SARCOPENIA IN AGING HUMANS - THE IMPACT OF MENOPAUSE AND DISEASE

We examine the association of the menopause transition, congestive hea rt failure, and Parkinson's disease on body composition and energy exp enditure. We present evidence suggesting that the normal menopausal tr ansition is associated with accelerated loss of fat-free mass, a decli ne in resting metabolic rate, and increased central body fatness. Seco nd, we show that the the cardiac cachexia associated with heart failur e is partially due to an elevated level of energy expenditure. Despite having a lower quantity of fat-free mass, congestive heart failure pa tients have a higher resting metabolic rate (approximate to 283 kcal/d ) for their metabolic size than healthy elderly. The elevated level of resting energy expenditure probably contributes to their unexplained weight loss. Parkinson's patients experience muscular rigidity and tre mor which could contribute to inappropriately high levels of energy ex penditure and difficulty in maintaining body weight and composition. W e examined resting metabolic rate and body composition in eight Parkin son's patients and 34 healthy age-matched controls. Parkinson's patien ts showed lower levels of fat-free mass (approximate to 6 kg), but sim ilar resting metabolic rates (1601 +/- 250 kcal/d) versus healthy cont rols (1671 +/- 212 kcal/d), suggesting a hypermetabolic state. A re-ex amination of daily energy needs and the metabolic factors contributing to periods of energy imbalance during the menopausal transition and i n several disease states may be a prerequisite to offsetting accelerat ed sarcopenia.