Sarcopenia and Osteoporosis Flashcards
Sarcopenia - Definition
Age associated loss of skeletal muscle mass and function. Complex syndrome associated with muscle mass loss alone or in conjunction with increased fat mass.
Sarcopenia - Cause (8)
Multifactorial
- Inactivity/disuse
- Endocrine function changes
- Insulin resistance
- ↓ motor neurons
- Nutritional deficiencies
- Inflammation
- Chronic disease
- Age related molecular changes
Sarcopenia - Risk Factors (4)
Smoking
Obesity
Physical inactivity
Ageing
Sarcopenia - Other Contributing Factors (4)
Comorbidities/illness
Trauma
Genetics
Neuromuscular dysfunction
Sarcopenia - Effect (5)
↑ risk of falls -> fractures
ADL impairment
Might be associated with heart disease, respiratory disease and cognitive impairment.
↑ risk of hospitalization
↑ medical health care cost
Sarcopenia - Screening (6)
- Decline in function, strength and health status.
- Self-reported mobility related difficulty.
- History of recurrent falls.
- Recent unintentional weight loss >5%
- Post hospitalization.
- Other chronic conditions (type 2 diabetes, chronic heart failure, COPD, chronic kidney disease, RA and cancer.
Sarcopenia - Practical Recommendations (5)
- Protein intake 1,6 - 1,8 g/kg/d daily.
- 5g of leucine per meal.
- Ensure adequate energy supply.
- Resistance exercise at least 2x week.
- Reduce sedentary time <6h per day or 6.000 - 10.000 steps per day.
Osteoporosis - Definition
Systemic skeletal disease characterized by low bone density and microarchitectural deterioration of bone tissue with a consequent increase in bone fragility.
Effect of Ageing on Bone
Greater loss of cancellous bone than cortical bone.
Imbalance between bone formation and bone resorption. ↑ osteoclasts ↓ osteoblasts.
Osteoporosis - Non-modifiable Risk Factors (8)
- 50+ years old
- Height loss
- North European ancestry
- Female - menopause
- Family history of osteoporosis, personal history of fragility fracture.
- Ethnicity (Caucasian and Asian)
- Oestrogen deficiency and amenorrhea
- Menopause and hysterectomy
Osteoporosis - Modifiable Risk Factors (7)
- Inactivity or sedentary lifestyle
- Excess intake of alcohol, tobacco and caffeine.
- Lower body weight and BMI
- Poor nutrition: calcium deficiency
- Vitamin D deficiency
- Eating disorders
- Frequent falls
Osteoporosis - Screening and Testing
Bone mineral density (BMD) is described as a T-score.
Osteoporosis: T-score <-2,5 at femoral neck or spine.
Osteopenia (low bone mass): T-score <-1 & >-2,5.
Osteoporosis - Management
- Resistance training has beneficial impact on physical function and ADLs.
- Regular weight bearing exercises.
- Vitamin D, calcium supplementation and dietary protein.
- Pharmacological intervention.