As people age, strength and muscle mass generally decline. This is known as sarcopenia (Sarx = flesh, penia= loss). Sarcopenia can be loss of muscle mass, loss of muscle strength, and/or loss of muscle quality. Severe muscle loss brings with it several serious risks and consequences. Ultimately, quality of life may be reduced significantly.
Sarcopenia commonly affects people more than 60 years of age and especially those above 80 years of age. However, preventive measures have best effect when initiated earlier--in your 40s or 50s. Awareness of the condition and knowledge of possible preventive measures is a must for anyone over 40 years of age. (More on this soon!)
It is estimated that about 30% of people above 65 years and about 50% of those above 80 years suffer from sarcopenia. With the increase in geriatric population, sarcopenia can be expected to affect more than 200 million people by 2050. That's a lot of folks.
Several contributing factors have been found to contribute to sarcopenia. When more than one of these is present, they may have an additive effect and increase the severity of muscle loss.
- MODIFIABLE RISK FACTORS
- Diet: decreased food intake and specifically decreased protein intake has been associated with development of sarcopenia.
- Use of alcohol and tobacco are also risk factors.
- Exercise: Disuse of muscle or poor physical exercise during life leads to an increased risk of sarcopenia.
- NON MODIFIABLE RISK FACTORS
- Age: risk for developing sarcopenia increases with increasing age, especially after 60 years of age
- Gender: men are at more risk than women
- Low Birth Weight: It has been discovered that children born with low birth weight are more at risk of developing sarcopenia later in life than children born with normal weight.
- Altered living conditions: Situations like prolonged bed rest, immobility and deconditioning, have been shown to increase the risk of sarcopenia.
- Chronic health conditions: Several chronic diseases have been linked with a loss of muscle mass and strength. Few of these are: cognitive impairment, mood disturbances, diabetes, end-stage renal disease, end stage liver disease and several malignancies.
Note that even without risk factors, sarcopenia is pretty much inevitable if you live long enough.
Sarcopenia does more than make your beach body less buff. If you have the misfortune of visiting loved ones in a nursing home, see how many people you spot with these complications.
- Functional decline Several studies have shown that people with sarcopenia experience weakness and frailty, making day to day tasks like getting dressed and cleaning up difficult to perform. Because of this, these patients develop varying levels of loss of independence. This in turn has been shown to often lead to depression.
- Disability As muscle mass and/or strength decreases, balance issues begin to surface. Repeated falls become common, leading to multiple and various trauma.
- Quality of life With loss of independence, quality of life decreases considerably. Another factor contributing to poor quality of life is the multiple hospital admissions and emergency room visits due to events like falls, incontinence, and other medical problems associated with aging and sarcopenia.
- Disease Loss of muscle mass and muscle strength has been associated with a variety of diseases. For example, some studies have shown that sarcopenia due to aging is often correlated with heart disease.
The incidence of these complications vary from person to person depending on general health and other comorbidities. Most of these can be prevented or at least minimized by following simple precautions and improving general health, nutrition, and exercise.
Studies have shown that people who enter their 60s with high muscle mass experience less muscle loss and enjoy a better quality of life in their senior years. In other words, building muscle now will come in handy later.
There are two general preventive categories: nutrition and exercise.
- PROTEIN Protein intake is essential to building muscle. Various studies have led to recommendations for protein, but there is still ambiguity regarding dosage.
- CREATINE Several studies have found that creatine supplementation in older adults who are doing resistance exercises increases strength and lean body mass. Creatine supplementation has also shown to decrease age-related loss of muscle strength. It can also increase functionality in older adults, helping them be more independent in performing daily activities.The best natural source of creatine is wild game, like venison, elk, buffalo, and bison. The next best source is lean, free-range meats which include turkey breast, chicken breast, Cornish hens, lamb and veal. Fo vegetarians, foods rich in amino acids like arginine, glycine, and methionine are needed. The body takes these amino acids and converts them to creatine which goes into muscles. These amino acids can be found in peanuts, walnuts, chickpeas, spirulina, raw watercress, spinach, oats, and sunflower seeds.
- Vitamin D Apart from being essential for bone health, vitamin D deficiency has also been associated with depression, fatigue and low energy levels. Recently, vitamin D has been shown to help preserve the muscle mass in the elderly. Thus, ensuring adequate vitamin D intake may help protect against osteoporosis, sarcopenia, and depression along with other health benefits.
Exercise programs have the most impact on combating muscle loss with aging. Building muscle early (and working to keep it) is the best way to prevent sarcopenia.
Several studies have compared people between 70-80 years old with people 20-30 years old participating in the same exercise regimen: a strengthening exercise program with weight lifting for 12 weeks. Researchers evaluated the participants' strength before and after the program and found that the amount of strength gain in both groups was similar, despite their age difference. This is very good news, since it shows that it is never too late to start strength training.
- RESISTANCE TRAINING Resistance exercises are exercises that increase muscle strength and endurance by requiring the muscles to work against resistance such as weights or resistance bands. These have been shown to be useful for both the prevention and treatment of sarcopenia. Research has shown that a program of progressive resistance training exercises can increase the protein synthesis rates in older adults in just two weeks. Resistance training has also been shown to have positive effects on the neuromuscular system and hormone concentrations apart from muscle building and protein synthesis.
- AEROBICS Combining strengthening exercises with aerobic exercises, as well as stretching and balance exercises, can increase the benefit to your muscles even more. An added advantage is that this type of regular physical activity can also promote heart, bone, metabolic, and mental health.
If you're planning on getting older, you should be preparing to thwart the onset of sarcopenia. "An ounce of prevention" and all that. Don't just live longer, live better.
Be seeing you.
- Iannuzzi-Sucich M, Prestwood KM, Kenny AM. Prevalence of sarcopenia and predictors of skeletal muscle mass in healthy, older men and women. J Gerontol A Biol Sci Med Sci 2002; 57:M772–M777. http://biomedgerontology.oxfordjournals.org/content/57/12/M772.full
- Cruz-Jentoft, A. J., Baeyens, J. P., Bauer, J. M., Boirie, Y., Cederholm, T., Landi, F., … Zamboni, M. (2010). Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People.Age and Ageing, 39(4), 412–423. http://ageing.oxfordjournals.org/content/39/4/412.abstract