Geriatric Physical Therapy: Sarcopenia, Frailty, Osteoporosis, and Fall Prevention

Vocabulary flashcards covering diagnostic criteria, screening tools, formulas, and physical therapy recommendations for sarcopenia, frailty, osteoporosis, and joint health in older adults.

Sarcopenia

A progressive skeletal muscle disorder involving loss of muscle mass, strength, and power, which is formally recognized as a muscle disease.

ICD-10 Code M62.84

The specific and diagnostic code for sarcopenia under the International Statistical Classification of Diseases and Related Health Problems.

Sarcopenia Physiological Benchmarks

Characterized by a $1.5\%$\text{--}$2\%$ annual decline in muscle strength after age 40, preferential loss of Type II (fast-twitch) muscle fibers, and a decline in muscle power that is more pronounced than the decline in strength.

EWGSOP2 Low Muscle Strength Criteria

Hand grip strength $<27\,kg$ for males or $<16\,kg$ for females, or a five-times chair rise time of $>15\,seconds$.

EWGSOP2 Low Muscle Quantity/Quality Criteria

Appendicular skeletal muscle mass divided by height squared $<7.0\,kg/m^2$ for males or $<5.5\,kg/m^2$ for females.

EWGSOP2 Severe Sarcopenia Criteria

Low physical performance characterized by a gait speed $<0.8\,m/sec$ or a Short Physical Performance Battery (SPPB) score $\le 8$.

SARC-F Questionnaire

A validated screening tool for detecting sarcopenia symptoms based on Strength, Assistance, Rise, Climb, and Falls, where a score of $\ge 4$ identifies individuals at risk for poor functional outcomes.

Frailty

A multidomain, dynamic state of increased vulnerability where physiological reserves are so depleted that the individual cannot effectively cope with acute stressors.

Fried Phenotype

A frailty measurement assessing 5 specific components (unintentional weight loss $\ge 10\,lbs$ in the last year, self-reported exhaustion, low grip strength, slow gait speed, and low physical activity level) scored as 0 (Robust), 1--2 (Prefrail), and $\ge 3$ (Frail).

Osteoporosis

A skeletal disease defined by low bone mass and microarchitectural deterioration, leading to increased bone fragility.

Osteopenia

A condition defined by bone mineral density between $1.0$ and $2.5$ standard deviations (SD) below the average for a healthy young adult.

Dual-Energy X-ray Absorptiometry (DEXA) Scan

The gold standard, non-invasive procedure using low-dose x-rays to measure bone mineral density and assess fracture risk.

T-Score

A bone mineral density score that compares patient BMD to a healthy young adult, used for postmenopausal females and males aged 50 and older.

Z-Score

A bone mineral density score that compares patient BMD to healthy people of similar age and ethnicity, used for younger patients.

FRAX Algorithm

A clinical tool used for Fracture Risk Assessment.

OSTA Score Formula

A simple preliminary screening formula used for Asians to determine if DEXA testing is needed: $\text{OSTA Score} = (\text{Body Weight in kg} - \text{Age in years}) \times 0.2$.

OSTA Risk Categories

Risk levels based on OSTA Score: High Risk ($\text{OSTA Score} > 20$, $\approx 61\%$ have osteoporosis), Moderate Risk ($\text{OSTA Score } 0\text{--}20$, $\approx 15\%$ have osteoporosis), and Low Risk ($\text{OSTA Score} < 0$).

Fall

Defined as a loss of upright position that results in downward displacement of the body to the floor or hitting another object.

Resistance Exercise Prescription for Sarcopenia

A therapeutic intervention with a minimum frequency of 2x/week, intensity starting at $30\%$\text{--}$60\%$ 1RM (progressing to $50\%$\text{--}$70\%$ 1RM), volume of 2--3 sets of 6--12 repetitions, and duration of at least 12 weeks.

CDC Exercise Guidelines for Adults 65 Biological Age and Older

Exercise recommendations consisting of 150 minutes of moderate-intensity aerobic activity, 2 days of muscle strengthening activities, and balance-improvement activities (e.g., tai chi).