Dtsch Med Wochenschr 2008; 133(7): 305-310
DOI: 10.1055/s-2008-1046711
Übersicht | Review article
Geriatrie, Ernährungsmedizin
© Georg Thieme Verlag KG Stuttgart · New York

Malnutrition, Sarkopenie und Kachexie im Alter - Von der Pathophysiologie zur Therapie

Ergebnisse eines internationalen Expertenmeetings der BANSS-StiftungMalnutrition, sarcopenia and cachexia in the elderly: from pathophysiology to treatment Conclusions of an international meeting of experts, sponsored by the BANSS FoundationJ. M. Bauer1 , R. Wirth2 , D. Volkert3 , H. Werner4 , C. C. Sieber1 , für die Teilnehmer des BANSS-Symposiums 2006
  • 1Lehrstuhl für Innere Medizin V - Geriatrie, Universität Erlangen-Nürnberg
  • 2Klinik für Akutgeriatrie, St. Marien-Hospital, Borken
  • 3Institut für Ernährungs- und Lebensmittelwissenschaften, Rheinische Friedrich-Wilhelm-Universität Bonn
  • 4Ev. Krankenhaus Elisabethenstift, Darmstadt
Further Information

Publication History

eingereicht: 10.7.2007

akzeptiert: 15.11.2007

Publication Date:
06 February 2008 (online)

Zusammenfassung

Malnutrition, Sarkopenie und Kachexie sind drei Syndrome, die für Funktionalität, Morbidität und Mortalität älterer Menschen große Bedeutung besitzen. Der Begriff der Malnutrition beschreibt eine defizitäre Versorgung mit Makro- und Mikronährstoffen. Bei der Sarkopenie handelt es sich um einen altersassoziierten Verlust von Muskelkraft und Muskelmasse. Die Kachexie ist durch einen Gewichtsverlust mit übermäßigem Abbau von Muskelmasse bei akuter oder chronischer Inflammation charakterisiert. Für alle drei Entitäten ist das Zusammenwirken eines weiten Spektrums möglicher Kausalfaktoren typisch. Hierbei sind für Sarkopenie und Kachexie neben inflammatorischen Prozessen auch Veränderungen der hormonellen Regulation von wesentlicher Bedeutung. Die Diagnose von Malnutrition, Sarkopenie und Kachexie erfordert neben einer diesbezüglichen Sensibilität des Arztes die Kenntnis der unterschiedlichen pathophysiologischen Grundlagen sowie den Einsatz spezieller diagnostischer Methoden. Aufgrund der demographischen Entwicklung ist durch den steigenden Betreuungsaufwand der betroffenen Patienten eine zunehmende Belastung des öffentlichen Gesundheitswesens zu erwarten. Daher sind weitere Studien erforderlich, die insbesondere für Sarkopenie und Kachexie die Entwicklung neuer Therapieoptionen auf der Basis der pathophysiologischen Kenntnisse ermöglichen.

Summary

Malnutrition, sarcopenia and cachexia are three syndromes that are highly relevant for capacity, morbidity and mortality of the elderly. The term malnutrition denotes a deficit of macro- und micronutrients, while sarcopenia describes an age-associated loss of muscle mass and strength. In cachexia weight loss und changes in body composition are closely related to acute and chronic inflammatory co-morbidities. A wide array of possible causal factors is typical for all three entities. Inflammatory processes and changes in hormonal regulation are of prominent importance for sarcopenia and cachexia.

The diagnosis of malnutrition, sarcopenia and cachexia requires, in addition to a special interest of the treating physician, a thorough knowledge of pathophysiology as well as the use of specific diagnostic methods. A better understanding of the causes of malnutrition, sarcopenia and cachexia will make it possible to use specific modes of treatment.

Because of the demographic shift an increasing financial burden has to be faced by the public health system resulting from the growing expenditure needed for the care of affected patients. Additional studies are, therefore, necessary to develop new therapeutic options based on the pathophysiology of these three entities. This is especially important with regard to sarcopenia and cachexia.

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Dr. Jürgen Martin Bauer

Medizinische Klinik 2, Klinikum Nürnberg, Lehrstuhl für Innere Medizin V-Geriatrie, Universität Erlangen-Nürnberg

Prof-Ernst-Nathan-Str. 1

90419 Nürnberg

Email: juergen.bauer@klinikum-nuernberg.de

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