Date: 17 Nov 2012
From muscle wasting to sarcopenia and myopenia: update 2012
Human muscle undergoes constant changes. After about age 50, muscle mass decreases at an annual rate of 1–2 %. Muscle strength declines by 1.5 % between ages 50 and 60 and by 3 % thereafter. The reasons for these changes include denervation of motor units and a net conversion of fast type II muscle fibers into slow type I fibers with resulting loss in muscle power necessary for activities of daily living. In addition, lipids are deposited in the muscle, but these changes do not usually lead to a loss in body weight. Once muscle mass in elderly subjects falls below 2 standard deviations of the mean of a young control cohort and the gait speed falls below 0.8 m/s, a clinical diagnosis of sarcopenia can be reached. Assessment of muscle strength using tests such as the short physical performance battery test, the timed get-up-and-go test, or the stair climb power test may also be helpful in establishing the diagnosis. Serum markers may be useful when sarcopenia presence is suspected and may prompt further investigations. Indeed, sarcopenia is one of the four main reasons for loss of muscle mass. On average, it is estimated that 5–13 % of elderly people aged 60–70 years are affected by sarcopenia. The numbers increase to 11–50 % for those aged 80 or above. Sarcopenia may lead to frailty, but not all patients with sarcopenia are frail—sarcopenia is about twice as common as frailty. Several studies have shown that the risk of falls is significantly elevated in subjects with reduced muscle strength. Treatment of sarcopenia remains challenging, but promising results have been obtained using progressive resistance training, testosterone, estrogens, growth hormone, vitamin D, and angiotensin-converting enzyme inhibitors. Interesting nutritional interventions include high-caloric nutritional supplements and essential amino acids that support muscle fiber synthesis.
Critchley M. The neurology of old age. Lancet. 1931;217:1331–7.CrossRef
Shock NW. Physiologic aspects of aging. J Am Diet Assoc. 1970;56:491–6.PubMed
Rosenberg IH. Sarcopenia: origins and clinical relevance. J Nutr. 1997;127:990S–1.PubMed
Morley JE. Aspects of the medical history unique to older persons. JAMA. 1993;269:677–8.CrossRef
von Haehling S, Anker SD. Cachexia as a major underestimated and unmet medical need: facts and numbers. J Cachexia Sarcopenia Muscle. 2010;1:1–5.CrossRef
van Kan A. Epidemiology and consequences of sarcopenia. J Nutr Health Aging. 2009;13:708–12.CrossRef
Podsiadlo D, Richardson S. The timed “up & go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142–8.PubMed
Drey M, Sieber CC, Bauer JM, Uter W, Dahinden P, Fariello RG, et al. C-terminal agrin fragment as a potential marker for sarcopenia caused by degeneration of the neuromuscular junction. Exp Gerontol. 2012. doi:10.1016/j.exger.2012.05.021.
Hettwer S, Dahinden P, Kucsera S, Farina C, Ahmed S, Fariello R, et al. Elevated levels of a C-terminal agrin fragment identifies a new subset of sarcopenia patients. Exp Gerontol. 2012. doi:10.1016/j.exger.2012.03.002.
Fülster S, Tacke M, Sandek S, Ebner N, Tschöpe C, Doehner W, et al. Muscle wasting in patients with chronic heart failure: results from the studies investigating co-morbidities aggravating heart failure (SICA-HF). Eur Heart J 2012; in press.
Muscaritoli M, Anker SD, Argilés J, Aversa Z, Bauer JM, Biolo G, et al. Consensus definition of sarcopenia, cachexia and precachexia: joint document elaborated by special interest groups (SIG) “cachexia-anorexia in chronic wasting diseases” and “nutrition in geriatrics”. Clin Nutr. 2010;29:154–9.PubMedCrossRef
Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000;55:M221–31.PubMedCrossRef
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39:412–23.PubMedCrossRef
Sipilä S, Suominen H. Effects of strength and endurance training on thigh and leg muscle mass and composition in elderly women. J Appl Physiol. 1995;78:334–40.PubMed
Burton LA, Sumukadas D. Optimal management of sarcopenia. Clin Interv Aging. 2010;5:217–28.PubMed
Liu CJ, Latham NK. Progressive resistance strength training for improving physical function in older adults. Cochrane Database Syst Rev 2009; 3:CD002759.
Gielen S, Sandri M, Kozarez I, Kratzsch J, Teupser D, Thiery J, et al. Exercise training attenuates MuRF-1 expression in the skeletal muscle of patients with chronic heart failure independent of age: the randomized Leipzig Exercise Intervention in Chronic Heart Failure and Aging catabolism study. Circulation. 2012;125:2716–27.PubMedCrossRef
Houston DK, Nicklas BJ, Ding J, Harris TB, Tylavsky FA, Newman AB, et al. Dietary protein intake is associated with lean mass change in older, community-dwelling adults: the health, aging, and body composition (Health ABC) study. Am J Clin Nutr. 2008;87:150–5.PubMed
Rozentryt P, von Haehling S, Lainscak M, Nowak JU, Kalantar-Zadeh K, Polonski L, et al. The effects of a high-caloric protein-rich oral nutritional supplement in patients with chronic heart failure and cachexia on quality of life, body composition, and inflammation markers: a randomized, double-blind pilot study. J Cachexia Sarcopenia Muscle. 2010;1:35–42.PubMedCrossRef
Fülster S, von Haehling S. A prospective study of the associations between 25-hydroxyvitamin D, sarcopenia progression and physical activity in older adults. Clin Endocrinol. 2011;74:138.CrossRef
Hagerty L, Lachey JL, Kumar R, Pearsall RS, Sherman M, Seehra J. Age-related lean tissue loss is attenuated by treatment with a form of soluble activin receptor type IIB. J Cachexia Sarcopenia Muscle. 2010;1:65–6. Abstract: 051.
von Haehling S, Morley JE, Anker SD. An overview of sarcopenia: facts and numbers on prevalence and clinical impact. J Cachexia Sarcopenia Muscle. 2010;1:129–33.CrossRef
Lauretani F, Russo CR, Bandinelli S, Bartali B, Cavazzini C, Di Iorio A, et al. Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol. 2003;95:1851–60.PubMed
- From muscle wasting to sarcopenia and myopenia: update 2012
Journal of Cachexia, Sarcopenia and Muscle
Volume 3, Issue 4 , pp 213-217
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Muscle mass
- Industry Sectors
- Author Affiliations
- 1. Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
- 2. GRECC, Veterans Affairs Medical Center, Saint Louis University School of Medicine, St. Louis, MO, USA
- 3. Centre for Clinical and Basic Research IRCCS San Raffaele, Rome, Italy