Rehabilitation in Sarcopenic Elderly

Abstract

Sarcopenia is defined as a disease (M62.84) characterized by progressive and generalized loss of skeletal muscle mass and strength, associated with a risk of adverse outcomes such as physical disability, poor quality of life and death. These negative outcomes affect mainly the aged subjects. Sarcopenia requires a rehabilitation program to improve physical performance but also nutrition. Malnutrition is a commonly occurring condition in older adults and results in numerous and substantial negative outcomes to the patients and the health care system, including hospitalization rates, morbidity and mortality. In the rehabilitation setting malnutrition has been shown to be related to functional decline, worse functional status and poor recovery. The implementation of physical activity for elder populations should be done throughout a good organized program tailored to the individual and his comorbidities with the aim to improve muscular mass and/or strength, to reduce risk of falls etc. In elderly population balanced protein supplementation of 1 to 1.5 g/kg/ day combined with exercise may be useful in preventing and reversing sarcopenia, as a part of a multimodal therapeutic approach. Leucine-enriched balanced amino acids and creatine enhance muscle strength, and vitamin D supplementation in doses sufficient to raise levels above 100 nmol/L should be given as adjunctive therapy. Nevertheless, current evidence of nutritional support to treat or prevent sarcopenia in the setting of rehabilitation in elderly persons with impairments is limited.