ReviewSarcopenia in the elderly: Diagnosis, physiopathology and treatment
Section snippets
Definition of sarcopenia
Sarcopenia is a subject of great interest for geriatricians, and the possibility of considering it as a geriatric syndrome has been in the air since 2010 [1]. The first author to speak of sarcopenia was Rosenberg, who wondered in 1989 why the loss of muscle mass seen in elderly subjects had not been given adequate attention [2]. It was he who first used the term of sarcopenia. The term sarcopenia derives from the Greek terms “sarx” (meat) and “penia” (loss) [3]. However, in the strong
Instrumental diagnosis of sarcopenia
Magnetic resonance imaging (MRI) allows us to calculate segmental and total muscle mass, and to assess muscle quality by calculating fat infiltration in muscle, which is a very interesting parameter. MRI has many advantages but is very expensive, is not easily accessible, and is not routinely indicated to study muscle mass, but has been used mainly for research purposes. It is a very complex test that requires highly specialized staff, specific software, and a relatively large amount of time.
Neuromuscular aging
Neuron loss is a progressive, irreversible process that increases with age.
Among the causes that contribute to strength loss observed in sarcopenia we must mention changes on nervous system due to age, which provoke the loss of motor units. A motor unit is made up of a single alpha motoneuron and all the muscle fibers connected with it. If alpha motoneuron is lost, denervated muscle fibers join to connect to surviving alpha motoneurons. This determines that a single alpha motoneuron must
Non-drug treatment
The practice of physical resistance exercise has been shown to improve muscle mass and strength, but is not always feasible in elderly subjects, and it is not yet known how long its effects last after it is discontinued [40]. It has also been shown that it is not sufficient to reverse the loss of muscle mass in elderly people.
Drug treatment
Pharmacological treatment of sarcopenia is a major area for research. Many drugs are being tested for their effects on muscle mass and strength, such as Ghrelin, GH
Conclusion
Despite the considerable volume of publications, there is no conclusive definition of sarcopenia and it is not recognized as a pathology. There is no clear association between the loss of muscle mass and strength, or the factors that contribute to their development. It would be logical to assume that there is a direct relationship between muscle mass and strength: the greater the mass the greater the strength, and vice versa. An active life style and diet seem to be associated protective
Contributors
All of authors contributed to the preparation of this manuscript equally.
Competing interests
None of the authors is currently receiving funds or grants for research of any kind. The conclusions reached reflect the thinking of the authors. The present study did not receive funding.
Provenance and peer review
Not commissioned, externally peer reviewed.
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