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Sarcopenia and the syndrome of frailty

Abstract

Sarcopenia is the process of loss of body mass, specifically the musculoskeletal tissue, with age, which ultimately leads to a syndrome of clinical entity poorly defined as frailty. It is probably as old as humanity itself. Functionally, frailty is described as a syndrome characterized by a progressive decrease in the body’s reserve and declining resistance to stressors, possibly because of declining capacity of multiple physiologic systems resulting in higher vulnerability morbidity and mortality. Ayurveda also mentions morbidity occurring with advancing age and various options for its management. Elixirs are recommended in Ayurveda, popularly called ‘rasayana’, for recovery from the symptoms of frailty. Worldwide, because of the wide demographic profile, the process of ageing exerts its effects on geriatric populations at different ages. Europeans were the first to paraphrase the word frailty for the ageing process. With better medical care and nutrition, a substantial subset of populations survives longer than 60 years or longer worldwide. The most relevant aspect of the recognition of syndrome of frailty is that the process is, to some extent, reversible, provided that adequate attention is paid and a timely intervention is performed for the needy subset of population, which is likely to improve the quality of life markedly, besides resulting in an increased life span.

References

  1. Gielen E, Vanderschueren S, O’Neill TW, et al. Musculoskeletal frailty: a geriatric syndrome at the core of fracture occurrence in older age. Calcif Tissue Int 2012; 91:161–177.

    CAS  Article  Google Scholar 

  2. Cooper C, Dere W, Evans W, Kanis JA, Rizzoli R, Sayer AA, et al. Frailty and sarcopenia: definition and outcome parameters. Osteoporos Int 2012; 23:1839–1848.

    CAS  Article  Google Scholar 

  3. Cruz-Jentoft AJ. Sarcopenia: the newest geriatric syndrome? Hospital Universitario Ramón y Cajal, Madrid, Spain.

  4. Helms ER, Aragon AA, Fitschen PJ. Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation. Journal of the International Society of Sports Nutrition 2014; 11:20.

  5. Cruz-Jentoft AJ, Landi F, Topinková E, Michel JP. Understanding sarcopenia as a geriatric syndrome. Curr Opin Clin Nutr Metab Care. 2010; 13:1–7.

    Article  Google Scholar 

  6. Inouye SK, Studenski S, Tinetti ME, Kuchel GA. Geriatric syndromes: clinical, research, and policy implications of a core geriatric concept. J Am Geriatr Soc 2007; 55:780–791.

    Article  Google Scholar 

  7. Theou O, Stathokostas L, Roland KP, Jakobi JM, Patterson C Vandervoort AA, Jones GR. The effectiveness of exercise interventions for the management of frailty: a systematic review. J Aging Res 2011; 2011:569194.

  8. Cruz-Jentoft AJ, Michel J-P. Is sarcopenia the best determinant of frailty? Promoting access to innovation and clinical research for frail old persons. Athens, Greece:IAGG/WHO/SFGG Workshop; 2011.

  9. Anker SD, Coats AJS, Morley JE. Evidence for partial pharmaceutical reversal of the cancer anorexia–cachexia syndrome: the case of anamorelin. J Cachexia Sarcopenia Muscle 2015; 6: 275–277.

  10. Stockton KA, Mengersen K, Paratz JD, Kandiah D, Bennell KL. Effect of vitamin D supplementation on muscle strength: a systematic review and meta-analysis. Osteoporos Int 2011; 22:859–871.

    CAS  PubMed  Google Scholar 

  11. Morley JE, von Haehling S, Anker SD, Vellas B. From sarcopenia to frailty: a road less traveled. J Cachexia Sarcopenia Muscle 2014; 5:5–8.

    Article  Google Scholar 

  12. Pötsch MS, Tschirner A, Palus S, von Haehling S, Doehner W, Beadle J, et al. The anabolic catabolic transforming agent (ACTA) espindolol increases muscle mass and decreases fat mass in old rats. J Cachexia Sarcopenia Muscle 2014; 5:149–158.

    Article  Google Scholar 

  13. Neves RX, Rosa-Neto JC, Yamashita AS, Matos-Neto EM, Riccardi DMR, Lira FS Jr, et al. White adipose tissue cells and the progression of cachexia: inflammatory pathways. J Cachexia Sarcopenia Muscle 2015; Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/jcsm.12041.

  14. Mogi M, Kohara K, Nakaoka H, Kan-no H, Tsukuda K, Wang X-L, et al. Diabetic mice exhibited a peculiar alteration in body composition with exaggerated ectopic fat deposition after muscle injury due to anomalous cell differentiation. J Cachexia Sarcopenia Muscle 2015; Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/jcsm.12044.

  15. Isidori AM, Giannetta E, Greco EA, Gianfrilli D, Bonifacio V,Isidori A, et al. Effects of testosterone on body composition, bone metabolism and serum lipid profile in middle-aged men: a meta-analysis. Clin Endicrinol 2005; 63:280–293.

    CAS  Article  Google Scholar 

  16. Rolland Y, Czerwinski S, Abella’n Van Khan G, et al. Sarcopenia: its assessment, etiology, pathogenesis, consequences and future perspectives. J Nutr Health Aging 2008; 12:433–450.

    CAS  Article  Google Scholar 

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Correspondence to Ajay Kumar Gupta MD.

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Gupta, A.K., Mishra, S. Sarcopenia and the syndrome of frailty. Egypt J Intern Med 28, 133–139 (2016). https://doi.org/10.4103/1110-7782.203297

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Keywords

  • ageing
  • geriatric
  • osteoporosis