Sarkopene Adipositas im Alter: Ursachen, Folgen und Behandlungsansätze

Zusammenfassung

Adipositas ist ein bekanntes Gesundheitsproblem, das durch das gleichzeitige Vorliegen einer Sarkopenie, also einem Verlust von Muskelmasse und -kraft, verstärkt wird. Vor allem Hochaltrige sind häufiger von negativen Gesundheitsfolgen wie Mobilitätseinschränkungen, chronischen Erkrankungen, kognitiven Defiziten, reduzierter Lebensqualität und erhöhtem Mortalitätsrisiko betroffen. In Deutschland liegt die Prävalenz bei über 65-Jährigen bei 4,5%. Ursachen sind biologische Faktoren wie altersbedingter Muskelabbau, chronische Entzündungen, hormonelle Veränderungen (z. B. Hormonmangel) sowie ein sitzender Lebensstil und hochkalorische Ernährung. Laut ESPEN-EASO sollten alle über 70-Jährigen und Patient*innen und solche mit chronischen Erkrankungen auf sarkopene Adipositas untersucht werden. Zur Diagnosestellung werden Muskelkraft und Körperzusammensetzung (mittels DXA oder BIA) gemessen. Im Staging werden bereits entstandene Folgeerkrankungen erfasst. Therapeutisch sind Krafttraining und proteinreiche Ernährung zentral. Präventiv sollten Adipositas und Sarkopenie durch regelmäßige Bewegung und ausgewogene Ernährung verhindert werden.

Abstract

Obesity is a recognized health issue, but its impact increases when combined with sarcopenia, characterized by a loss of muscle mass and strength. This condition primarily affects older adults, leading to mobility limitations, chronic diseases, cognitive decline, reduced quality of life, and higher mortality risk. In Germany, the prevalence of sarcopenic obesity is estimated at 4.5% among individuals aged 65 or older. Contributing factors include biological processes like age-related muscle loss, chronic inflammation, hormonal changes (e. g., deficiencies), and lifestyle factors such as physical inactivity and high-calorie diets. ESPEN-EASO recommends screening for sarcopenic obesity in all patients aged 70 or older and those with chronic diseases. Diagnosis involves measuring muscle strength and body composition (by DXA or BIA). Staging identifies secondary diseases caused by sarcopenic obesity. Key treatments include resistance training to enhance muscle strength and a high-protein diet. Prevention focuses on regular exercise and a balanced diet, especially in older adults.

Schlüsselwörter

Adipositas - Sarkopenie - Diagnose - Prävention - Krafttraining

Keywords

Obesity - sarcopenia - diagnosis - prevention - resistance training

Publication History

Article published online:
28 February 2025

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