Skip to main content
Erschienen in: Zeitschrift für Rheumatologie 5/2018

04.04.2018 | Polymyalgia rheumatica | Leitthema

Sarkopenie und Frailty beim älteren Rheumapatienten

verfasst von: Univ.-Prof. Dr. med. U. Lange

Erschienen in: Zeitschrift für Rheumatologie | Ausgabe 5/2018

Einloggen, um Zugang zu erhalten

Zusammenfassung

Sarkopenie, die bei bis zu 50 % der über 80-Jährigen vorkommt, ist eine altersassoziierte Erkrankung, gekennzeichnet durch einen kombinierten Verlust an Muskelmasse, -kraft und -leistung. Die Folgen sind vielfältig, wobei die Sarkopenie eng mit der Gebrechlichkeit (Frailty) verknüpft ist. Zu den wichtigen Risikofaktoren zählen genetische/epigenetische Faktoren, Immobilisation, Fehl- und Mangelernährung, Hormonmangelzustände, chronische Entzündung und ein Anstieg der inhibitorischen Faktoren der Geweberegeneration. Jenseits einer Quantifizierung der Muskelmasse sind daher funktionelle Untersuchungen zentraler Bestandteil der Sarkopeniediagnostik. Aktuell wird eine ganze Reihe an Interventionsstrategien getestet, so u. a. Trainingsregimes, Ernährungsprogramme, Hormonersatztherapien sowie pharmakologische Ansätze mit anabolen Prinzipien. Nach der aktuellen Datenlage kommt Trainingsprogrammen und Medikamenten ein hohes Potenzial zu.
Literatur
1.
Zurück zum Zitat Spira D, Norman K, Nikolov J et al (2016) Prevalence and definition of sarcopenia in community dwelling older people. Data from the Berlin aging study II (BASE-II). Z Gerontol Geriatr 49:94–99CrossRefPubMed Spira D, Norman K, Nikolov J et al (2016) Prevalence and definition of sarcopenia in community dwelling older people. Data from the Berlin aging study II (BASE-II). Z Gerontol Geriatr 49:94–99CrossRefPubMed
2.
Zurück zum Zitat Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European working groups on sarkopenia in older people. Age Ageing 39:412–423CrossRefPubMedPubMedCentral Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European working groups on sarkopenia in older people. Age Ageing 39:412–423CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Cruz-Jentoft AJ, Landi F, Schneider SM et al (2014) Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing 43:748–759CrossRefPubMedPubMedCentral Cruz-Jentoft AJ, Landi F, Schneider SM et al (2014) Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing 43:748–759CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Fielding RA, Vellas B, Evans WJ et al (2011) Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc 12:249–256CrossRefPubMed Fielding RA, Vellas B, Evans WJ et al (2011) Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc 12:249–256CrossRefPubMed
5.
Zurück zum Zitat Studenski SA, Peter KW, Alley DE et al (2014) The FNIH sarcopenia project: ratinale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci 69:547–558CrossRefPubMedPubMedCentral Studenski SA, Peter KW, Alley DE et al (2014) The FNIH sarcopenia project: ratinale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci 69:547–558CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Kemmler W, Jakob F, Sieber C (2017) Sarkopenie. Pathophysiologie und Therapie. Osteologie 26:7–12CrossRef Kemmler W, Jakob F, Sieber C (2017) Sarkopenie. Pathophysiologie und Therapie. Osteologie 26:7–12CrossRef
7.
Zurück zum Zitat Iannuzzi-Sucich M, Prestwood KM, Kenny AM (2002) Prevalence of sarcopenia and predictors of skeletal muscle mass in healthy, older men and women. J Gerontol A Biol Sci Med Sci 57:M772–7CrossRefPubMed Iannuzzi-Sucich M, Prestwood KM, Kenny AM (2002) Prevalence of sarcopenia and predictors of skeletal muscle mass in healthy, older men and women. J Gerontol A Biol Sci Med Sci 57:M772–7CrossRefPubMed
8.
Zurück zum Zitat Gariballa S, Alessa A (2013) Sarcopenia, prevalence and prognostic significance in hospitalized patients. Clin Nutr 32:772–776CrossRefPubMed Gariballa S, Alessa A (2013) Sarcopenia, prevalence and prognostic significance in hospitalized patients. Clin Nutr 32:772–776CrossRefPubMed
9.
