[ Summary ] |
Frail elderly patients often have both sarcopenia and declining physical endurance. The causes of sarcopenia and declining physical endurance can be attributed to age, reduced activity and nutrition, as well as diseases. Assessment of the multi-factorial causes of sarcopenia and declining physical endurance is important because rehabilitation nutrition differs depending on the particular etiology. The concept of rehabilitation nutrition as a combination of both rehabilitation and nutritional care management, as outlined in the general International Classification of Functioning, Disability and Health guidelines is used to evaluate nutritional status and to maximize functionality in sarcopenic patients and the frail elderly. Resistance training and endurance training are useful for treatment of age-related sarcopenia and declining physical endurance. In contrast, resistance training and endurance training are contraindicated in nutrition-related sarcopenia without adequate nutrition care management. Sarcopenic dysphagia is characterized by the loss of swallowing muscle mass and functions associated with generalized loss of skeletal muscle mass and function. Therapy strategies for sarcopenic dysphagia include dysphagia rehabilitation, general treatment of sarcopenia, and nutritional improvement. Malnutrition contributes to the etiology of secondary sarcopenia and sarcopenic dysphagia. Therefore, nutrition care managemen to increase muscle mass and strength is indispensable for sarcopenic dysphagia rehabilitation, including resistance training of swallowing muscles, early mobilization and early monitoring of oral intake. |