Academic Geriatric Medicine, University of Southampton, Southampton, UK.
Age Ageing. 2013 Mar;42(2):145-50. doi: 10.1093/ageing/afs191. Epub 2013 Jan 11.
Sarcopenia is the age-related loss of skeletal muscle mass and function. It is now recognised as a major clinical problem for older people and research in the area is expanding exponentially. One of the most important recent developments has been convergence in the operational definition of sarcopenia combining measures of muscle mass and strength or physical performance. This has been accompanied by considerable progress in understanding of pathogenesis from animal models of sarcopenia. Well-described risk factors include age, gender and levels of physical activity and this knowledge is now being translated into effective management strategies including resistance exercise with recent interest in the additional role of nutritional intervention. Sarcopenia is currently a major focus for drug discovery and development although there remains debate about the best primary outcome measure for trials, and various promising avenues to date have proved unsatisfactory. The concept of 'new tricks for old drugs' is, however, promising, for example, there is some evidence that the angiotensin-converting enzyme inhibitors may improve physical performance. Future directions will include a deeper understanding of the molecular and cellular mechanisms of sarcopenia and the application of a lifecourse approach to understanding aetiology as well as to informing the optimal timing of interventions.
肌肉减少症是与年龄相关的骨骼肌质量和功能的丧失。它现在被认为是老年人的一个主要临床问题，该领域的研究正在呈指数级增长。最近最重要的发展之一是，肌肉质量和力量或身体表现的测量相结合，对肌肉减少症的操作定义达成了共识。这伴随着对从肌肉减少症动物模型发病机制的理解的巨大进展。明确的危险因素包括年龄、性别和身体活动水平，这些知识现在正在转化为有效的管理策略，包括抗阻力运动，最近人们对营养干预的额外作用也产生了兴趣。肌肉减少症目前是药物发现和开发的重点，但对于试验的最佳主要结果测量仍存在争议，迄今为止，各种有前途的途径都不尽如人意。“旧药新用”的概念很有前景，例如，有证据表明血管紧张素转换酶抑制剂可能会改善身体机能。未来的方向将包括更深入地了解肌肉减少症的分子和细胞机制，并应用生命过程方法来理解病因学，以及为干预的最佳时机提供信息。