Zurück zum Zitat Smoliner C, Sieber CC, Wirth R (2014) Prevalence of sarcopenia in geriatric hospitalized patients. J Am Med Dir Assoc 15:267–272CrossRefPubMed Smoliner C, Sieber CC, Wirth R (2014) Prevalence of sarcopenia in geriatric hospitalized patients. J Am Med Dir Assoc 15:267–272CrossRefPubMed
10.
Zurück zum Zitat Landi F, Liperoti R, Fusco D et al (2012) Sarcopenia and mortality among older nursing home residents. J Am Med Dir Assoc 13:121–126CrossRefPubMed Landi F, Liperoti R, Fusco D et al (2012) Sarcopenia and mortality among older nursing home residents. J Am Med Dir Assoc 13:121–126CrossRefPubMed
11.
Zurück zum Zitat Ngeuleu A, Allali F, Medrare L et al (2017) Sarcopenia in rheumatoid arthritis: prevalence, influence of disease activity and associated factors. Rheumatol Int 37:1015–1020CrossRefPubMed Ngeuleu A, Allali F, Medrare L et al (2017) Sarcopenia in rheumatoid arthritis: prevalence, influence of disease activity and associated factors. Rheumatol Int 37:1015–1020CrossRefPubMed
12.
Zurück zum Zitat Rolland Y, Czerwinski S, Abellan von Kann G et al (2008) Sarcopenia: Its assessment, etiology, pathogenesis, consequences and further perspectives. J Nutr Health Aging 12:433–450CrossRefPubMedPubMedCentral Rolland Y, Czerwinski S, Abellan von Kann G et al (2008) Sarcopenia: Its assessment, etiology, pathogenesis, consequences and further perspectives. J Nutr Health Aging 12:433–450CrossRefPubMedPubMedCentral
13.
16.
Zurück zum Zitat Lakomek H‑J, Brabant T, Lakomek M, Lüttje D (2013) Multimorbidität bei älteren Rheumapatienten Teil 1. Z Rheumatol 72:530–538CrossRefPubMed Lakomek H‑J, Brabant T, Lakomek M, Lüttje D (2013) Multimorbidität bei älteren Rheumapatienten Teil 1. Z Rheumatol 72:530–538CrossRefPubMed
17.
Zurück zum Zitat Andrews JS, Trupin L, Yelin EH et al (2017) Frailty and reduced physical function go hand in hand in adults with rheumatoid arthritis: a US observational cohort study. Clin Rheumatol 36:1031–1039CrossRefPubMedPubMedCentral Andrews JS, Trupin L, Yelin EH et al (2017) Frailty and reduced physical function go hand in hand in adults with rheumatoid arthritis: a US observational cohort study. Clin Rheumatol 36:1031–1039CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Hoganson DD, Crowson CS, Warrington KJ et al (2010) Lack of association of high body mass index with risk for developing Polymyalgia rheumatica. Int J Rheum Dis 13:e1–e5CrossRefPubMedPubMedCentral Hoganson DD, Crowson CS, Warrington KJ et al (2010) Lack of association of high body mass index with risk for developing Polymyalgia rheumatica. Int J Rheum Dis 13:e1–e5CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Björkman MP, Tilvis RS (2010) Muscle functions in polymyalgia rheumatica and giant-cell arteritis. Healthy Aging Clin Care Elder 2:1–8CrossRef Björkman MP, Tilvis RS (2010) Muscle functions in polymyalgia rheumatica and giant-cell arteritis. Healthy Aging Clin Care Elder 2:1–8CrossRef
20.
Zurück zum Zitat Evans WJ (2010) Skeletal muscle loss: cachexia, sarcopenia, and inactivity. Am J Clin Nutr 91:1123S–1127SCrossRefPubMed Evans WJ (2010) Skeletal muscle loss: cachexia, sarcopenia, and inactivity. Am J Clin Nutr 91:1123S–1127SCrossRefPubMed
21.
Zurück zum Zitat Baumgartner RN, Waters DL, Gallagher D et al (1999) Predictors of skeletal muscle mass in elderly men and women. Mech Ageing Dev 107:123–126CrossRefPubMed Baumgartner RN, Waters DL, Gallagher D et al (1999) Predictors of skeletal muscle mass in elderly men and women. Mech Ageing Dev 107:123–126CrossRefPubMed
22.
Zurück zum Zitat Janssen I, Heymsfield SB, Ross R (2002) Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 50:889–896CrossRefPubMed Janssen I, Heymsfield SB, Ross R (2002) Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 50:889–896CrossRefPubMed
23.
Zurück zum Zitat Genest SLF (2017) Funktionsdiagnostik der Sarkopenie. Osteologie 26:13–17CrossRef Genest SLF (2017) Funktionsdiagnostik der Sarkopenie. Osteologie 26:13–17CrossRef
24.
