Sarcopenia is the name given to the later, more severe stages of the age-related loss of muscle mass and strength that afflicts all older individuals. Over the past few decades, researchers have increasingly focused on establishing clinical definitions of sarcopenia and and exploring the mechanisms of sarcopenia. Here, researchers take the present standards for diagnosis and use them to build an aging clock for muscle loss, an attempt to provide a more definite measure of risk and progression of sarcopenia, particularly in its earlier stages.
Sarcopenia is a progressive, generalised skeletal muscle disease linked to negative health changes that accumulate across the lifespan. From a pathophysiological standpoint, endocrine and metabolic abnormalities interact with the low-grade chronic inflammation (i.e., “inflammageing“), that is observed in advanced agers, leading to a reduction of protein-synthesis and regeneration, and a parallel pattern of muscle wasting due to increased apoptosis and protein-lysis.
Among the number of initiatives launched to advance knowledge on sarcopenia and prompt preventive/therapeutic approaches, the European Working Group on Sarcopenia in Older People (EWGSOP) has emerged as the most influential in raising awareness and moving the field forward. EWGSOP consensus firstly introduced a broad clinical definition for sarcopenia not limited to muscle loss. This was eventually developed more recently (EWGSOP2) to move muscle weakness and reduced performance to the forefront as primary indicators of sarcopenia. EWGSOP2’s recommendations also developed an algorithm for case-finding, diagnosis, and severity determination for a consistent identification of people with sarcopenia or its risk, and simple, specific cut-off points for measures that identify and characterise sarcopenia.
While EWSGOP2’s algorithm for sarcopenia screening has undeniably increased awareness of this condition, its categorical nature does not allow to automatically obtain an outcome that quantifies the degree of sarcopenia. Conversely, a scalar, quantitative measure would help identify individuals who do not qualify as sarcopenic despite displaying subclinical alterations that potentially deserve preventive strategies. Such marker would also allow to determine whether interventions aimed at mitigating sarcopenia are truly effective.
This cross-sectional study was planned to develop, in healthy middle-aged and older adults, a novel predictor of sarcopenia based on the motor-functional and anthropometric tests derived from EWGSOP2, which were the primary outcome measures. Participants were tested for body composition, physical performance, blood biomarkers, and risk scores for major healthy issues. Muscle Age Acceleration (MAA) was modelled with Elastic Net regression to extract EWGSOP test mostly contributing to the musculoskeletal ageing trajectory. According to MAA, three trajectories were identified: accelerated agers displayed higher risk for sarcopenia (19%), as compared to normal (9%) and decelerated (2%), paralleled by significant subclinical alterations of blood chemistry markers in accelerated agers.
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