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Learning outcomes:
At the end of this unit the student will be able to:
Explain the consequences associated with sarcopenia in
an aging population and
collate the studies describing ways physical therapists
can counter the associated adverse changes.
Consequences of Sarcopenia
The age-related loss of muscle, coined sarcopenia in
1989.
The loss of skeletal muscle mass is accompanied by the
loss of muscle strength, rate of force development, and
muscle power.
Sarcopenia contributes to deficits in mobility, a decline
in functional capacity, and a reduction in skeletal
muscle oxidative capacity.
These muscle impairments, in combination with a
greater fat mass, contribute to the greater risk of falling,
frailty, and the development of comorbid conditions
such as insulin resistance or type 2 diabetes that
adversely impact health.
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Mitochondrial Dysfunction.
The aging-associated damage to muscle mitochondrial
DNA (mtDNA) may reduce the rate of muscle cell
protein synthesis, adenosine triphosphate (ATP)
synthesis, and ultimately may lead to the death of
muscle fibers and loss of muscle mass.
Consistent with other metabolic changes that are seen
with aging, because these mitochondrial abnormalities
have also been shown to be at least partially reversible
with exercise.
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Apoptosis.
Age related loss of myocytes via apoptosis has been
suggested to be a key mechanism behind the muscle
loss associated with human aging as well, though this
evidence is preliminary.
Recent data demonstrate that physical exercise can
mitigate skeletal muscle apoptosis in aged animals.
These basic science considerations should prompt the
clinician to consider exercise as not only a counter to
loss of physical fitness and function, but perhaps also a
mode of slowing down the apoptotic pathways
underlying sarcopenia.
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Influence of Genetics.
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MUSCLE COUNTERMEASURES
FOR OLDER INDIVIDUALS
Resistance training for individuals age 65 years and
older induces predictable increases in muscle strength,
muscle power, and mobility function in communitydwelling older persons, nursing home inhabitants, and
the hospitalized older adults.
Significant improvements in strength and mobility
function have also been reported in individuals 80
years of age and older.
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References:
Andrew A. Guccione, Rira A. Wong, Dale Avers, 2012
Geriatric Physical Therapy, 3rd ed, Elsevie
Timothy L. Kauffman, John O. Barr, Michael L. Moran
2007 Geriatric Rehabilitation Manual, 2 nd ed, Churchill
Livingstone
ACSMs guidelines for exercise testing and
prescription.9th edition.
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Thank you
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