Tom 17, Nr 1 (2023)
Inne materiały uzgodnione z Redakcją
Opublikowany online: 2023-02-28
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Sarkopenia — możliwości diagnostyki i leczenia w warunkach POZ
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Forum Medycyny Rodzinnej 2023;17(1):37-43.
Streszczenie
Sarkopenia (niewydolność mięśni), definiowana jako niski poziom siły, ilości i/lub jakości mięśni oraz sprawności fizycznej, jest zjawiskiem powszechnym wśród osób w podeszłym wieku. Diagnostyka sarkopenii powinna być pr zeprowadzana w przypadkach podejrzanych klinicznie oraz wśród tych pacjentów , którzy uzyskali co najmniej 4 pkt w badaniu przesiewowym, jakim powinien stać się kwestionariusz SARC-F. Sarkopenię można uznać za prawdopodobną i rozpocząć leczenie, jeżeli wykazano niską siłę ścisku dłoni tj. poniżej 16 kg w przypadku kobiet i 27 kg w przypadku mężczyzn lub wtedy, gdy w teście 5-krotnego wstawania z krzesła chorzy uzyskali czas przekraczający 15 sekund. Aby potwierdzić sarkopenię, należy wykazać niską jakość lub ilo ść mięśni przy użyciu metod takich jak DXA (uznawanej za „złoty standard”), BIA , CT lub MRI. P onieważ nie są one dostępne w warunkach opieki podstawowej, można je zastąpić pomiarem obwodu łydki z wynikiem poniżej 31 cm. W ocenie sprawności fizycznej obok testu „wstań i idź”, SPBB oraz 400-metrowego testu marszu, najpr zydatniejszy okazuje się test prędkości chodu na dystansie 4 metrów z punktem odcięcia poniżej ≤ 0,8 m/s, któr y potwierdza ciężką postać sarkopenii. Leczenie chorych z sarkopenią polega przede wszystkim na stosowaniu ćwiczeń, szczególnie oporowych w połączeniu z podażą białka na poziomie minimum 1–1,5 g/kg masy ciała/dobę.
Słowa kluczowe: sarkopeniaosoby starszeopieka podstawowa
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