Diagnosis and treatment of sarcopenia.🔬🔬🔬

As populations around the world tend to age, sarcopenia has gradually become a public health concern. Recent studies have shown that middle-aged and elderly people with sarcopenia have a higher incidence of cardiovascular disease than the general population. They had a 72% and 33% increase in the incidence of cardiovascular disease and the risk of cardiovascular events, respectively. 

What is sarcopenia?

In clinical practice, sarcopenia generally refers to the continuous decrease in the number, strength and function of skeletal muscle caused by aging. It can make the patient slow and unsteady. It also makes people prone to falls and fractures. Organ function may also be affected. It can lead to heart and lung failure, and even death. Its pathogenesis and etiology are complex. It is currently believed that sarcopenia is associated with the following pathological changes: Autophagy of skeletal muscle stem cells, excessive inflammatory state, oxidative stress, muscle mitochondrial dysfunction, protein breakdown and synthesis disorders, microvascular endothelial dysfunction and metabolic disorders, etc. Risk factors for sarcopenia include physical inactivity and malnutrition.

Diagnosis of sarcopenia.

Appendicular skeletal muscle mass index (ASMI) is a determining index. Appendicular skeletal muscle mass can be measured by dual-energy X-ray absorptiometry and divided by the square of height to calculate the index. The presence of sarcopenia was considered if it was less than 7.0 kg/m2 in men and 5.4 kg/m2 in women. The diagnostic process for sarcopenia is as follows:

If the patient is 65 years or older, perform a pace test.

If the pace is greater than 0.8m/s, measure the patient's grip strength. There is no sarcopenia if the grip strength is >25kg in men or >18kg in women. If the grip strength of men is ≤25kg or the grip strength of women is ≤18kg, ASMI should be measured. Sarcopenia was diagnosed if ASMI < 7.0 kg/m2 in men or ASMI < 5.4 kg/m2 in women.

If the pace is smaller than 0.8m/s, measure ASMI. Sarcopenia was diagnosed if < 7.0 kg/m2 in men or < 5.4 kg/m2 in women.

Nutritional interventions for sarcopenia.

Nutritional interventions for sarcopenia require adequate supplementation of these three.

Protein: Human skeletal muscle stores large amounts of various forms of protein. An important solution for the treatment of sarcopenia is to supplement high-quality protein. It improves muscle mass. Among them, leucine whey protein is widely believed to stimulate muscle protein synthesis, thereby it can maintain muscle mass. Therefore, foods rich in whey protein such as eggs, soy products and milk are recommended.

Vitamin D: Vitamin D plays a key role in the process of bone mineralization. It regulates the absorption of calcium and phosphorus in the body. Maintaining healthy bones and muscles depends on vitamin D. Therefore, vitamin D supplementation is great significance for improving and strengthening the muscle function of the elderly.

Omega-3 Fatty Acids: Studies have shown that both muscle mass and synthesis of muscle protein can be improved by omega-3 fatty acids. 

Exercise intervention for sarcopenia.

While muscle mass in older adults declines with age, exercise can slow or even reverse the decline in muscle function and mass. Since sarcopenia also increases the risk of cardiovascular disease, many patients with sarcopenia have cardiovascular disease. Moderate exercise can reduce the incidence of adverse cardiovascular events and help prevent cardiovascular disease. However, patients with cardiovascular disease also have certain risks when exercising. Their exercise should be done after evaluation and advice. 

• For healthy people: Get at least 150 minutes of moderate-intensity physical activity per week, or 75 minutes of vigorous-intensity physical activity per week, or a combination of the two. Studies have shown additional benefits of increasing moderate-intensity exercise to 300 minutes per week, or high-intensity exercise to 150 minutes per week. It is recommended to exercise several times a week, and daily exercise would be more recommended.
• For those with other medical conditions: Patients should be diagnosed and treated for their disease, as well as undergo a cardiopulmonary exercise test to assess exercise capacity. According to the patient's physical condition, cardiopulmonary capacity, disease, etc. to develop an individualized exercise program. The patient's Borg Scale of Perceived Exertion can be used to determine whether the intensity of exercise is appropriate.

Medical treatment of sarcopenia.

Medications for sarcopenia include hormones, omega-3 fatty acids, osteocalcin, stem cell transplantation, and more. They are of great help in the prevention and treatment of sarcopenia.

The basis of sarcopenia prevention and treatment lies in diet and exercise, and then combined with drug treatment depending on the patient's condition. A healthy diet and exercise can also reduce the risk of cardiovascular disease. Seniors and their families should pay more attention.