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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.

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 Organisationโ€™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 sarcopeniaโ€™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 โ€˜muscle wasting diseaseโ€™ 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;27:337โ€“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;5:1โ€“3

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