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Sarcopenia
Background
Overview
Definition
Sarcopenia is defined as a progressive and generalized skeletal muscle disorder characterized by accelerated loss of muscle mass and function.
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Pathophysiology
The pathophysiology of sarcopenia involves age-related structural changes and mechanisms at cellular and subcellular levels, including qualitative changes in posttranslational modifications of muscle proteins, loss of coordinated control between contractile, mitochondrial, and sarcoplasmic reticulum protein expression, and progressive loss of motoneurons leading to reduced muscle fiber number and size.
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Epidemiology
The prevalence of sarcopenia in community-dwelling older adults ranges from 9.9% to 40.4%, depending on the definition used. The prevalence of sarcopenia is reported to be 25-35% in patients with cancer and 40-70% in patients with liver cirrhosis.
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Risk factors
The primary risk factors for sarcopenia include advancing age, a sedentary lifestyle, inadequate nutrition, and certain chronic diseases such as diabetes, obesity, and liver cirrhosis.
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Disease course
Clinically, sarcopenia presents with decreased muscle strength, impaired physical performance, and an overall decline in functional abilities. It can lead to reduced mobility, diminished QoL, and increased risk of fall-related injuries.
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Prognosis and risk of recurrence
Sarcopenia is associated with adverse outcomes, including falls, functional decline, frailty, and a significantly higher risk of mortality, independent of population and sarcopenia definition.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of sarcopenia are prepared by our editorial team based on guidelines from the American Society of Clinical Oncology (ASCO 2023,2020), the American Academy of Family Physicians (AAFP 2021,2020), the American Association for the Study of Liver Diseases (AASLD 2021), the European Society of Medical Oncology (ESMO 2021), the European Society for ...
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