronic inflammatory
disease ?
CRUZ JENTOFT A et al
Curr Opin Clin Nutr Metab Care

Different kinds of weight loss

Cachexia

Anorexia

Malab
sorption

Sarcopenia

Hyper
metabolism

Anemia

Yes

No

No

Proteolysis
CRP

Yes

No

No

Yes

Yes

Vitamin A

Weight loss
Lean tissue
Fat tissue
Appetite

Albumin

MORLEY JE et al Nutrition 2008; 24: 815-9

Table II: Sarcopenia is a geriatric syndrome

Risk
factors factors
Constitutional
Female gender
Low birth rate
Genetic susceptibility

Ageing
Increased muscle turnover
Reduced number of muscle cells
Hormonal deregulation
Changes in nervous system
Mitochondrial dysfunction
Peripheral vascular flow

Living habits
Malnutrition
Low protein intake
Alcohol/ smoking
Physical inactivity

Chronic health conditions

Cognitive impairment
Mood disturbances
Diabetes mellitus
Heart / liver / lung / renal failure
Osteoarthritis
Chronic pain
Drugs

Living conditions
Starvation
Bed rest /immobility /deconditioning
Weightlessness

Body protein
content
Thermo regulation
Insulin resistance
Immunity
Infections
Axial muscular
tonus
Falls
Masticator force
Venous flow
Osteopenia /
fractures
SARCOPENI
Frailty

Mobility

Impaired gait
Falls
Low endurance
Physical performance

Poor
outcomes
Disability
Poor quality of life
Nursing home admission
Mortality

Qualiy of Life

Physical Frailty

Care costs

CRUZ JENTOFT A et al Curr Opin Clin Nutr Metab Care 2010; 13: 1-7

Sarcopenia: Causes and Implications12