Comprehensive approach to sarcopenia and cachexia treatment

Abstract

Sarcopenia is characterized by a progressive and generalized loss of skeletal muscle mass and strength and is categorized into primary, or age-related, sarcopenia and secondary sarcopenia that can be activity, nutrition, or disease related. Resistance training is the best approach for the treatment of age-related sarcopenia. Increasing physical activity and avoiding prolonged and unnecessary bed rest or a sedentary lifestyle are good general strategies for mitigating activityrelated sarcopenia. The treatment goals for nutrition-related sarcopenia involve the maintenance of a positive energy and protein balance. Early recognition and treatment of cachexia is important and differs depending on the cachectic stage (precachexia, cachexia, or refractory cachexia). Physical exercise may counteract both precachectic and cachectic stages by virtue of its anti-inflammatory effects. Less well-established approaches include nutrition therapy for which the evidence is limited, pharmacologic treatment which largely is still in development, and psychosocial interventions which may have positive effects. A comprehensive approach, including rehabilitation nutrition, psychosocial interventions, and pharmacologic therapies, may be used for treating sarcopenia and cachexia. Rehabilitation nutrition can help to maximize functionality in people with sarcopenia and cachexia. Further research on the treatments for sarcopenia and cachexia, especially those that are multimodal, is necessary.