Zurück zum Zitat Fried LP, Tangen CM, Walston J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146–M156CrossRefPubMed Fried LP, Tangen CM, Walston J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146–M156CrossRefPubMed
25.
Zurück zum Zitat Stewart VH, Saunders DH, Greig CA (2014) Responsiveness of muscle size and strength to physical training in very elderly people: a systematic review. Scand J Med Sci Sports 24:e1–e10CrossRefPubMed Stewart VH, Saunders DH, Greig CA (2014) Responsiveness of muscle size and strength to physical training in very elderly people: a systematic review. Scand J Med Sci Sports 24:e1–e10CrossRefPubMed
26.
Zurück zum Zitat Guigoz Y, Yellas B, Garry PJ (1996) Assessing the nutritional status of the elderly: the mini nutritional assessment as part of the geriatric evaluation. Nutr Rev 54:59–64CrossRef Guigoz Y, Yellas B, Garry PJ (1996) Assessing the nutritional status of the elderly: the mini nutritional assessment as part of the geriatric evaluation. Nutr Rev 54:59–64CrossRef
27.
Zurück zum Zitat Cohen S, Nathan JA, Goldberg AL (2015) Muscle wasting in disease: molecular mechanisms and promissing therapies. Nat Rev Drug Discov 14:58–74CrossRefPubMed Cohen S, Nathan JA, Goldberg AL (2015) Muscle wasting in disease: molecular mechanisms and promissing therapies. Nat Rev Drug Discov 14:58–74CrossRefPubMed
28.
Zurück zum Zitat Campins L, Camps M, Riera A et al (2016) Oral drugs related with muscle wasting and sarcopenia. A review. Pharmacology 99:1–8CrossRefPubMed Campins L, Camps M, Riera A et al (2016) Oral drugs related with muscle wasting and sarcopenia. A review. Pharmacology 99:1–8CrossRefPubMed
29.
Zurück zum Zitat Peterson MD, Rhea MR, Sen A et al (2010) Resistance exercise for muscular strength in older adults: a metaanalysis. Ageing Res Rev 9:226–237CrossRefPubMedPubMedCentral Peterson MD, Rhea MR, Sen A et al (2010) Resistance exercise for muscular strength in older adults: a metaanalysis. Ageing Res Rev 9:226–237CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Borde R, Hartobagyi T, Granacher U (2015) Dose-response relationship of resistance training in healthy old adults: a systematic review and meta-analysis. Sports Med 45:1693–1720CrossRefPubMedPubMedCentral Borde R, Hartobagyi T, Granacher U (2015) Dose-response relationship of resistance training in healthy old adults: a systematic review and meta-analysis. Sports Med 45:1693–1720CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Peterson MD, Sen A, Gordon PM (2011) Influence of resistance exercise on lean body mass in aging adults: a meta-analysis. Med Sci Sports Exerc 43:249–258CrossRefPubMedPubMedCentral Peterson MD, Sen A, Gordon PM (2011) Influence of resistance exercise on lean body mass in aging adults: a meta-analysis. Med Sci Sports Exerc 43:249–258CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Pennings B, Koopman R, Beelen M et al (2011) Exercise before protein intake allows for greater use of dietary protein-derived amino acids for de novo muscular protein synthesis in both young and elderly men. Am J Clin Nutr 93:322–331CrossRefPubMed Pennings B, Koopman R, Beelen M et al (2011) Exercise before protein intake allows for greater use of dietary protein-derived amino acids for de novo muscular protein synthesis in both young and elderly men. Am J Clin Nutr 93:322–331CrossRefPubMed
33.
Zurück zum Zitat Bud NA, Gorissen SH, van Loon LJ (2013) Anabolic resistance of muscle protein synthesis with aging. Exerc Sport Sci Rev 41:169–173CrossRef Bud NA, Gorissen SH, van Loon LJ (2013) Anabolic resistance of muscle protein synthesis with aging. Exerc Sport Sci Rev 41:169–173CrossRef
34.
Zurück zum Zitat Hickson M (2015) Nutritional interventions in sarcopenia: a critical review. Proc Nutr Soc 74:378–386CrossRefPubMed Hickson M (2015) Nutritional interventions in sarcopenia: a critical review. Proc Nutr Soc 74:378–386CrossRefPubMed
35.
