Körperzusammensetzung im Alter

Zusammenfassung

Der Altersprozess ist sowohl mit quantitativen als auch mit qualitativen Veränderungen der Körperzusammensetzung verbunden. Ältere Menschen haben im Vergleich zu jüngeren Erwachsenen weniger fettfreie Körpermasse, bedingt durch eine Atrophie der Skelettmuskulatur und der inneren Organe, Abnahme des Körperwassergehalts und der Knochenmasse. Dem gegenüber steht eine Expansion von Fettgewebe, verbunden mit der Umverteilung von Fett von peripheren zu zentralen Speichern. Das Ausmaß der Altersveränderungen wird in verschiedenen Studien unterschiedlich eingeschätzt, ist individuell sehr variabel und wesentlich von der Entwicklung des Körpergewichts abhängig. Qualitative Veränderungen ergeben sich dadurch, dass die Zellmasse, insbesondere die Muskelmasse, schneller und stärker abnimmt als interzelluläres Bindegewebe und Wasser. Der Anteil der Zellmasse an der fettfreien Masse ist im Alter deutlich geringer als bei jüngeren Erwachsenen, zwischen den an Anzahl und Größe reduzierten Muskelzellen finden sich zunehmend Bindegewebs- und Fetteinlagerungen. Die Altersveränderungen der Körperzusammensetzung haben unter funktionellen und metabolischen Aspekten weit reichende Konsequenzen und zählen im Hinblick auf Leistungsfähigkeit, Gesundheitszustand und Lebenserwartung zu den bedeutendsten Altersveränderungen überhaupt. Sowohl die geringere Muskelmasse als auch der höhere (viszerale) Körperfettgehalt gehen mit eingeschränkter körperlicher Leistungsfähigkeit und weit reichenden metabolischen Risiken einher. Die reduzierte Knochenmasse ist mit erhöhtem Osteoporose- und Frakturrisiko verbunden. Im Hinblick auf eine Minimierung der Altersveränderungen und den Erhalt von Zell-, Muskel- und Knochenmasse spielen körperliche Aktivität und bedarfsgerechte Energie- und Nährstoffzufuhr eine Schlüsselrolle. Pharmakologische Maßnahmen sind aufgrund zweifelhafter Wirkung und der Gefahr unerwünschter Nebenwirkungen dagegen nicht zu empfehlen.

Abstract

Aging is accompanied by changes in body composition that are quantitative as well as qualitative in nature. Body composition in the elderly is characterized on the one hand by reduced fat free mass, due to an atrophy of skeletal muscle, visceral and bone mass and a reduction of total body water. On the other hand there is an increase in adipose tissue, associated with the redistribution of fat from peripheral to central stores. The extent of these age-related changes varies between different investigations and between individuals and is considerably dependent on the direction and extent of body weight changes. Qualitative changes are observed because of a more pronounced decrease in body cell mass - particularly skeletal muscle mass - compared to intercellular connective tissue and water. In the elderly, the ratio of body cell mass to fat-free mass is clearly reduced in comparison with younger adults. Skeletal muscle in the elderly is characterized by a decrease in number and size of muscle cells and infiltration of fat and connective tissue. Age-related changes of body composition are accompanied by extensive functional and metabolic consequences. With respect to physical capacity, health status and life expectancy they are counted among the most significant age-related changes at all. Reduced skeletal muscle mass as well as increased (visceral) body fat mass go along with reduced physical performance and increased metabolic risks. Reduced bone mass is associated with increased risk of osteoporosis and bone fractures. With regard to minimization of age-related changes and maintenance of cell mass, muscle mass and bone mass, physical activity and adequate energy and nutrient intake play a key role. Pharmacological interventions, in contrast, are not recommended because of doubtful success and risk of adverse effects.

Schlüsselwörter

Körperzusammensetzung - Altern - ältere Menschen - Muskelmasse - Sarkopenie

Key words

Body composition - age-related changes - elderly - muscle mass - muscle quality - sarcopenia

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