Tratamiento integral de la sarcopenia senil
Resumen
El objetivo del presente artículo es hacer una revisión de la evidencia actual acerca de la sarcopenia con énfasis en su tratamiento. La sarcopenia es una condición que involucra disminución de la masa, fuerza y funcionalidad muscular. Compromete la calidad de vida de los adultos mayores hasta el punto de la discapacidad. El envejecimiento fisiológico predispone un estado catabólico consecuencia de la disminución de la síntesis proteica y mayor destrucción de las fibras musculares. El reporte del European Working Groupon Sarcopenia in Older People (EWSOP) propone el diagnóstico basado en la disminución de la masa muscular, fuerza y rendimiento físico. La mejor aproximación terapéutica integral comprende la combinación de un adecuado aporte nutricional y un programa de ejercicios. Las herramientas de manejo nutricional que poseen evidencia de su beneficio son una dieta hiperproteica, suplementación con aminoácidos de cadena ramificada y vitamina D. Actualmente se dispone de varios programas de ejercicios que garantizan una ganancia progresiva de masa muscular e incluso previenen estados sarcopénicos. No hay que restar importancia al ejercicio aeróbico, flexibilidad y equilibrio que conjuntamente mejoran la movilidad de las personas. Es necesario continuar con estudios bien estructurados en torno a un tratamiento nutricional y ejercicio combinados para concluir su beneficio en el manejo de la sarcopenia.
The objective of this article is to review current evidence about sarcopenia with emphasis on its treatment. Sarcopenia is a condition that involves decrease in muscle mass, strength and function. It compromises the life quality of an elderly untill disability. Physiological aging predisposes a catabolic state due to protein synthesis decrement and an increase in muscle fibers destruction. The Report of the European Working Group on Sarcopenia in Older People (EWSOP) proposes diagnosis based on the decrement in muscle mass, strength and physical performance. The best overall therapeutic approach comprises the combination of an adequate nutritional intake and an exercise program. Nutritional management tools that have evidence of their benefit is a high protein diet, supplementation with branched-chain amino acids and vitamin D. Currently there are several exercise programs that ensure a progressive muscle gain and even prevent sarcopenic status. Not to downplay aerobic exercise, flexibility and balance that together improve the pacients’ mobility. It is necessary to continue with well-structured studies around nutritional treatment and exercise combined together to complete its benefits in the management of sarcopenia.
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[2] I. Janssen, D. S. Shepard, P. T. Katzmarzyk, and R. Roubenoff, “The healthcare costs of sarcopenia in the united states,” Journal of the American Geriatrics Society, vol. 52, pp. 80–85, 2004.
[3] J. L. Roig, “Sarcopenia: Algo más que la disminución de la masa muscular,” http://g-se.com/es/fisiologia-del-ejercicio/articulos/ sarcopenia-algo-mas-que-la-disminucion-de-la-masa-muscular-231, 2013, Accessed: 15 de febrero del 2016.
[4] C. Kisner and L. Colby, “Ejercicios contra resistencia para la recuperación muscular,” in Ejercicio Terapéutico: fundamentos y técnicas, 5th ed, Buenos Aires, Argentina, 2010, pp. 154–157.
[5] F. Mata-Ordóñez, I. Chulvi-Medrano, J. Heredia-Elvar, S. Moral-González, J. Marcos-Becerro, and M. Da Silva-Grigogolleto, “Sarcopenia and resistance training: actual evidence,” Journal of Sport and Health Research, vol. 5, pp. 7–24, 2013.
[6] A. A. Sayer, S. M. Robinson, H. P. Patel, T. Shavlakadze, C. Cooper, and M. D. Grounds, “New horizons in the pathogenesis, diagnosis and management of arcopenia,” Age and ageing, vol. 42, pp. 145–150, 2013.
[7] A. Cruz-Jentoft, F. Landi, S. Schneider, C. Z´u˜niga, H. Arai, Y. Boirie, L. Chen, R. Fielding, F. Martin, J. Michel, C. Sieber, J. Stout, S. Studenski, B. Vellas, J. Woo, M. Zamboni, and T. Cederholm, “Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. report of the international sarcopenia initiative (EWGSOP and IWGS),” Age and ageing, vol. 43, pp. 748–759, 2014.
[8] A. Laviano, C. Gori, and S. Rianda, “Sarcopenia and nutrition,” Adv Food Nutr Res, vol. 71, pp. 101–136, 2014.
[9] H. J. Denison, C. Cooper, A. A. Sayer, and S. M. Robinson, “Prevention and optimal management of sarcopenia: a review of combined exercise and nutrition interventions to improve muscle outcomes in older people,” Clinical interventions in aging, vol. 10, p. 859, 2015.
