Sarcopenia

Question 1

define sarcopenia

Answer 1

Sarcopenia is the accelerated loss of muscle mass and strength

Question 2

what are the geriatric giants?

Answer 2

incontinence, instability, immobility and intellectual impairments

Question 3

what are the symptoms of sarcopenia?

Answer 3

gradual loss of muscle mass, general weakness, less stamina

Question 4

what is the grip strength test?

Answer 4

patient sits on chair with arm flat on chair arm and holds dynamometer. The test is done for 30s on each hand alternating three times.

Question 5

what is the male cut off for grip strength test?

Answer 5

less than 27kg

Question 6

what is the female cut off for grip strength test?

Answer 6

less than 16kg

Question 7

what are the steps used by the european diagnostics for sarcopenia?

Answer 7

1. clinical suspicion
2. case finding
3. confirming with measurements

Question 8

what tests are done during initial case finding for sarcopenia?

Answer 8

gait speed, grip test, rise from chair

Question 9

what is the gait speed cut off for case finding?

Answer 9

0.8m/s, 1.2m/s is needed to cross the road at traffic lights

Question 10

what measurements are used to confirm sarcopenia case?

Answer 10

1. dual energy x ray absorptiometry
2. bioelectrical impedance
3. CT/ MRI
4. D3 creatine
5. anthropometry
6. potassium levels?

Question 11

describe dual energy x ray absorpiometry

Answer 11

measures bone loss.

appendicular lean mass is calculated and divided by height^2.

Question 12

what is bioelectrical impedance?

Answer 12

it is a portable machine that is electrical current to estimate muscle mass, good foer the 80+

Question 13

what is the function of cross sectional imaging?

Answer 13

eg. CT and MRI to assess the muscle quality

Question 14

what is D3 creatine dilution?

Answer 14

vast majority of Cr found in muscle. it is deuterium-labelled Cr taken orally. 48-96hrs later D3 Cr is measured in urine

Question 15

why use potassium as a marker?

Answer 15

98% of potassium is found within cells and 80% of this is within cells that are in muscles

Question 16

what simple anthropometry tests can be done?

Answer 16

skinfold test - see thickness and limb circumference

Question 17

how is sarcopenia treated?

Answer 17

1. resistance exercise
2. having 1-1.2g/kg of protein daily
3. myostatin’s - ACE inhib to prevent mitochondrial decline

Question 18

what can sarcopenia lead to?

Answer 18

disability, lack of independence, increasing risk of falls, fractures, injury, less active and less muscle will lead to more fat and therefore more risk of hypertension, obesity and DM

Question 19

what ageing research occurs in newcastle?

Answer 19

national institute for health research- NIHR

Question 20

what sarcopenia research is occurring in NCL?

Answer 20

using biobank in a large prospective epidemiology study.

Question 21

what did the ncl biobank study find?

Answer 21

1. 50.1% with probable sp had 1 or more cardio conditions

2. 64.8% with probable sp had multimorbidities

Question 22

how many of the 40-70 group have probable sp?

Answer 22

biobank suggests that 5.3% have probable sp

Question 23

define geriatric medicine

Answer 23

speciality within internal medicine focusing on the complex are of elderly people

Question 24

the 2014, lit review focused on which diagnostic methods as alternatives?

Answer 24

1. D3 cr
2. potassium
3. anthropometry
4. ultrasounds

Question 25

what year is the study from that discusses alternative and less used diagnostics methods

Answer 25

2014 literature review

Question 26

what year was the study linking end stage renal disease and sarcopenia?

Answer 26

2021

Question 27

what is sarcopenia?

Answer 27

a degenerative muscoskeletal disorder involving the loss of muscle mass and function

Question 28

in 2021, how much sarcopenia cost the USA?

Answer 28

$18.5 billion - linked to increased falls, functional decline, frailty and premature mortality

Question 29

what is cachexia?

Answer 29

wasting and weakness due to severe chronic illness

Question 30

what is confounded to sarcopenia?

Answer 30

malnutrition and cachexia

Question 31

how is CKD a model of accelerated ageing (2021)?

Answer 31

characteristic aberrant changes in muscle mass and function

Question 32

2021 ref - how many of those with end stage CKD have sarcopenia?

Answer 32

between 15-55%

Question 33

what does the UK biobank do?

Answer 33

it is a large epidemiological study base that investigates genetics, lifestyle, environmental factor sin health and disease

Question 34

what are risk factors for sarcopenia?

Answer 34

reduced physical activity, inflammation, lower kidney function and more comorbidities

Question 35

what are type 2 fast fibres?

Answer 35

sprint - higher glycolic potential, lower oxidative capacity

Question 36

what are type 1 fatigue resistant fibres?

Answer 36

contain more mitochondrion, capillaries, myoglobin - slow, strength

Question 37

what type of fibres experience atrophy with age?

Answer 37

type 2

Question 38

since age causes neuronal loss, how does that link to muscle mass loss?

Answer 38

reduced number of muscle fibres

Question 39

what is the implication of reduction of GH with age?

Answer 39

less anabolic effects - less muscle and more visceral fat

Question 40

inflammation links to sarcopenia, how?

Answer 40

there is more TNF-a, IL-6, links to obesity, which there is less muscle strength

Question 41

what things cause sarcopenia?

Answer 41

1. hormones - oestrogen decrease and less GH
2. neuronal loss - less muscle fibres
3. inflammation
4. age