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Sarcopenia

Sarkopenie

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Summary

Sarcopenia is a very common, but frequently overlooked and undertreated geriatric syndrome comprising pronounced muscle mass and strength/performance loss. Estimated prevalence is between 5 and 40% in the general population, accompanied by an exponential incline with increasing age. Sarcopenia is connected to atrophy and loss of muscle fibers and motor units, affecting primarily the fast-twitch muscle fibers und their motor units. Fast-twitch muscle fibers seem to be more prone to failure of function and loss over time. Main causes for the development of sarcopenia are hormonal changes (reduced release of testosterone, estrogen, and growth hormone), nutritional deficiencies, chronic inflammation, and particularly a decrease in physical activity due to sedentary lifestyle with advancing age. Treatment options for sarcopenia comprise an active lifestyle with physical activity and exercise training, modifications of nutritional intake, and pharmacological therapies. Strength training and an adequate nutritional intake form the basis of successful sarcopenia treatment.

Zusammenfassung

Die Sarkopenie ist ein häufiges und oft übersehenes geriatrisches Syndrom mit einem verstärkten Verlust von Muskelmasse und Muskelkraft/Leistung. Die geschätzte Prävalenz liegt bei 5–40 % in der Bevölkerung – mit einem altersbezogenen exponentiellen Anstieg. Einer Sarkopenie liegen eine Atrophie und ein Verlust von Muskelfasern bzw. der motorischen Einheiten zugrunde. Sie betrifft vorrangig die schnellen Typ-II-Muskelfasern und deren motorische Einheiten. Schnelle Typ-II-Muskelfasern scheinen anfälliger für einen Funktionsverlust und einen Untergang der Muskelfasern zu sein. Wichtige Ursachen einer Sarkopenie sind hormonelle Veränderungen (abfallende Testosteron‑, Östrogen- und Wachstumshormonspiegel), Mangelernährung, chronische Entzündungsprozesse und insbesondere eine reduzierte körperliche Aktivität aufgrund eines vorwiegend bewegungsarmen Lebensstils. Behandlungsoptionen umfassen einen aktiven Lebensstil mit viel körperlicher Bewegung und sportlicher Aktivität, Anpassung der Ernährung und ggf. auch eine pharmakologische Therapie. Krafttraining und eine adäquate Ernährung stellen die Grundlage eines erfolgreichen Behandlungskonzepts einer Sarkopenie dar.

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Funding

This study was supported by the German Federal Ministry of Education and Research (BMBF 01EO1003 and BMBF 01EO1503). The author is responsible for the contents of this publication.

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  1. Centrum Thrombosis and Haemostasis, University Medical Center Mainz, Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany

    Karsten Keller MD

  2. Center for Cardiology, University Medical Center Mainz, Johannes Gutenberg-University Mainz, Mainz, Germany

    Karsten Keller MD

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Keller, K. Sarcopenia. Wien Med Wochenschr 169, 157–172 (2019). https://doi.org/10.1007/s10354-018-0618-2

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