The diagnosis and treatment of sarcopenia and sarcopenic obesity

BACKGROUND: Sarcopenia is a progressive, generalized disease of skeletal muscle characterized by a loss of muscle strength and muscle mass. The combination of obesity and sarcopenia is called sarcopenic obesity. Because of the aging of the population in many countries around the world, sarcopenia and sarcopenic obesity are a challenge for global health policy. METHODS: This review is based on pertinent publications retrieved by a selective literature search. RESULTS: The effects of sarcopenia on health and quality of life are far-reaching and include difficulty coping with everyday life, an increased risk of falling, frequent hospitalization, and increased mortality. A population-based study in Germany revealed a 7% prevalence of sarcopenia in adults aged 65 and above. The prevalence of sarcopenic obesity was 4.5%. Persons aged 65 and above who are at increased risk for sarcopenia should be screened, e.g., with the SARC-F questionnaire. If screening yields a suggestive finding (SARC-F ≥ 4 points), the diagnosis of sarcopenia should be confirmed or ruled out by measurements of muscle strength (e.g. hand-grip strength, reference values: women <16 kg, men <27 kg) and appendicular muscle mass (women <5.5 kg/m2, men <7.0 kg/m2). The demonstration of reduced muscle strength is sufficient to initiate treatment. For the diagnosis of sarcopenic obesity, increased fat mass is additionally required. The goal of treatment is to improve mobility and reduce negative health outcomes. The treatment consists of resistance training and nutritional interventions. CONCLUSION: A targeted and structured approach to the detection and treatment of sarcopenia and sarcopenic obesity can make a major contribution to the maintenance or improvement of these patients' functionality and quality of life.