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avje starostnikov | health of the elderly 216 Adequate intake in some of these nutrients have been repeatedly shown
to be valuable in preserving muscle mass and protecting against normal
decline in the elderly, both in randomized controlled trials and in
cohort analyses. Given that nutrition may influence the development
of sarcopenia, nutrition intervention may represent a feasible measure
for preventing or postponing age-related decline in muscle mass and
function.
Keywords: nutrition, sarcopenia, n-3 fatty acid, vitamin D, nutritional
assessment
Introduction
Sarcopenia is defined as the presence of low muscle strength, low muscle quan-
tity/quality and low physical performance (Morley et al., 2011; Cruz-Jentoft
et al., 2019). Today it is recognized as an age-related disease with ICD-10-CM
(M62.84) code (Anker et al., 2016). The overall estimates of prevalence of sarco-
penia in older adults worldwide is 10% (Shafiee et al., 2017), while it may be as
high as 30% in community-dwelling populations and even higher than 30% for
populations in long-term care (Cruz-Jentoft et al., 2014). The consequences of
having sarcopenia are reflected in loss of independence due to impaired phys-
ical performance, increased risk of mobility disorders, falls and fractures and
impaired ability to perform activities of daily living, leading to nursing home
admission, depression, hospitalization, and even death (Landi et al., 2013; Cor-
rea-de-Araujo and Hadley 2014; Cruz-Jentoft and Sayer 2019). In addition, its
presence is associated with other comorbidities, such as osteoporosis, diabetes
mellitus, insulin resistance, obesity, and chronic kidney disease, which have an
important impact on the public health burden (Beaudart et al., 2014; Kim et al.,
2014; Pacifico et al., 2020).
Multiple risk factors contribute to the aetiology of sarcopenia. Chang-
es in muscle morphology, neurodegenerative process, anabolic and sex hor-
mone production or sensitivity, protein balance, increased oxidative stress, in-
flammation and genetic predisposition are important risk factors (Roubenoff,
2003; Fulle et al., 2004; Can et al., 2016; Coen et al., 2019; Bauer, 2021; Priego et
al., 2021). which leads to reduced mobility, fragility and loss of independence.
This process called sarcopenia is secondary to several factors such as sedentary
lifestyle, inadequate nutrition, chronic inflammatory state and neurological al-
terations. However, the endocrine changes associated with aging seem to be of
special importance in the development of sarcopenia. On one hand, advancing
age is associated with a decreased secretion of the main hormones that stimu-
late skeletal muscle mass and function (growth hormone, insulin-like growth
factor 1 (IGF[sbnd]IAlong with these changes in older adults, decreased ba-
sal metabolic rate and increased dietary protein needs are also detected (Wil-
son and Morley, 2003; Bauer et al., 2013; Boirie, 2014). Besides these endoge-
nous factors, inadequate nutrition and a sedentary lifestyle also contribute to
the complex aetiology of sarcopenia (Rolland et al., 2008; Walrand et al., 2011;
to be valuable in preserving muscle mass and protecting against normal
decline in the elderly, both in randomized controlled trials and in
cohort analyses. Given that nutrition may influence the development
of sarcopenia, nutrition intervention may represent a feasible measure
for preventing or postponing age-related decline in muscle mass and
function.
Keywords: nutrition, sarcopenia, n-3 fatty acid, vitamin D, nutritional
assessment
Introduction
Sarcopenia is defined as the presence of low muscle strength, low muscle quan-
tity/quality and low physical performance (Morley et al., 2011; Cruz-Jentoft
et al., 2019). Today it is recognized as an age-related disease with ICD-10-CM
(M62.84) code (Anker et al., 2016). The overall estimates of prevalence of sarco-
penia in older adults worldwide is 10% (Shafiee et al., 2017), while it may be as
high as 30% in community-dwelling populations and even higher than 30% for
populations in long-term care (Cruz-Jentoft et al., 2014). The consequences of
having sarcopenia are reflected in loss of independence due to impaired phys-
ical performance, increased risk of mobility disorders, falls and fractures and
impaired ability to perform activities of daily living, leading to nursing home
admission, depression, hospitalization, and even death (Landi et al., 2013; Cor-
rea-de-Araujo and Hadley 2014; Cruz-Jentoft and Sayer 2019). In addition, its
presence is associated with other comorbidities, such as osteoporosis, diabetes
mellitus, insulin resistance, obesity, and chronic kidney disease, which have an
important impact on the public health burden (Beaudart et al., 2014; Kim et al.,
2014; Pacifico et al., 2020).
Multiple risk factors contribute to the aetiology of sarcopenia. Chang-
es in muscle morphology, neurodegenerative process, anabolic and sex hor-
mone production or sensitivity, protein balance, increased oxidative stress, in-
flammation and genetic predisposition are important risk factors (Roubenoff,
2003; Fulle et al., 2004; Can et al., 2016; Coen et al., 2019; Bauer, 2021; Priego et
al., 2021). which leads to reduced mobility, fragility and loss of independence.
This process called sarcopenia is secondary to several factors such as sedentary
lifestyle, inadequate nutrition, chronic inflammatory state and neurological al-
terations. However, the endocrine changes associated with aging seem to be of
special importance in the development of sarcopenia. On one hand, advancing
age is associated with a decreased secretion of the main hormones that stimu-
late skeletal muscle mass and function (growth hormone, insulin-like growth
factor 1 (IGF[sbnd]IAlong with these changes in older adults, decreased ba-
sal metabolic rate and increased dietary protein needs are also detected (Wil-
son and Morley, 2003; Bauer et al., 2013; Boirie, 2014). Besides these endoge-
nous factors, inadequate nutrition and a sedentary lifestyle also contribute to
the complex aetiology of sarcopenia (Rolland et al., 2008; Walrand et al., 2011;
