Zusammenfassung
GRUNDLAGEN: Viele Studien haben nachgewiesen, dass die Ethologie von Sarkopenie multikausal und sehr komplex ist. Die Verminderung der Muskelmasse führt zu einem Verlust von Muskelkraft, später zu einem abnehmenden funktionellem Status mit eingeschränkter Mobilität, damit wiederum zu einem höheren Sturzrisiko und zum Schluss zu einem höheren Mortalitätsrisiko. Aktuelle Empfehlungen und Leitlinien geben an, dass körperliche Inaktivität oder ein abnehmendes Niveau der körperlichen Aktivität Teil des Entstehungszyklus von Sarkopenie sind und deshalb körperliche Aktivität als wichtige Säule bei der Entwicklung und Behandlung von Sarkopenie berücksichtigt werden muss. THEMA: Ergebnisse zum Zusammenhang von körperlicher Aktivität und dem Alternsprozess haben nicht immer eindeutige Resultate gezeigt. Diese Inkonsistenz der wissenschaftlichen Ergebnisse ist zum Einen darauf zurückzuführen, dass Begriffe und das zugrunde liegende Konstrukt nicht einheitlich benutzt werden. Zum Anderen beruhen die unterschiedlichen Ergebnisse in der Heterogenität der Zielpopulation, Art der Interventionen oder auch den eingesetzten Messinstrumentarien. Diese Aspekte werden in dem Artikel thematisiert. Mit Bezug auf die zukünftigen Herausforderungen für die Rolle und den Einsatz von körperlicher Aktivität werden zusätzlich in diesem Artikel mögliche Barrieren und Anregungen zur Prävention und Behandlung von Sarkopenie diskutiert. Eine Vielzahl von Studien zeigt, dass strukturierte und gut geplante Trainingsprogramme, bestehend aus progressivem Krafttraining oder einem Schnellkrafttraining, positive Effekte auf die Sarkopenie oder Sarkopenie bezogene Komponente haben. Weniger eindeutig ist allerdings der Erkenntnisstand zum Transfer dieser Ergebnisse auf funktionelle Parameter. SCHLUSSFOLGERUNGEN: Beides, körperliche Aktivität und Training, haben gezeigt, dass sie das Sarkopenierisiko und den Beginn von funktionellen Einschränkungen bei älteren Menschen reduzieren können. Unglücklicherweise weist die Kohorte älterer Menschen gerade die höchsten Anteile von inaktiven oder gering aktiven Menschen auf. Deshalb scheint es zwingend notwendig, ältere Menschen zu motivieren, ihr körperliches Aktivitätsniveau zu erhöhen und sicheren Zugang sowie entsprechenden Trainingsprogramme bereit zu stellen.
Summary
BACKGROUND: Numerous studies have demonstrated that the etiology of sarcopenia is multi-causal and very complex process. The degradation of muscle mass leads to a loss of strength, later on to a decreased functional status, impaired mobility, a higher risk of falls, and eventually an increased risk of mortality. Present guidelines state that physical inactivity or a decreased physical activity level is a part of the underlying mechanisms of sarcopenia and therefore physical activity can be seen as an important factor to reverse or modify the development of sarcopenia. TOPIC: Results in the area of physical activity and aging have not always been homogeneous. The inconsistent findings in this research area are related to the different understanding of terms and underlying constructs along with different population, type of intervention, or measurement methods. These aspects will be discussed in the paper. With regard to the formulated future role of physical activity this article will discuss in addition different barriers and challenges in the prevention and treatment of sarcopenia. A multitude of studies shows that structured exercise programs including progressive resistance or power training have positive effects on sarcopenia and sarcopenia-related outcomes but less or inconclusive information is available for the transfer to functional outcomes. CONCLUSIONS: Both physical activities and exercise have shown to decrease risk of sarcopenia and onset of functional limitations in older persons. Unfortunately the cohort of older persons is the one with the highest percentage of individuals classified as inactive or sedentary. Therefore motivating older persons to increase their physical activity level as well as providing safe access to exercise programs seems to be a mandatory task.
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Freiberger, E., Sieber, C. & Pfeifer, K. Physical activity, exercise, and sarcopenia – future challenges. Wien Med Wochenschr 161, 416–425 (2011). https://doi.org/10.1007/s10354-011-0001-z
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DOI: https://doi.org/10.1007/s10354-011-0001-z