Case history
Case history #1
An 82-year-old woman lives alone without support and has not been outdoors for the past year. She has high blood pressure and osteoarthritis, for which she is taking a thiazide diuretic and a non-opioid analgesic. She is brought to hospital following a fall in her flat. On physical examination she is found to be thin and mildly disorientated. Her blood pressure is 90/60 mmHg and heart rate is 92 bpm. There is no fever, and her oxygenation is above 93% on room air. Her skin turgor is diminished, cardiorespiratory examination is normal, and there are no lateralised neurological signs. She is dizzy on standing and cannot walk without support. Blood tests show a creatinine slightly above normal values, with a low sodium of 131 mmol/L. She is found to have a slow gait speed of 0.7 m/second that is not attributed to articular pain. Her BMI is 19.5 kg/m² and her hand grip is 15 kg of force. The treating team decided to investigate further the cause of her low physical performance. Dual-energy x-ray absorptiometry (DXA) shows an appendicular skeletal mass index (ASMI) of 5.2 kg/m².
Case history #2
A 79-year-old man came to the clinic accompanied by his daughter because of weakness and lack of stamina. He has been receiving treatment for prostate cancer with a luteinising hormone-releasing hormone agonist for the past 2 years. He reports that he has lost weight despite eating well. He says he feels fatigued but is not depressed. On physical examination he is found to be thin with a low grip strength. Laboratory investigation reveals a slight normochromic normocytic anaemia. DXA shows a bone density with a T-score of -2 and an ASMI of 6.5 kg/m².
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