title: Sarcopenia and frailty in chronic respiratory disease.
abstract: Sarcopenia and frailty are geriatric syndromes characterized by multisystem decline, which are related to and reflected by markers of skeletal muscle dysfunction. In older people, sarcopenia and frailty have been used for risk stratification, to predict adverse outcomes and to prompt intervention aimed at preventing decline in those at greatest risk. In this review, we examine sarcopenia and frailty in the context of chronic respiratory disease, providing an overview of the common assessments tools and studies to date in the field. We contrast assessments of sarcopenia, which consider muscle mass and function, with assessments of frailty, which often additionally consider social, cognitive and psychological domains. Frailty is emerging as an important syndrome in respiratory disease, being strongly associated with poor outcome. We also unpick the relationship between sarcopenia, frailty and skeletal muscle dysfunction in chronic respiratory disease and reveal these as interlinked but distinct clinical phenotypes. Suggested areas for future work include the application of sarcopenia and frailty models to restrictive diseases and population-based samples, prospective prognostic assessments of sarcopenia and frailty in relation to common multidimensional indices, plus the investigation of exercise, nutritional and pharmacological strategies to prevent or treat sarcopenia and frailty in chronic respiratory disease.
authors.affiliation: 1 Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, UK.
authors.forename: Anna E
authors.initials: AE
authors.lastname: Bone
authors.affiliation: 1 Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, UK.
authors.forename: Nilay
authors.initials: N
authors.lastname: Hepgul
authors.affiliation: 2 NIHR Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust and Imperial College, London, UK.|3 The Hillingdon Hospital NHS Foundation Trust, Middlesex, UK.
authors.forename: Samantha
authors.initials: S
authors.lastname: Kon
authors.affiliation: 1 Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Maddocks
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D016330:Frail Elderly; D006801:Humans; D018908:Muscle Weakness / Q000150:complications / Q000503:physiopathology*; D018482:Muscle, Skeletal / Q000503:physiopathology; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology*; D012140:Respiratory Tract Diseases / Q000150:complications / Q000503:physiopathology; D055948:Sarcopenia / Q000150:complications / Q000503:physiopathology*
keywords: COPD; exercise; frail; rehabilitation; respiratory disease; sarcopenia