Zurück zum Zitat Denison HJ, Cooper C, Sayer AA et al (2015) Prevention and optimal management of sarcopenia: a review of combined exercise and nutrition interventions to improve muscular outcomes in older people. Clin Interv Aging 10:859–869PubMedPubMedCentral Denison HJ, Cooper C, Sayer AA et al (2015) Prevention and optimal management of sarcopenia: a review of combined exercise and nutrition interventions to improve muscular outcomes in older people. Clin Interv Aging 10:859–869PubMedPubMedCentral
36.
Zurück zum Zitat Cermak NM, Res PT, de Groot LC et al (2012) Protein supplementation augments the adaptive response of skeletal muscle to resistance-type exercise training: a meta-analysis. Biomed Res Int 96:1454–1464 Cermak NM, Res PT, de Groot LC et al (2012) Protein supplementation augments the adaptive response of skeletal muscle to resistance-type exercise training: a meta-analysis. Biomed Res Int 96:1454–1464
37.
Zurück zum Zitat Finger D, Goltz FR, Umpierre D et al (2015) Effects of protein supplementation in older adults undergoing resistance training: a systematic review and meta-analysis. Sports Med 45:245–255CrossRefPubMed Finger D, Goltz FR, Umpierre D et al (2015) Effects of protein supplementation in older adults undergoing resistance training: a systematic review and meta-analysis. Sports Med 45:245–255CrossRefPubMed
38.
Zurück zum Zitat Bauer J, Biolo G, Cederholm T et al (2013) Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc 14:542–559CrossRefPubMed Bauer J, Biolo G, Cederholm T et al (2013) Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc 14:542–559CrossRefPubMed
39.
Zurück zum Zitat Deutz NE, Bauer JM, al Barazzoni Ret (2014) Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clin Nutr 33:929–936CrossRefPubMedPubMedCentral Deutz NE, Bauer JM, al Barazzoni Ret (2014) Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clin Nutr 33:929–936CrossRefPubMedPubMedCentral
40.
Zurück zum Zitat Pennings B, Boirie Y, Senden JM et al (2011) Whey protein stimulates postprandial muscle protein accretion more effectively than do casein and casein hydrolysate in older men. Am J Clin Nutr 93:997–1005CrossRefPubMed Pennings B, Boirie Y, Senden JM et al (2011) Whey protein stimulates postprandial muscle protein accretion more effectively than do casein and casein hydrolysate in older men. Am J Clin Nutr 93:997–1005CrossRefPubMed
41.
Zurück zum Zitat Duan Y, Li F, Li Y et al (2015) The role of leucine and its metabolites in protein and energy metabolism. Amino Acids 48:41–54CrossRefPubMed Duan Y, Li F, Li Y et al (2015) The role of leucine and its metabolites in protein and energy metabolism. Amino Acids 48:41–54CrossRefPubMed
42.
Zurück zum Zitat Breen L, Philipps SM (2011) Skeletal muscle protein metabolism in the elderly: Interventions to counteract the „anabolic resistance“ of aging. Nutr Metab 8:68CrossRef Breen L, Philipps SM (2011) Skeletal muscle protein metabolism in the elderly: Interventions to counteract the „anabolic resistance“ of aging. Nutr Metab 8:68CrossRef
43.
Zurück zum Zitat Pennings B, Koopman R, Beelen M et al (2011) Exercising before protein intake allows for greater use of dietary protein-derived amino acids for de novo muscle protein synthesis in both young and elderly men. Am J Clin Nutr 93:322–331CrossRefPubMed Pennings B, Koopman R, Beelen M et al (2011) Exercising before protein intake allows for greater use of dietary protein-derived amino acids for de novo muscle protein synthesis in both young and elderly men. Am J Clin Nutr 93:322–331CrossRefPubMed
44.
Zurück zum Zitat Burd NA, Gorissen SH, van Loon LJ (2013) Anabolic resistance of muscle protein synthesis with aging. Exerc Sport Sci Rev 41:169–173CrossRefPubMed Burd NA, Gorissen SH, van Loon LJ (2013) Anabolic resistance of muscle protein synthesis with aging. Exerc Sport Sci Rev 41:169–173CrossRefPubMed
45.
Zurück zum Zitat Fitschen PJ, Wilson GJ, Wilson JM et al (2013) Efficacy of beta-hydroxy-beta-methylbutyrate supplementation in elderly and clinical populations. Nutrition 29:29–36CrossRefPubMed Fitschen PJ, Wilson GJ, Wilson JM et al (2013) Efficacy of beta-hydroxy-beta-methylbutyrate supplementation in elderly and clinical populations. Nutrition 29:29–36CrossRefPubMed
