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Frailty generally overlaps with malnutrition\/sarcopenia in cirrhosis, leading to increased morbidity and mortality. Rapid nutritional screening assessment should be performed in all patients with cirrhosis, and more specific tests for sarcopenia should be performed in those at high risk. The pathogenesis of malnutrition\/sarcopenia in cirrhosis is complex\/multifactorial and not just reduction in protein\/calorie intake. Hyperammonemia appears to be the main driver of sarcopenia in cirrhosis through several molecular signalling pathways. Nutritional management in malnourished patients with cirrhosis should be undertaken by a multidisciplinary team to achieve adequate protein\/calorie intake. While the role of branched\u2010chained amino acids remains somewhat contentious in achieving a global benefit of decreasing mortality\u2010 and liver\u2010related events, they, and vitamin supplements, are recommended for those with advanced liver disease. Novel strategies to reverse sarcopenia such as hormone supplementation, long\u2010term ammonia\u2010lowering agents and myostatin antagonists, are currently under investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Malnutrition\/sarcopenia and frailty are unique, inter\u2010related and multi\u2010dimensional problems in cirrhosis which require special attention, prompt assessment and appropriate management as they significantly impact morbidity and mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.15571","type":"journal-article","created":{"date-parts":[[2019,11,8]],"date-time":"2019-11-08T08:46:09Z","timestamp":1573202769000},"page":"64-77","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":198,"title":["Review article: malnutrition\/sarcopenia and frailty in patients with cirrhosis"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8842-032X","authenticated-orcid":false,"given":"Chalermrat","family":"Bunchorntavakul","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine Rajavithi Hospital College of Medicine Rangsit University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4898-7778","authenticated-orcid":false,"given":"K. 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