Sarcopenia and Its Associated Factors Among Hip Fractures Patients

Skeletal muscle is the largest body compartment in most adults with the exception of an enlarged adipose tissue mass in the presence of obesity. Skeletal muscles grow in size from birth onward, reaching peak mass in the third decade. Many factors determine an individual adult's total body skeletal muscle mass and include their size(height),magnitude of adiposity, race, genetic factors, activity, hormone levels and diet. By the fourth decade populations and individuals begin to show a gradual loss in skeletal muscle mass and the rate of atrophy appears to accelerate beyond the seventh decade. The senescence-related changes in skeletal muscle are, in turn, associated with adverse out- comes such as pathological bone fractures and even death. The term sarcopenia, from the Greek roots is widely used to describe the age-associated decrease in muscle mass observed in several cross-sectional and longitudinal studies. Interest in sarcopenia mainly results from its linkage with unfavorable outcomes, including mobility disorders, increased risk of falling, reduced ability to function in activities of daily living, loss of independence, poor quality of life, and reduced life expectancy. Measuring skeletal muscle mass, composition, strength and physical performance is thus a vital part of not only studying sarcopenia, but also of growing importance in clinically evaluating and monitoring the greatly increasing population of ageing at risk adults in most countries. Our report highlights aspects of evaluating these features of skeletal muscle and expands on earlier methodological and historical reviews. While the main phenotypic feature of sarcopenia is loss of lean tissue, notably skeletal muscle, there is growing recognition that sarcopenia can co-exist in the presence of obesity. A skeletal muscle compartment reduced in mass may thus be masked by the presence of excess fat. Diagnosing sarcopenia-obesity may thus include measures beyond that of skeletal muscle mass such as BMI and total body fat, topics that we will allude to in the review that follows. Loss of skeletal muscle also plays an important role in two other conditions, cachexia and frailty, creating a spectrum of phenotypes and clinical conditions that encompass sarcopenia There are two main factors for Skeletal muscle evaluation, skeletal muscle mass and composition, are the main determinants of global muscle metabolic function, strength and physical performance. Vascular and neurological integrity are also essential components that ultimately contribute to a skeletal muscle's metabolic and mechanical functionality. The'quality' of a skeletal muscle is a loosely defined concept that broadly includes aspects of anatomic structure, chemical composition and metabolic and mechanical performance. Our review encompasses aspects of measuring skeletal muscle mass, composition and function in relation to the evaluation of individuals and groups for the presence of sarcopenia and related conditions. Multiple methods of measuring skeletal muscle mass are available for research and clinical purposes that vary in cost, complexity and availability. A high prevalence of low muscle mass in hip-fracture patients has been shown. Hip fractures carry a high risk of both death and disability with a 8-36 % excess mortality within 1 year and more than 50 % of the survivors not regaining their own pre-injury level of independence. Sarcopenia may worsen the functional prognosis after hip fracture occurrence, but the association between reduced muscle mass and functional ability remains unclear in this group of older and frail persons. Conversely, muscle strength has been indicated as a strong independent predictor of the functional outcome, whereas lower-limb performance is usually not accessible at an early stage, because of the direct consequences of the hip fracture on ambulation. There are no available studies in our locality about sarcopenia and its related factors