What is Sarcopenia?
- Progressive loss of muscle mass, strength and physical performance associated with ageing
- Can also be influenced by nutritional status
- Higher prevalence of sarcopenia in older adults3,4
Malnutrition - the start of reduced Quality of Life
Malnutrition affects people of all ages, but the risk is 30 % greater in people over the age of 65 years.1
One reason: The gap between the amount of nutrition consumed and the amount the body needs.
Please pay attention: There is a close relationship between nutritional status, sarcopenia and frailty2
Definition of Frailty
- An age-related syndrome
- Reduces a person’s ability to complete Activities of Daily Living (ADLs)
- Decreases ability to respond to external stressors, such as acute illnesses5
Relationship of Malnutrition, Sarcopenia and Frailty
5 indicators of frailty6
- Weight loss of over 5 % in 6 months
- Feelings of exhaustion
- Low energy expenditure
- Slow gait speed
- Weak grip strength
Recognising and treating malnutrition is essential for managing sarcopenia and frailty.
Early detection is key
Watch this introduction video for the SARC-F tool to detect sarcopenia patients
Sarcopenia screening and assessment
In order to effectively manage sarcopenia, here is an easy step by step guide for screening and assessment adapted from Cruz-Jentoft AJ, et al. Age Ageing. 2019;48(1):16-31.
Sarcopenia risk is identified by confirming low muscle strength by any of the following
A: Initial screening tool: SARC-F
B: Basic assessment supporting screening
Diagnosis is confirmed by assessing low muscle quantity or quality
Confirming diagnosis:
DXA (Dual-energy X-ray absorptiometry) and
BIA (Bioelectrical impedance analysis) CT** or
MRI (Magnetic resonance imaging)
References:
1) McGregor RA, Poppitt SD. Nutr Metab (Lond) 2013;10(1):46.
2) Xu ZR et al. Br J Nutr 2015;113(1):25–34.
3) Bakker OJ et al. Pancreatology 2014;14(5):340–6.
4) National Collaborating Centre for Acute Care, February 2006. Nutrition support in adults Oral nutrition support, enteral tube feeding and parenteral nutrition.
5) Stratton RJ et al. Wallingford: CABI Publishing; 2003.
6) Elia M. Malnutrition Action Group of BAPEN and the National Institute for Research Southampton. Biomedical Research Centre; 2015.
7) Osland E et al. JPEN J Parenter Enteral Nutr 2011;35(4):473–87.
Severity of sarcopenia is confirmed by a low score from any of the following physical performance outcome measurements
Confirming severity with:
Gait Speed test
SPPB (Short Physical Performance Battery) test
TUG (Timed-up-and-go) test
400 m walk test
Managing sarcopenia by
- Nutritional support
- Physical activity
- Managing medication
Sarcopenia Screening.pdf
Download the complete guide to support and manage your sarcopenia patients here.
- Filename
- Sarcopenia Screening.pdf
- Size
- 2 MB
- Format
Physical exercises support patients' well-being too
Be prepared for training
Excercise to maintain strength
Exercise to stay flexible
Excercise to improve balance
Fresubin Exercise booklet
Find tips and tricks for physical training in this exercise booklet for your patients. It contains a wide variety of different exercises for strength, balance and flexibility.
- Filename
- Exercise Booklet.pdf
- Size
- 2 MB
- Format
How to support a good nutritional status?
Improving energy intake
Frail older people are at risk of energy deficient diets that may lead to unintentional weight loss
- The minimum effective dose of 400 kcal daily oral nutritional supplementation (ONS) reduces risk of mortality in older people with malnutrition/frailty7
- Additional energy intakes of 317 to 474 kcal improve the outcome of tackling sarcopenia and frailty in elderly people8,9
Meeting protein requirements
Older people are at risk of protein deficient diets10
Current guidelines recommend intakes of
- 1.0–1.2 g protein/kg body weight/day for healthy older adults
- 1.2–1.5 g protein/kg body weight/day for those with chronic diseases11,12
Protein contributes to the maintenance of muscle mass
Vitamin D supplementation
Frailty is associated with changes in gait speed. Older people are also at risk of vitamin D deficiency5
- Vitamin D contributes to the maintenance of normal bones and of normal muscle function
- A daily intake of 20 μg helps to reduce the risk of falling associated with postural instability and muscle weakness. Falling is a risk factor for bone fractures among men and women 60 years of age and older
References:
1. Russell CA et Elia M. A report by BAPEN. 2011.
2. Bollwein J et al. The journal of nutrition, health & aging. 2013;17:351.
3. Cruz-Jentoft AJ, et al. Age Ageing. 2019;48(1):16-31.
4. Beaudart C, et al. J Cachexia Sarcopenia Muscle. 2017;8(2):238-244.
5. Morley JE et al. Journal of the American Medical Directors Association. 2013;14:392.
6. Clegg A et al. Lancet. 2013;381:752.
7. Milne A et al. The Cochrane database of systematic reviews. 2009:CD003288.
8. Cawood AL et al. Ageing research reviews. 2012;11:278.
9. Hubbard GP et al. Clinical nutrition. 2012;31:293.
10. Joint FAO/WHO/UNU Expert Consultation on Protein and Amino Acid Requirements in Human Nutrition. World health organization technical report series. 2007;935:1.
11. Deutz NEP et al. Clinical nutrition. 2014;33:929.
12. Bauer J et al. Journal of the American Medical Directors Association. 2013;14:542.