[10] D. Paddon-Jones and B. B. Rasmussen, “Dietary protein recommendations and the prevention of sarcopenia: protein, amino acid metabolism and therapy,” Current opinion in clinical nutrition and metabolic care, vol. 12, p. 86, 2009.
[11] M. Rondanelli, M. Faliva, F. Monteferrario, G. Peroni, E. Repaci, and F. Allieri, “Novel insights on nutrient management of sarcopenia in elderly,” BioMed research international, 2015.
[12] R. Rizzoli, “Nutrition and sarcopenia,” Journal of Clinical Densitometry, vol. 18, pp. 483–487, 2015.
[13] N. Toshikuni, T. Arisawa, and M. Tsutsumi, “Nutrition and exercise in the management of liver cirrhosis,” World journal of gastroenterology: WJG, vol. 20, p. 7286, 2014.
[14] S. S. Bukhari, B. E. Phillips, D. J. Wilkinson, M. C. Limb, D. Rankin, W. K. Mitchell, H. Kobayashi, P. Greenhaff, K. Smith, and P. Atherton, “Intake of lowdose leucine-rich essential amino acids stimulates muscle anabolism equivalently to bolus whey protein in older women at rest and after exercise,” American Journal of Physiology-Endocrinology and Metabolism, vol. 308, pp. E1056–E1065, 2015.
[15] Y. Boirie, B. Morio, E. Caumon, and N. J. Cano, “Nutrition and protein energy homeostasis in elderly,” Mechanisms of ageing and development, vol. 136, pp. 76 84, 2014.
[16] R. M. Daly, R. L. Duckham, and J. Gianoudis, “Evidence for an interaction between exercise and nutrition for improving bone and muscle health,” Current osteoporosis reports, vol. 12, pp. 219–226, 2014.
[17] R. Vidal Ruiz, “Entrenamiento de la fuerza en ancianos,” http://www. fueradelamasa.com/entrenamiento-de-la-fuerza-en-ancianos/, 2013, Accessed: 2 de enero de 2016.
[18] I. Chulvi-Medrano, “Entrenamiento de fuerza combinado con oclusión parcial superimpuesta. una revisión,” Revista Andaluza de Medicina del Deporte, vol. 4, pp. 121–128, 2011.
[19] J. Christie, “Progressive resistance strength training for improving physical function in older adults,” International journal of older people nursing, vol. 6, pp. 244–246, 2011.
[20] E. Díaz, C. Saavedra, and J. Meza, Documento técnico elaborado para MINSAL. Guía contemporánea de ejercicio y salud, 2007.
[21] A. M. Joseph, P. J. Adhihetty, and C. Leeuwenburgh, “Beneficial effects of exercise on agerelated mitochondrial dysfunction and oxidative stress in skeletal muscle,” The Journal of physiology, 2015.
[22] Y. Makanae and S. Fujita, “Role of exercise and nutrition in the prevention of sarcopenia,” Journal of nutritional science and vitaminology, vol. 61, pp. S125 S127, 2015.
[23] S.-B. Hernández and I. Chulvi-Medrano, “Entrenamiento bajo oclusión vascular,” https://www.entrenamiento.com/salud/ entrenamiento-bajo-oclusion-vascular/, 2013, Accessed: 15 de febrero de 2016.
[24] J. T. Fajardo and G. M. Ferlíu, “Entrenamiento por medio de vibraciones mecánicas: revisión de la literatura,” Revista Digital, vol. 10, pp. 1–25, 2004.
[25] A. Machado, D. García-López, J. González+Gallego, and N. Garatachea, “Wholebody vibration training increases muscle strength and mass in older women: a randomizedcontrolled trial,” Scandinavian journal of medicine & science in sports, vol. 20, pp. 200–207, 2010.
[26] M. Suominen, S. Jyvakorpi, K. Pitkala, H. Finne-Soveri, P. Hakala, S. Mannisto, H. Soini, and S. Sarlio-Lahteenkorva, “Nutritional guidelines for older people in finland,” The journal of nutrition, health & aging, vol. 18, pp. 861–867, 2014.
[27] R. R. Deer and E. Volpi, “Protein intake and muscle function in older adults,” Current Opinion in Clinical Nutrition & Metabolic Care, vol. 18, pp. 248–253, 2015.
[28] M. P. Bjorkman, M. H. Suominen, K. H. Pitkala, H. U. Finne-Soveri, and R. S. Tilvis, “Porvoo sarcopenia and nutrition trial: effects of protein supplementation on paladines, quizhpi, villota: Tratamiento integral de la sarcopenia senil. functional performance in home-dwelling sarcopenic older people-study protocol for a randomized controlled trial,” Trials, vol. 14, p. 387, 2013.
[29] I. Bosaeus and E. Rothenberg, “Nutrition and physical activity for the prevention and treatment of age-related sarcopenia,” in Proceedings of the Nutrition Society, 2015, pp. 1–7.
