Sarkopenie: Eine Herausforderung im Alter

Zusammenfassung

Sarkopenie ist ein geriatrisches Syndrom, das durch einen generalisierten Verlust von Muskelmasse und Muskelfunktion gekennzeichnet ist. Damit verbunden ist eine erhöhte Wahrscheinlichkeit von Stürzen, Frakturen, Behinderung und Mortalität. Seit Oktober 2016 gibt es in den USA einen ICD-10-CM-Kode (M62.84) für Sarkopenie. In Deutschland kann Sarkopenie seit 2018 im ICD-10-GM (M62.50) kodiert werden. Zur Selektion in der Primärversorgung besteht die Möglichkeit, mittels eines Sarkopenie-Fragebogens (SARC-F) gefährdete Patienten zu identifizieren. Diese können dann einer weiterführenden Diagnostik zugeführt werden. Gemäß der aktuellen revidierten Fassung des europäischen Sarkopeniekonsensus sind ein Therapiebeginn und eine weitere Ursachenabklärung bereits bei Vorliegen einer eingeschränkten Muskelkraft möglich. Gegenwärtig besteht die Therapie aus Kraft- und Balancetraining sowie einer Ernährungsberatung, mit dem Ziel einer proteinreichen Ernährung. Eine medikamentöse Behandlung der Sarkopenie ist noch nicht verfügbar. Einige Substanzen sind jedoch in der klinischen Prüfung. Am vielversprechendsten scheint die Gruppe der Myostatin-Antagonisten zu sein.

Abstract

Sarcopenia is defined as a geriatric syndrome based on a generalised skeletal muscle loss and impairment of physical performance. Sarcopenia is associated with an increased likelihood of adverse outcomes including falls, fractures, disability and mortality. Since October 2016 there is an ICD-10-CM code (M62.84) for sarcopenia in the USA. In Germany (ICD-10-GM) it is possible to encode sarcopenia since 2018 (M62.50). For screening in the primary care setting, a questionnaire (SARC-F) has been introduced to identify patients at risk for sarcopenia, leading to further diagnostics. According to the current revised version of the European sarcopenia consensus definition, therapy and further assessment of causes can already be started when reduced muscle strength is diagnosed. At present, the therapy consists of resistance and balance training as well as nutritional advice with the aim of a protein-rich diet. A drug treatment of sarcopenia is not available so far. However, some substances are in clinical trials. Most promising seems to be the group of myostatin antagonists.

Schlüsselworte

Sarkopenie - Geriatrie - Muskel - Stürze

Key words

sarcopenia - geriatrics - muscle - falls

Publikationsverlauf

Artikel online veröffentlicht:
02. Juni 2020

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