Shopping Cart

No products in the cart.

Sarcopenia

Decoding Sarcopenia: Advances in Research and Management: Dive into the evolving landscape of sarcopenia research. From cutting-edge studies on its impact on cancer patients to innovative management strategies, gain insights into combating this muscle-wasting condition.

Predicting and acknowledging the role of resilience in elderly patients

Resilience is characterised by the ability to bounce back after exposure to a stressor or a form of adversity. It is frequently separated into physical and psychological components, with the former being defined as the ability to recover following age-related losses or disease. A decline in resilience is both a marker and a risk factor for accelerated ageing and frailty, respectively. The aim of this editorial was to showcase the importance of resilience in the recovery of frail patients. It also exposes the mechanisms behind resilience, as well as the gaps in its clinical assessment.
Read MorePredicting and acknowledging the role of resilience in elderly patients

Frailty: a predictor of mortality, hospital readmission, and length of stay?

The Hospital Frailty Risk Score (HFRS) was developed to detect frail individuals based on data extracted from hospital databases. An association between the HFRS, 30-day mortality, 30-day emergency hospital readmission, and long length of stay (LOS) was originally validated in populations of elderly patients admitted to hospital via the emergency department. Data regarding the HFRS’ predictive ability in the context of direct admissions and post-discharge outcomes is thus lacking. The aim of this study was to investigate the associations between the HFRS and 30-day mortality, 30-day hospital readmission, and long LOS by analysing in- and out-patient healthcare in France.
Read MoreFrailty: a predictor of mortality, hospital readmission, and length of stay?

Muscle mass, hepatocellular carcinoma and liver transplantations: a review

For hepatocellular carcinoma, the most common type of liver cancer, liver transplantations are considered the best treatment, as they present with a 60-80% survival rate for 5 years. Suitability for a transplant is assessed by factors such as the patient’s tumour presentation and their responses to treatments, with the Milan Criteria representing the total criteria with all additional prognostic factors. Yet, general health is rarely included into this judgement. General health, especially low muscle pass (e.g, sarcopenia) may affect survival rates for liver transplantations; this has, however, rarely been addressed. This study discovered that a higher pre-operative muscle mass contributed to an increased rate of long-term survival post-liver transplantation. This review by Beumer B et al. aimed to determine whether adding in the consideration of muscle mass, and working beyond the Milan Criteria, may benefit our understanding of the outcomes of liver transplantations.
Read MoreMuscle mass, hepatocellular carcinoma and liver transplantations: a review

Frailty instruments in patients with heart failure: a comparison of predictive performance

Frailty is characterised by increased vulnerability to acute stressors. As it is common in adults with heart failure (HF), frailty has been used as a predictor of mortality and morbidity for HF patients. Frailty Phenotype, the most commonly used frailty instrument in HF, is used for the physical examination of frailty. While physical frailty instruments are commonly used in clinical practice, a proportion of studies have expressed issues with such tools. As HF may have detrimental effects on physical function, the use of physical instruments may lead to an under- or over-estimation of frailty. This study aims to compare the predictive ability of three physical frailty instruments (the Frailty Phenotype, the St Vincent’s Frailty instrument and the SHARE-FI); and three multi-domain instruments (the FRAIL scale, the Deficit Accumulation Index, and St Vincent’s Frailty plus cognition 7 and mood) in adults with HF.
Read MoreFrailty instruments in patients with heart failure: a comparison of predictive performance

Knowledge gaps surrounding the definition, diagnosis, and management of sarcopenia

While it was initially characterised by a loss of muscle mass, sarcopenia has been defined by several international panels as a decline in muscle function, with a focus on muscle strength and physical performance. Despite the existence of algorithms and research into screening tools for its diagnosis, sarcopenia has not yet been appropriately recognised by the World Health Organisation’s latest version of the ICD (ICD-11), which is used by most countries. Definitions of sarcopenia are growing more precise, yet this does not translate into improved patient care and outcomes. This article aims to summarise the knowledge gaps surrounding sarcopenia’s definition, diagnosis, and treatment in current clinical practice. It also highlights the next steps in achieving worldwide sarcopenia recognition.
Read MoreKnowledge gaps surrounding the definition, diagnosis, and management of sarcopenia

Sarcopenia: an adverse prognostic factor for patients with head and neck cancer?

Sarcopenia is characterised by progressive and generalised skeletal muscle loss, both in terms of mass and function. Its main risk factors include ageing, gender, sedentary lifestyles and malnutrition. The latter is also frequently diagnosed alongside head- and- neck squamous cell carcinomas (HNSCC), with up to 46%-49% of patients being malnourished upon diagnosis. Although sarcopenia has been identified as a prognostic factor for HNSCC, only a small number of studies investigate the association between sarcopenia and survival in HNSCC. This study aimed to assess the association between pre-therapeutic sarcopenia and survival, as well as its impact on tolerance of chemoradiotherapy for the treatment of HNSCC. The outcomes measured in this study were overall survival (OS), disease-free survival (DFS), and treatment tolerance.
Read MoreSarcopenia: an adverse prognostic factor for patients with head and neck cancer?

Clinical Frailty Scale and Frailty Index in Predicting Long-Term Survival for the Critically Ill: a review

Frailty is a state of vulnerability, recognised clinically, where patients experience an ageing-associated decline in their physical and cognitive abilities. There are two main scales for measuring frailty. The Clinical Frailty Scale (CFS) is often used for intensive care unit patients. The Diseases-10 Modified Frailty Index (mFI) is also used; it is derived from the understanding of 11 comorbidities. However, it was unknown how the two compare. In this study of 7,001 patients, it was found that a greater proportion of patients were categorised as frail using the CFS, and this scale also predicted better those who would survive past the 6-month mark versus those who would die. This indicates that the two scales are not equivalent, and the mFI should not be used for frailty. This review by A. Subramaniam et al. aimed to highlight the differences between the two scales, the Clinical Frailty Scale and the Diseases-10 Modified Frailty Index, to determine which is a better predictor of frailty.
Read MoreClinical Frailty Scale and Frailty Index in Predicting Long-Term Survival for the Critically Ill: a review

SARCOPENIA DEFINITION

Sarcopenia is a condition which focuses on muscle loss. Loss of muscle mass and function, especially muscle strength and gait speed, associated with aging occurs in sarcopenia. Sarcopenia, cachexia, and malnutrition are considered as the main causes of muscle wasting and affect millions of elderly people and patients. Moreover, muscle atrophy can develop independently from diseases and age through disuse of the muscles. For a better classification and common language in medical science for ‘muscle wasting disease’ there is a proposal to combine the concepts of muscle wasting, sarcopenia, frailty, and cachexia by disease aetiology and disease progression. Patients with muscle atrophy show decreased muscle strength and therefore reduced quality of life, which is caused by a lower activity and increased exercise intolerance.

Despite a large number of studies, the understanding of the development of muscle wasting and the involved pathways remains very limited and more research is needed. Although many researchers and pharmaceutical companies have tried to find therapies for muscle atrophy, including cachexia and sarcopenia, no solution has been established until now.

REFERENCES

Rosenberg IH. Sarcopenia: origins and clinical relevance. Clin Geriatr Med 2011;27:337–339.

Anker SD, Coats AJ, Morley JE, Rosano G, Bernabei R, von Haehling S, Kalantar-Zadeh K. Muscle wasting disease: a proposal for a new disease classification. J Cachexia Sarcopenia Muscle 2014;5:1–3

Subscribe to the SCWD Newsletter

Stay Informed with the Latest Updates and Exclusive Insights!