46.
Zurück zum Zitat Deutz NE, Pereira SL, Hays NP et al (2013) Effect of beta-hydroxy-beta-methylbutyrate (HMB) on lean body mass during 10 days of bed rest in older adults. Clin Nutr 32:704–712CrossRefPubMed Deutz NE, Pereira SL, Hays NP et al (2013) Effect of beta-hydroxy-beta-methylbutyrate (HMB) on lean body mass during 10 days of bed rest in older adults. Clin Nutr 32:704–712CrossRefPubMed
47.
Zurück zum Zitat Vukovic MD, Stubbs NB, Bohlken RM (2011) Body composition in 70-year-old adults responds to dietary beta-hydroxy-beta-methlybutyrate similarly to that of young adults. J Nutr 131:2049–2052CrossRef Vukovic MD, Stubbs NB, Bohlken RM (2011) Body composition in 70-year-old adults responds to dietary beta-hydroxy-beta-methlybutyrate similarly to that of young adults. J Nutr 131:2049–2052CrossRef
48.
Zurück zum Zitat Flakoll P, Sharp R, Baier S et al (2004) Effect of beta-hydroxy-beta-methylbutyrate, arginine, and lysine supplementation on strength, functionality, body composition, and protein metabolism in elderly women. Nutrition 20:445–451CrossRefPubMed Flakoll P, Sharp R, Baier S et al (2004) Effect of beta-hydroxy-beta-methylbutyrate, arginine, and lysine supplementation on strength, functionality, body composition, and protein metabolism in elderly women. Nutrition 20:445–451CrossRefPubMed
49.
Zurück zum Zitat Di Girolamo FG, Situlin R, Mazzucco S et al (2014) Omega-3 fatty acids and protein metabolisms: enhancement of anabolic interventions for sarcopenia. Curr Opin Clin Nutr Metab Care 17:145–150CrossRefPubMed Di Girolamo FG, Situlin R, Mazzucco S et al (2014) Omega-3 fatty acids and protein metabolisms: enhancement of anabolic interventions for sarcopenia. Curr Opin Clin Nutr Metab Care 17:145–150CrossRefPubMed
50.
Zurück zum Zitat Annweiler C, Schott AM, Berrut G et al (2009) Vitamin D‑related changes in physical performance: a systematic review. J Nutr Health Aging 13:893–898CrossRefPubMed Annweiler C, Schott AM, Berrut G et al (2009) Vitamin D‑related changes in physical performance: a systematic review. J Nutr Health Aging 13:893–898CrossRefPubMed
51.
Zurück zum Zitat Muir SW, Montero-Odasso M (2011) Effect of vitamin D supplementation on muscle strength, gait and balance in older adults: a systematic review and meta-analysis. J Am Geriatr Soc 59:2291–2300CrossRefPubMed Muir SW, Montero-Odasso M (2011) Effect of vitamin D supplementation on muscle strength, gait and balance in older adults: a systematic review and meta-analysis. J Am Geriatr Soc 59:2291–2300CrossRefPubMed
52.
Zurück zum Zitat Cesari M, Pahor M, Bartali B et al (2004) Antioxidants and physical performance in elderly persons: the Invecchiare in Chianti (InCHIANTI) study. Am J Clin Nutr 79:289–294CrossRefPubMed Cesari M, Pahor M, Bartali B et al (2004) Antioxidants and physical performance in elderly persons: the Invecchiare in Chianti (InCHIANTI) study. Am J Clin Nutr 79:289–294CrossRefPubMed
53.
Zurück zum Zitat Lauretani F, Semba RD, Bandinelli S et al (2008) Low plasma carotenoids and skeletal muscle strength decline over 6 years. J Gerontol A Biol Sci Med Sci 63:376–383CrossRefPubMedPubMedCentral Lauretani F, Semba RD, Bandinelli S et al (2008) Low plasma carotenoids and skeletal muscle strength decline over 6 years. J Gerontol A Biol Sci Med Sci 63:376–383CrossRefPubMedPubMedCentral
Metadaten
Titel
Sarkopenie und Frailty beim älteren Rheumapatienten
verfasst von
Univ.-Prof. Dr. med. U. Lange
Publikationsdatum
04.04.2018
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Rheumatologie / Ausgabe 5/2018
Print ISSN: 0340-1855
Elektronische ISSN: 1435-1250
DOI
https://doi.org/10.1007/s00393-018-0444-3

Weitere Artikel der Ausgabe 5/2018

Zeitschrift für Rheumatologie 5/2018 Zur Ausgabe

Mitteilungen der DRL

Mitteilungen der DRL

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.