Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.
J Rehabil Med. 2020 Apr 14;52(4):jrm00042. doi: 10.2340/16501977-2672.
Impairment of physical function is the main determinant of morbidity/mortality in sarcopenia and frailty. Physical function tests are performed by the movement around the joints, and skeletal muscles are the main generators of the forces required to perform these functional tasks. However, the central nervous system, which initiates and coordinates muscle movements, controls the magnitude and temporal parameters of muscle forces.
Non-systematic literature review was performed about the effects of aging on neuromotor control.
The ability of a muscle to produce force by aging is deteriorated not only by muscle structural changes, but also by neuromotor control dysfunction. With aging, changes in muscle structure and loss of volumes in brain structures related with movement and cognition have been shown. Age-related cognitive impairment can have considerable negative effects on the force generating capacity of skeletal muscles. In this sense, the relationship has been found between handgrip strength, gait speed, and cognition.
Treatments targeting muscle mass only would be insufficient unless we address the impairment of neurocognitive functions. It is essential that prescribing life-long exercise is important for healthy aging including the preservation of muscle mass/strength, physical and cognitive functioning, and independent living.
在肌肉减少症和衰弱症中，身体功能的损伤是发病率/死亡率的主要决定因素。身体功能测试是通过关节运动来进行的，骨骼肌肉是完成这些功能任务所需力量的主要产生者。然而，发起和协调肌肉运动的中枢神经系统控制着肌肉力量的大小和时间参数。
对衰老对神经运动控制的影响进行了非系统性文献回顾。
肌肉随年龄增长产生力量的能力不仅因肌肉结构变化而恶化，还因神经运动控制功能障碍而恶化。随着年龄的增长，与运动和认知相关的肌肉结构变化和脑结构体积的丧失已经显现出来。与年龄相关的认知障碍会对骨骼肌肉的力量产生能力产生相当大的负面影响。从这个意义上说，已经发现握力、步态速度和认知之间存在关系。
如果我们不解决神经认知功能的损伤，仅针对肌肉质量的治疗将是不够的。重要的是，终生锻炼的规定对于健康衰老至关重要，包括肌肉质量/力量、身体和认知功能以及独立生活的维持。
