Both cachexia and sarcopenia involve muscle loss; these conditions also do not have specific treatments. Specifically, cachexia is a wasting disorder characterized by involuntary extreme weight loss, muscle wasting, and loss of body fat. In comparison, sarcopenia is a generalized and progressive skeletal muscle disorder which involves accelerated muscle mass and function loss.  Their distinctions are further discussed below. 

What is Cachexia 

Definition 

Cachexia came from the Greek words “kakos” and “hexis” which translates to “bad condition”. It is a wasting disorder characterized by involuntary extreme weight loss, and muscle wasting; some may experience loss of body fat. Individuals with cachexia get so frail and weak that they become vulnerable to various illnesses (Watson, 2018).

Symptoms 

The symptoms of cachexia include muscle and fat loss, fatigue, loss of appetite, reduced muscle strength, anemia, high inflammation levels, and swelling. The specific symptoms according to the three main categories are the following (Brennan, 2021): 

• Precachexia 

Five percent of body weight is lost due to a disease and is accompanied by appetite loss, metabolism changes, and inflammation. 

• Cachexia 

More than 5% of body weight is involuntarily lost in 12 months or less; the other symptoms may include fatigue, loss of muscle strength, appetite loss, fatigue, and inflammation. 

• Refractory Cachexia 

This occurs when the patient has cancer and loses weight, muscle function, and response to cancer treatment. Around 80% of cancer patients experience cachexia in the late stages. 

Causes/ Risk factors 

As a complex syndrome, cachexia’s exact causes may vary; the underlying factors include increased metabolism, increased energy expenditure, reduced nutrition, increased muscle breakdown, and prevention of muscle growth. It often occurs at the late stages of severe conditions such as cancer, chronic obstructive pulmonary disease, chronic renal failure, congestive heart failure, Crohn’s disease, cystic fibrosis, rheumatoid arthritis, and HIV (Nall, 2021). 

Treatment 

The goal is to improve the quality of life since there is no distinct treatment to reverse cachexia. The therapies employed to address the symptoms include appetite stimulants, diet changes, adapted exercise, and medication to improve mood, lessen nausea, and decrease inflammation (Watson, 2018). 

What is Sarcopenia  

Definition

Sarcopenia came from the Greek words “sark” which means “flesh” and “penia” which means “poverty”. It is a generalized and progressive skeletal muscle disorder which involves accelerated muscle mass and function loss. This commonly occurring age-related process in older people is often associated with falls, frailty, functional decline, and mortality (Jentoft & Sayer, 2019). 

Symptoms 

The symptoms of sarcopenia include weakness, loss of stamina, and severe muscle mass loss (aggravated by reduced physical activity) which significantly affects balance, gait, and the ability to perform daily tasks (Young, 2017). 

Causes 

The causes of sarcopenia include the reduction in nerve cells which send signals from the brain to the muscles, lower levels of certain hormones such as growth hormone, insulin-like growth factor, and testosterone, a decrease in the ability to transform protein into energy, and not having enough protein. This condition typically happens faster at around age 75 but may speed up at age 65 to 80 (WebMD, 2021). 

Treatment 

There is currently no medication approved by the U.S. FDA for the treatment of sarcopenia. The use of hormone therapy is being investigated to help increase lean muscle mass. Home remedies include exercise, proper nutrition, and dietary supplements (Pietro, 2017). 

Difference between Cachexia and Sarcopenia 

Definition

Cachexia is a wasting disorder characterized by involuntary extreme weight loss, muscle wasting, and sometimes loss of body fat. Individuals with cachexia get so frail and weak that they become vulnerable to various illnesses (Watson, 2018). As for sarcopenia, it is a generalized and progressive skeletal muscle disorder which involves accelerated muscle mass and function loss. This commonly occurring age-related process in older people is often associated with falls, frailty, functional decline, and mortality (Jentoft & Sayer, 2019). 

Etymology 

Cachexia came from the Greek words “kakos” and “hexis” which translates to “bad condition”. In comparison, sarcopenia came from the Greek words “sark” which means “flesh” and “penia” which means “poverty”.

Symptoms 

Cachexia’s symptoms include muscle and fat loss, fatigue, loss of appetite, reduced muscle strength, anemia, high inflammation levels, and swelling (Brennan, 2021)

Regarding sarcopenia, the symptoms include weakness, loss of stamina, and severe muscle mass loss (aggravated by reduced physical activity) which significantly affects balance, gait, and the ability to perform daily tasks (Young, 2017). 

