The new concept of sarcopenia
Sarcopenia is one of the topics most debated by researchers, in US as well in Europe and Asia. The scientific evidence about the negative impact of sarcopenia over the last ten years has exponentially increased. However, to date there is no universally accepted definition and the diagnosis of sarcopenia is still little used in clinical practice.
This special issue of Journal Gerontology and Geriatrics is entirely dedicated to sarcopenia with the main aim to translate the scientific evidences into clinical practice. The articles that make up this special issue will analyze from definition to diagnosis, from risk factors to prevalence and incidence, and will provide a summary of the main scientific evidences in the field of prevention and treatment.
The introductory article presents a general overview on sarcopenia and will analyze in detail the indications of the recent sarcopenia definition revision provided by the European Consensus (EWGSOP2).
The article by Boetto and colleagues addresses the important problem of sarcopenia among subjects institutionalized in nursing home. In this context the scientific evidence is very scarce and the results of this original research represent a very important data to promote a careful screening and assessment of sarcopenia in nursing home and more generally in all care settings.
The article by Martone and colleagues provides a complete review on the evaluation and diagnosis of sarcopenia, from the anthropometric measures (i.e. mid-arm muscle circumference and calf circumference), that represent a very useful tool for a simple application in clinical practice, up to the most promising muscle mass assessment techniques (i.e., ultrasound) and biomarkers (i.e., D3-creatine dilution method). In particular, the article underlines the importance of a correct diagnosis of sarcopenia, which in turn is the biological substratum of physical frailty.
The article by D’Angelo and colleagues presents a detailed review on the effectiveness of exercise in preventing and treating sarcopenia. Furthermore, the article describe the exercise protocol adopted in the “Sarcopenia and Physical fRailty IN older people: multicomponenT Treatment strategies” (SPRINTT) project. The SPRINTT clinical trial will provide in the near future evidence of physical activity and nutritional supplementation in preventing several adverse outcomes associated with sarcopenia and physical frailty in older adults.
The article by Serafini and colleagues describes the importance of the nutritional approach both as prevention and as treatment. As well known, to maintain a good muscle mass and muscle function, it is important to consume high amount of proteins and specific amino acids. Considering these significant scientific evidences, this special issue on sarcopenia hosts the results of an important Italian research project on longevity (Look-up 7+). The results of the Look-up 7+ surveys demonstrate that there is a significant decline in daily meat-derived protein intake with advancing age. These findings also indicate that the higher meat consumption does not correlate with higher prevalence of cardiovascular risk factors, such as blood pressure and cholesterol and glucose levels.
Finally, the wide range of negative health-related events to which sarcopenia contributes has activated rigorous research efforts in the attempt to untangle its multifaceted pathophysiology and develop effective specific treatments. For example, recent researches have shown that proteins, essential amino acids, leucine, HMB and vitamin D play a role in the metabolism of skeletal muscle and are valid nutritional supplements. The best strategy to prevent and treat sarcopenia in older people is to combine a specific exercise protocol and adequate amino acid intake, as expected in the multi-center European clinical trail “Sarcopenia and Physics fRailty IN elderly: multi-component treatment strategies “(SPRINTT).
Francesco Landi (Guest Editor) 1, Stefano Volpato 2
1 Fondazione Policlinico Universitario “Agostino Gemelli” IRCSS,
Università Cattolica del Sacro Cuore, Rome, Italy;
2 Department of Medical Science, University of Ferrara, Italy