Sarcopenia: clinical approach

Abstract

Sarcopenia, the diminution of muscular mass and performance, is an important risk factor for general health and specifically for bone fractures independently of the bone mineral density.
After reaching a maximal development around 40 years of age, the muscular mass (MM) diminishes constantly, even after 70 years of age at a rate of 1% per year in men and 0.5% per year in women.
From the clinical approach the best measure of MM is accomplished by DXA measuring the appendicular MM. The study of the patient should include physical test to assess strength (hand grip), power (sit/stand test and climb stairs) and muscular performance (walking speed).
Subjects over 65 years of age, or those with frequent fall, osteoporotic fractures or manifest diminution of their physical performance could undergo studies for sarcopenia detection.
Medical interventions to restore or prevent MM loss should include resistance exercises, protein content of the diet between 1.0 to 1.2 g/kg and vitamin D administration to keep 25 HOD over 30 ng/ml. Intensive research of new agents include, among others, antibodies anti-miostatin and SARM.