Musculoskeletal Pathologies (Sarcopenia)

Question 1

What parts of the body does musculoskeletal conditions affect? Give some examples of conditions related to the body part?

Answer 1

Joints - osteoarthritis, rheumatoid arthritis, gout
Bones - osteoporosis, fragility fractures
Muscles - sarcopenia, fibromyalgia
Spine - Back and neck pain

Question 2

What are the two most common forms of arthritis?

Answer 2

1. Osteoarthritis
2. Rheumatoid arthritis

Question 3

Where does osteoarthritis most commonly occur in the body?

Answer 3

Fingers, toes, neck, lower back, knees and hips

Question 4

Define sarcopenia?

Answer 4

The progressive and generalised loss of skeletal muscle mass and strength usually as a result of ageing, with a risk of adverse outcomes such as physical disability, poor quality of life and death

Question 5

What are the 3 stages of sarcopenia?

Answer 5

1. pre-sarcopenia
2. sarcopenia
3. severe sarcopenia

Question 6

Sarcopenia aetiology?

Answer 6

• Ageing (alterations in hormone production/increased cytokine production increases risk)
• Lifestyle factors (physical inactivity, smoking, poor diet)
• Genetic influence
• Low/inadequate nutrition
• Apoptosis

Question 7

What are some complications of sarcopenia?

Answer 7

• Low/decreased mobility/physical performance
• Frailty (increased risk of hospitalisation, disability and mortality)
• Mortality

Question 8

How would someone get diagnosed for sarcopenia?

Answer 8

• Test of physical performance (gait speed <1.0m/sec)
• DEXA scanner
• Anthropometric methods for determining loss of muscle strength/function
• Bioelectrical impedance
• Cachexia (usually caused by other chronic illnesses)

Question 9

What are the 3 main mechanisms of muscle wasting?

Answer 9

1. malnutrition
2. sarcopenia
3. cachexia

Question 10

Someone who suffers from frailty has what risk factors?

Answer 10

• Increased vulnerability to stressors
• Reduced capacity of physiological systems
• Increased risk of adverse health conditions
• Suffers from biological abnormalities (inflammation biomarkers), falls, hospitalisation, disability, death
• Social isolation/loneliness
• Weight loss
• Poor nutrition
• Cognitive impairment

Question 11

*Cycle of frailty

Answer 11

Question 12

What are some treatments applicable for sarcopenia?

Answer 12

• Resistance training
• Nutritional therapy (especially EAA supplementation, incresed protein intake)
• Physical therapy

Pharmological treatments including testosterone, selective androgenn receptor modulators (SARMs) or growth hormone (ghrelin)