Management of Sarcopenia in Elderlies

Yıl 2016, Cilt: 10 Sayı: 4, 243 - 249, 20.12.2016

Hakan Yaman Ramazan Vural

https://doi.org/10.21763/tjfmpc.271330

Cited By: 1

Öz

Improvement in living conditions,
science and technology has enabled the management of several diseases. However,
in elderly people new medical condition, which cannot be explained by other
definitions of disease are evolving. These are called geriatric syndromes.
Sarcopenia might be one of these syndromes. Commonly it is defined as loss of
muscle mass and functionality due to aging. Changes of the body composition,
significant decline of the muscle mass and functions due to aging leads to
decrease of physical performance, loss of strength, immobility, falls, and
physical disability. An interdisciplinary approach
is needed for the diagnosis and management of frailty. The diagnosis is based
on the evaluation of the muscle mass, muscle strength, and physical performance
of the patients by different methods and tests. The management process begins
with the diagnosis and could be divided into two parts: non-pharmacological
(physical activity and nutritional support) and/ or pharmacological management.
Potential drugs, which are under development do not fulfill our expectations,
because they are lacking any scientific evidence. Data on mechanism,
effectivity, and safety are still missing. Therefore, non-pharmacological
methods like sports and nutrition are sustaining their importance.  Management approaches to sarcopenia should
develop and facilitate sportive exercise and nutritional support programs.
Family physicians play an important role during the care of this specific risk
group. They might play an important at the early diagnosis, the follow-up and
coordination of the care of this condition.

Yaşam koşullarının
iyileşmesi ile bilim ve teknolojideki gelişmeler, birçok hastalığın yönetimini
olanaklı kılmaktadır. Bu çerçevede, yaşlı bireylerin sayıları artmaktadır.
Yaşlı hastada, çoğunlukla atipik semptomlarla kendini gösteren ve hastalık
tanımı ile açıklanamayan klinik durumları tanımlamak için, geriatrik sendrom
terimi kullanılmaktadır. Bu terim, yaşlı hastalarda sık görülen, yaşam
kalitesini bozup, morbidite ve mortaliteyi arttırabilen klinik durumları ifade
etmektedir. Bu sendromlar arasında sarkopeniyi de saymak mümkündür. Yaygın
tanımı ile sarkopeni, yaşlılığa bağlı kas kütlesi ve fonksiyon kaybını ifade
eder. Yaşlanmayla beden bileşiminde oluşan
değişiklikler, kas kütlesi ve işlevlerindeki anlamlı kayıplar ile bedensel
verimde azalmalara, güç kaybına, bedensel bağımlılığa, düşmelere ve bedensel
engelliliğe neden olmaktadır. Sarkopeni’nin tanısı ve tedavisi interdisipliner
yaklaşım gerektirmektedir.Tedavi süreci tanının konulması ile başlamaktadır.
Tanı kas kütlesinin, kas gücünün ve
fiziksel performansın değişik yöntem ve testlerle değerlendirilmesi sonucu
konulmaktadır.Sarkopeni’nin
yönetimini non-farmakolojik (Bedensel Etkinlik ve Nütrisyonel Destek) ya/ ya da
ilaç tedavileri olarak iki gruba ayırmak mümkündür. Geliştirilmeye başlanan potansiyel
ilaçların kanıt eksiklikleri nedeniyle, henüz beklentilerimizi
karşılayabilecek nitelikte olmadıkları anlaşılmaktadır. İlaç tedavilerinin
mekanizması, etkinliği ve güvenliği ile ilgili veriler henüz yeterli değildir.
Bu nedenle, spor ve nütrisyonel destek gibi non-farmakolojik tedavilerin önemi
sürmektedir. Yaklaşımında ise, planlama ve
uygulama bakımından sarkopenili bireye özel sporsal alıştırma ve beslenme
destek planları geliştirilmeli ve uygulamaya konulmalıdır. Aile hekimlerinin,
bu risk grubunun bakımında önemli rolü bulunmaktadır. Sorunun erken tespitinde
rol alabileceği gibi, bakımın takibinde ve koordinasyonunda ilgili uzmanlık
dallarına desteği mümkündür. 

Anahtar Kelimeler

Geriatric syndrome, frailty, sarcopenia

Kaynakça

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