Sarcopenia

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Evaluation of skeletal muscle mass

Several procedures are available to measure muscle mass, and there is no doubt that the ease of obtaining an estimate of muscle mass has led to the surge of interest in sarcopenia (Table 1). Magnetic resonance imaging and computed tomography (CT) are arguably the most accurate gold standards. By these methods, muscle mass is quantitated with the added advantage of being able to determine muscle quality, fat mass, and fatty muscle infiltration. The most commonly used methods are DEXA and

Relationship of muscle mass and muscle strength

Increasing data suggest that muscle strength may be a more important outcome predictor than muscle mass. Grip strength is highly correlated with quadriceps strength and lower extremity strength. Grip strength therefore may be the most convenient clinical measure of muscle strength.

Prediction of future decline in physical function, disability, morbidity, and mortality can be made using physical function instruments. Commonly used evaluations include the short physical performance battery, 400-m

Causes of sarcopenia

Although the diagnosis of sarcopenia may be suspected clinically, the diagnosis depends on the demonstration of a loss of appendicular muscle mass. Thus, the measure of muscle mass represents a final common pathway but does not explain why a loss of muscle mass occurred.

Because the term sarcopenia was derived from cross-sectional observational studies, it has been difficult to determine whether the term should be reserved for changes in muscle mass that seem to progress in apparently normal

Resistance Exercise Training

The primary intervention should include resistance exercise training. Progressive resistance exercise training increases muscle protein mass and strength in men and women. The increase in muscle protein mass is attributable to an acute and chronic increase in muscle protein turnover resulting in the rate of muscle protein synthesis exceeding that of muscle proteolysis. Coincident with the increase in amount of muscle protein are increases in maximum voluntary muscle strength and muscle fiber

Summary

The definition of sarcopenia continues to evolve, from an observational phenomenon to a differential diagnostic approach. Clinical relevance for sarcopenia is defined by a loss in lean muscle mass and impairment of functional status.

A therapeutic approach to the loss of skeletal muscle mass and strength in older persons depends on correct classification. The term sarcopenia should be reserved for age-related decline in muscle mass that is not attributable to the presence of proinflammatory

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