Sarcopenia and Aging

Sarcopenia refers to the gradual decline in muscle mass and quality noted with advancing age. There is growing evidence linking sarcopenia to functional disability, falls, decreased bone density, glucose intolerance, and decreased heat and cold tolerance in older adults. Factors implicated in the etiology of sarcopenia include decreased physical activity, malnutrition, increased cytokine activity, oxidative stress, and abnormalities in growth hormone and sex steroid axes. At present, progressive resistance training is the best intervention shown to slow down or reverse this condition. Preliminary studies show that the utilization of several trophic factors, notably testosterone and DHEA, may have a salutary effect on muscle mass and/or strength in older adults. More research is needed, however, before drawing definite conclusion as to the clinical utility of these substances in the management of sarcopenia.     

Promoting Healthy Aging During COVID-19

Older adults have been markedly impacted by the coronavirus disease 19 (COVID-19) pandemic. The American Geriatrics Society previously published a White Paper on Healthy Aging in 2018 that focused on a number of domains that are core to healthy aging in older adults: health promotion, injury prevention, and managing chronic conditions; cognitive health; physical health; mental health; and social health. The potentially devastating consequences of COVID-19 on health promotion are recognized. The purpose of this article is multifold. First, members of the Healthy Aging Special Interest Group will present the significant difficulties and obstacles faced by older adults during this unprecedented time. Second, we provide guidance to practicing geriatrics healthcare professionals overseeing the care of older adults. We provide a framework for clinical evaluation and screening related to the five aforementioned domains that uniquely impact older adults. Last, we provide strategies that could enhance healthy aging in the era of COVID-19.     

Complexities of care: Common components of models of care in geriatrics

As people age, they are more likely to have an increasing number of medical diagnoses and medications, as well as healthcare providers who care for those conditions. Health professionals caring for older adults understand that medical issues are not the sole factors in the phenomenon of this “care complexity.” Socioeconomic, cognitive, functional, and organizational factors play a significant role. Care complexity also affects family caregivers, providers, and healthcare systems and therefore society at large. The American Geriatrics Society (AGS) created a work group to review care to identify the most common components of existing healthcare models that address care complexity in older adults. This article, a product of that work group, defines care complexity in older adults, reviews healthcare models and those most common components within them and identifies potential gaps that require attention to reduce the burden of care complexity in older adults.