Treating sarcopenia in clinical practice: where are we now?
Sarcopenia - or the loss of muscle mass, strength and function with ageing - represents an important health issue of the twenty-first century because of its devastating effects in addition to an increased prevalence of aged people. The devastating health effects of sarcopenia are multiple: an increased falls risk, a decreased physical ability and quality of life and an independent increase of all-cause mortality. Although the ultimate remedy for sarcopenia yet has to be found, some interventions have proven their merit and might be of practical use in clinical practice, especially for geriatricians, who deal most with sarcopenia. This review intends to summarize the current therapeutic interventions, their proposed mechanism of action as well as their clinical value. The results of our review highlight the importance of exercise (50% resistance training, 50% endurance training), nutrition (25-30 g proteins with essential amino acids every meal and long-chain ω-3 fatty acids) and limitation of alcohol and smoking. In addition, studies also suggest a place for vitamin D (aim serum levels >30 ng/L), testosterone (aim serum levels >300 ng/dL) and creatine (15-20 g/d for five days, thereafter 3-5 g/d). In conclusion, although more studies are needed to elucidate the exact effectiveness and safety of many sarcopenia interventions, the current evidence already provides clinically useful information, which might benefit the patient with (pre-)sarcopenia.
a Faculty of Medicine and Health Sciences, Department of Internal Medicine , Ghent University , Ghent , Belgium.
Anton
A
De Spiegeleer
a Faculty of Medicine and Health Sciences, Department of Internal Medicine , Ghent University , Ghent , Belgium.
Mirko
M
Petrovic
b Faculty of Medicine and Health Sciences, Department of Family Medicine and Primary Health Care , Ghent University , Ghent , Belgium.
Pauline
P
Boeckxstaens
a Faculty of Medicine and Health Sciences, Department of Internal Medicine , Ghent University , Ghent , Belgium.
Nele
N
Van Den Noortgate
D000375:Aging; D004044:Dietary Proteins; D015444:Exercise; D005853:Geriatrics; D006801:Humans; D009752:Nutritional Status; D017410:Practice Guidelines as Topic; D055948:Sarcopenia / Q000503:physiopathology / Q000628:therapy*; D013739:Testosterone; D014807:Vitamin D
D004044:Dietary Proteins; D014807:Vitamin D; D013739:Testosterone
Ageing; Alcohol; Antioxidants; Carnitine; Citrullin; Creatine; DHEA; Exercise; Geriatrics; Ginkgo biloba; Growth hormone; Muscle mass; Muscle strength; Nutrition; Oestrogen; Proteins; Sarcopenia; Sleep; Smoking; Testosterone; Vitamin D; Withania somnifera; Ω-3 fatty acids