Review ArticleSarcopenia, frailty and their prevention by exercise
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Sarcopenia and frailty: two interrelated concepts
As people age, some physiological changes frequently occur, such as decreased hormone production, increased oxidative stress, difficulty to provide adequate demand of oxygen to cells, and impairments in physical function. These changes are directly related to the risk of sarcopenia and frailty in the old population [1].
Primary sarcopenia is an age-related syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes such as
Nervous system
The nervous system function becomes impaired with aging. The basal ganglia, the cerebellum, and prefrontal cortex play a predominant role in motor planning and execution. Basal ganglia and cerebellum are mainly involved in motor planning while prefrontal cortex is related to the control and execution of movements [13]. The feedback loops between these structures mediate movement planning and control. Basal ganglia suffer a significant degenerative loss when compared to other brain areas during
Oxidative stress, sarcopenia, and frailty
Sarcopenia and frailty, even if they are different pathological entities, are closely related and have some mechanisms in common [61]. Oxidative stress is one of such mechanisms although its causative correlation is still under debate. This is the reason for describing some of the mechanisms involved in oxidative stress in both sarcopenia and frailty in this one single section (See Fig. 3). Sarcopenia is essentially caused by an alteration of the protein turnover leading to an imbalance between
Exercise interventions to improve sarcopenia and frailty
Accumulating evidence supports physical inactivity as a modifiable risk factor for developing many chronic diseases, such as diabetes, cancer, obesity, hypertension, musculoskeletal disorders and depression [91]. Indeed, regular physical exercise has become one of the key issues for the prevention of both chronic diseases and functional impairment, thus being considered of great importance for achieving a healthy lifestyle at all ages, especially in the old population [92], [93]. It is
Exercise alone is not enough
The complex etiology of sarcopenia and frailty explains the reason why isolated pharmacological and/or nutritional strategies do not seem to be effective enough in the prevention and treatment of these geriatric syndromes. Because the maintenance of muscle function is even more important than the maintenance of muscle mass, it is not surprising that interventions that have attempted to improve physical function in older persons by increasing muscle mass (IGF, growth hormone, testosterone) have
Acknowledgements
This work was supported by the following grants: Instituto de Salud Carlos III and co-funded by FEDER [grant number PIE15/00013], AICO/2016/076 from Conselleria de Educacion, Investigacion, Cultura y Deporte, SAF2016–75508-R from the Spanish Ministry of Education and Science (MEC), CB16/10/00435 (CIBERFES), PROMETEOII2014/056 de “Consellería, de Sanitat de la Generalitat Valenciana and EU Funded CM1001 and FRAILOMIC-HEALTH.2012.2.1.1-2 and ADVANTAGE-724099 Join Action (HP-JA) 3rd EU Health
Declarations of interest
None.
References (127)
- et al.
Frail phenotype and mortality prediction: a systematic review and meta-analysis of prospective cohort studies
Int. J. Nurs. Stud.
(2015) Lower extremity muscle mass predicts functional performance in mobility-limited elders
J. Nutr. Health Aging
(2008)Frailty consensus: a call to action
J. Am. Med. Dir. Assoc.
(2013)Age-related changes of the functional architecture of the cortico-basal ganglia circuitry during motor task execution
NeuroImage
(2011)Age-associated changes in motor unit physiology: observations from the Baltimore longitudinal study of aging
Arch. Phys. Med. Rehabil.
(2009)Exercise training as a drug to treat age associated frailty
Free Radic. Biol. Med.
(2016)Redox modulation of mitochondriogenesis in exercise. Does antioxidant supplementation blunt the benefits of exercise training?
Free Radic. Biol. Med.
(2015)- et al.
Control of translation initiation through integration of signals generated by hormones, nutrients, and exercise
J. Biol. Chem.
(2010) Aging is associated with diminished accretion of muscle proteins after the ingestion of a small bolus of essential amino acids
Am. J. Clin. Nutr.
(2005)Skeletal muscle hypertrophy and atrophy signaling pathways
Int. J. Biochem. Cell Biol.
(2005)
A ribosomal perspective on proteostasis and aging
Cell Metab.
Nutritional status according to the mini nutritional assessment (MNA(R)) and frailty in community dwelling older persons: a close relationship
J. Nutr. Health Aging
Longitudinal study of muscle strength, quality, and adipose tissue infiltration
Am. J. Clin. Nutr.
