Sarcopenia and cachexia in chronic diseases: from mechanisms to treatment.

The two main manifestations of wasting disorders in chronic disease are cachexia and sarcopenia. Due to sharing common pathological features, including impairments in systemic inflammation responses, neurohormonal activity, and metabolic systems, the two disorders can present with similar symptoms (tissue depletion, dyspnoea, anorexia, asthenia, fatigue, and impaired physical performance). Wasting disorders are associated with reduced quality of life and increased mortality. Cachexia is characterized by systemic tissue depletion with weight loss and sarcopenia by skeletal muscle loss accompanied by diminished muscular strength and physical performance. Wasting syndromes can be identified through clinical criteria but also through multiple imaging and diagnostic techniques. Additionally, blood biomarkers can be used for diagnosing wasting disorders. In the past decade, intensive research has focused on new therapeutic strategies within a multimodal approach, which embraces nutritional support, physical activity, and targeted pharmacological therapy. Despite some promising first therapeutic results for selected novel agents, a guideline-recommended pharmacological therapy is not yet available for cachexia or sarcopenia. More research is needed to better understand and thereby learn how to treat these wasting disorders.