Sarcopenia and Osteoporosis

Question 1

Sarcopenia - Definition

Answer 1

Age associated loss of skeletal muscle mass and function. Complex syndrome associated with muscle mass loss alone or in conjunction with increased fat mass.

Question 2

Sarcopenia - Cause (8)

Answer 2

Multifactorial
- Inactivity/disuse
- Endocrine function changes
- Insulin resistance
- ↓ motor neurons
- Nutritional deficiencies
- Inflammation
- Chronic disease
- Age related molecular changes

Question 3

Sarcopenia - Risk Factors (4)

Answer 3

Smoking
Obesity
Physical inactivity
Ageing

Question 4

Sarcopenia - Other Contributing Factors (4)

Answer 4

Comorbidities/illness
Trauma
Genetics
Neuromuscular dysfunction

Question 5

Sarcopenia - Effect (5)

Answer 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

Question 6

Sarcopenia - Screening (6)

Answer 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.

Question 7

Sarcopenia - Practical Recommendations (5)

Answer 7

• 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.

Question 8

Osteoporosis - Definition

Answer 8

Systemic skeletal disease characterized by low bone density and microarchitectural deterioration of bone tissue with a consequent increase in bone fragility.

Question 9

Effect of Ageing on Bone

Answer 9

Greater loss of cancellous bone than cortical bone.
Imbalance between bone formation and bone resorption. ↑ osteoclasts ↓ osteoblasts.

Question 10

Osteoporosis - Non-modifiable Risk Factors (8)

Answer 10

• 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

Question 11

Osteoporosis - Modifiable Risk Factors (7)

Answer 11

• 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

Question 12

Osteoporosis - Screening and Testing

Answer 12

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.

Question 13

Osteoporosis - Management

Answer 13

• Resistance training has beneficial impact on physical function and ADLs.
• Regular weight bearing exercises.
• Vitamin D, calcium supplementation and dietary protein.
• Pharmacological intervention.