Difficulties with physical function associated with obesity, sarcopenia, and sarcopenic-obesity in community-dwelling elderly women: the EPIDOS (EPIDemiologie de l′OSteoporose) Study
Am. J. Clin. Nutr.
Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: a meta-analysis
Ageing Res. Rev.
Adaptations in muscular activation of the knee extensor muscles with strength training in young and older adults
J. Electromyogr. Kinesiol
A multicomponent exercise intervention that reverses frailty and improves cognition, emotion, and social networking in the community-dwelling frail elderly: a randomized clinical trial
J. Am. Med. Dir. Assoc.
IKKbeta/NF-kappaB activation causes severe muscle wasting in mice
Cell
Redox control of skeletal muscle atrophy
Free Radic. Biol. Med.
Aging muscle
Am. J. Clin. Nutr.
Age-dependent increases in oxidative damage to DNA, lipids, and proteins in human skeletal muscle
Free Radic. Biol. Med.
Oxidative stress and the mitochondrial theory of aging in human skeletal muscle
Exp. Gerontol.
Mitochondrial dysfunction and sarcopenia of aging: from signaling pathways to clinical trials
Int. J. Biochem Cell Biol.
Update on the oxidative stress theory of aging: does oxidative stress play a role in aging or healthy aging?
Free Radic. Biol. Med.
Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study
Lancet
Sarcopenia: european consensus on definition and diagnosis: report of the European working group on sarcopenia in older people
Age Ageing
Difference in muscle quality over the adult life span and biological correlates in the Baltimore longitudinal study of aging
J. Am. Geriatr. Soc.
Muscle quality, strength, and lower extremity physical performance in the Baltimore longitudinal study of aging
J. Frailty Aging
Prevalence of sarcopenia in the world: a systematic review and meta- analysis of general population studies
J. Diabetes Metab. Disord.
Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries
J. Gerontol. Biol. Sci. Med. Sci.
Interventions to prevent or reduce the level of frailty in community-dwelling older adults: a scoping review of the literature and international policies
Age Ageing
Sarcopenia in the aging high-fat fed rat: a pilot study for modeling sarcopenic obesity in rodents
Biogerontology
The role of nutrition in the prevention of sarcopenia
Wien. Med. Wochenschr.
Frailty in older adults: evidence for a phenotype
J. Gerontol. Biol. Sci. Med. Sci.
Aging, motor skill, and the energy cost of walking: implications for the prevention and treatment of mobility decline in older persons
J. Gerontol. Biol. Sci. Med. Sci.
The estimated numbers and relative sizes of thenar motor units as selected by multiple point stimulation in young and older adults
Muscle Nerve
Age-related EMG variables during maximum voluntary contraction
Percept. Mot. Skills
Older adults exhibit a reduced ability to fully activate their biceps brachii muscle
J. Gerontol. Biol. Sci. Med Sci.
Age related changes in surface myoelectric signals
Scand. J. Rehabil. Med.
Aging, the central nervous system, and mobility in older adults: interventions
J. Gerontol. Biol. Sci. Med. Sci.
Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia
J. Appl. Physiol. (1985)
Muscle wasting and resistance of muscle anabolism: the "anabolic threshold concept" for adapted nutritional strategies during sarcopenia
Sci. World J.
Exercise: the lifelong supplement for healthy ageing and slowing down the onset of frailty
J. Physiol.
Resistance exercise increases AMPK activity and reduces 4E-BP1 phosphorylation and protein synthesis in human skeletal muscle
J. Physiol.
Mediation of IGF-1-induced skeletal myotube hypertrophy by PI(3)K/Akt/mTOR and PI(3)K/Akt/GSK3 pathways
Nat. Cell Biol.
Human skeletal muscle is refractory to the anabolic effects of leucine during the postprandial muscle-full period in older men
Clin. Sci. (Lond.)
Bolus ingestion of individual branched-chain amino acids alters plasma amino acid profiles in young healthy men
Springerplus
Effects of leucine supplementation and resistance training on myopathy of diabetic rats
Physiol. Rep.
Protein intake and muscle health in old age: from biological plausibility to clinical evidence
Nutrients
Impaired anabolic response of muscle protein synthesis is associated with S6K1 dysregulation in elderly humans
FASEB J.
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