Maintaining Muscle Function Across the Lifespan

Abstract

Sarcopenia is a geriatric syndrome currently defined as pathological loss of muscle mass and function. Sarcopenia is not only a major contributor to loss of physical function in older adults but is also associated with increased risk of morbidity, mortality, and increased healthcare costs. As a complex and multifactorial syndrome, sarcopenia has been associated with numerous degenerative changes during the aging process, but there is building evidence for significant contributions to the development of sarcopenia from neurodegenerative changes in the peripheral nervous system. A variety of interventions have been investigated for the treatment of sarcopenia, but current management is primarily focused on nutrition and therapeutic exercise interventions. Great strides have been made to improve screening procedures and diagnostic criteria for sarcopenia, but continued optimization of diagnostic and screening strategies is needed to better identify individuals with sarcopenia or at risk of developing sarcopenia. Understanding and addressing the major drivers of sarcopenia pathogenesis will help develop therapeutics that can reduce the impact of sarcopenia on affected individuals and society.

Physiatric Evaluation and Management to Optimize the Care of Older Adults at Risk for Sarcopenia

“…For PGY-1 positions, there were 589 applicants and 156 matches, and for PGY-2 positions, there were 680 applicants and 325 matches. 1 Superimposed upon the increasingly competitive residency match process, the Couples Match poses unique challenges. Since 1984, two individuals have been able to participate in the Match together through the Couples Match.…”

“…2 However, of the 1224 couples participating in the 2021 Main Residency Match, the Couples Match rate was 93.4%, a 2.2% decrease from 2020 and the lowest Couples Match rate since 2010. 1 Moreover, no data are available regarding the specialties in which couples matched into or the number of couples that matched into the same specialty.…”

“…The study by Choi et al 1 included patients with stroke whose trunk impairment scores were 20 or less, who could walk independently for more than 10 m without ankle-foot orthosis, and who had mean baseline Postural Assessment Scale scores ranging from 17.2 to 19.2. According to previous studies, a trunk impairment score of 20 can indicate normal trunk function in daily life, 7 and a Postural Assessment Scale score of 12.5 at admission can predict independent ambulation at discharge in inpatients with stroke who undergo rehabilitation.…”

“…According to previous studies, a trunk impairment score of 20 can indicate normal trunk function in daily life, 7 and a Postural Assessment Scale score of 12.5 at admission can predict independent ambulation at discharge in inpatients with stroke who undergo rehabilitation. 8 This means that the patients included in the study by Choi et al 1 had relatively mild stroke. Therefore, the results cannot be generalized to patients with chronic stroke who still require active rehabilitation programs or patients with moderate to severe stroke.…”

“…The recent article by Arnold and Padilla Colon 1 provides a thorough yet concise review of sarcopenia and highlights an opportunity for physiatrists to be actively engaged in the evaluation and management of this high-risk patient population. As experts in both function and neuromusculoskeletal conditions, physiatrists are uniquely qualified to assume a key role in the assessment and treatment of patients with, or at risk for, sarcopenia.…”