Causes/ Risk Factors 

As a complex syndrome, cachexia’s exact causes may vary; the underlying factors include increased metabolism, increased energy expenditure, reduced nutrition, increased muscle breakdown, and prevention of muscle growth. It often occurs at the late stages of severe conditions such as cancer, chronic obstructive pulmonary disease, chronic renal failure, congestive heart failure, Crohn’s disease, cystic fibrosis, rheumatoid arthritis, and HIV (Nall, 2021).  In comparison, the causes of sarcopenia include the reduction in nerve cells which send signals from the brain to the muscles, lower levels of certain hormones such as growth hormone, insulin-like growth factor, and testosterone, a decrease in the ability to transform protein into energy, and not having enough protein. This condition typically happens faster at around age 75 but may speed up at age 65 to 80 (WebMD, 2021). 

Treatment 

Regarding cachexia, the goal is to improve the quality of life since there is no distinct treatment to reverse it. The therapies employed to address the symptoms include appetite stimulants, diet changes, adapted exercise, and medication to improve mood, lessen nausea, and decrease inflammation (Watson, 2018). As for sarcopenia, there is currently no medication approved by the U.S. FDA for its treatment. The use of hormone therapy is being investigated to help increase lean muscle mass. Home remedies include exercise, proper nutrition, and dietary supplements (Pietro, 2017). 

Cachexia vs Sarcopenia

Frequently Asked Questions (FAQs): 

What is the difference between cachexia and malnutrition?

Cachexia is a wasting disorder characterized by involuntary extreme weight loss and muscle wasting; some patients may also experience loss of body fat (Watson 2018). In comparison, the World Health Organization (WHO) defines malnutrition as including undernutrition such as wasting and stunting, having inadequate vitamins or minerals, obesity, overweight, and developing diet-related noncommunicable illnesses (2021). Moreover, cachexia is difficult to reverse while malnutrition can be treated with nutritional therapies (Quilty, n.d.) 

What is the difference between sarcopenia and muscle atrophy?

Sarcopenia is not always muscle atrophy, and it has been mostly characterized utilizing muscle strength or mass (Dionne, 2012). In comparison, muscle atrophy is the loss or wasting of muscle tissue (My-MS.org, 2021). 

What is the sarcopenia?

It is a generalized and progressive skeletal muscle disorder which involves accelerated muscle mass and function loss. This commonly occurring age-related process in older people is often associated with falls, frailty, functional decline, and mortality (Jentoft & Sayer, 2019). 

What are the stages of cachexia?

The 3 stages are (Quilty, n.d.): 

Stage 1: Pre-cachexia (weight loss ≤ 5%, anorexia and metabolic change)

Stage 2: Cachexia (weight loss ≥ 5% or BMI ≤ 20 kg/m2 or sarcopenia and weight loss > 2%, reduced food intake and systemic inflammation)

Stage 3: Refractory Cachexia (Cannot be reversed; cancer is procatabolic and nonresponsive to treatment; low performance score; and expectation of ≤ 3-month survival)

Summary 

• Cachexia is a wasting disorder characterized by involuntary extreme weight loss, muscle wasting, and sometimes loss of body fat (Watson, 2018). As for sarcopenia, it is a generalized and progressive skeletal muscle disorder which involves accelerated muscle mass and function loss.
• As a complex syndrome, cachexia’s exact causes may vary; the underlying factors include increased metabolism, increased energy expenditure, reduced nutrition, increased muscle breakdown, and prevention of muscle growth (Nall, 2021).  In comparison, the causes of sarcopenia include the reduction in nerve cells which send signals from the brain to the muscles, lower levels of certain hormones such as growth hormone, insulin-like growth factor, and testosterone, a decrease in the ability to transform protein into energy, and not having enough protein.
• There are no distinct treatments for cachexia and sarcopenia; the therapies employed to address the symptoms of cachexia include appetite stimulants, diet changes, and adapted exercise (Watson, 2018). As for sarcopenia, the use of hormone therapy is being investigated to help increase lean muscle mass. Home remedies include exercise, proper nutrition, and dietary supplements (Pietro, 2017).

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