Sarcopenia: back to basics

August 3, 2022
/ Aging, Muscle, Sarcopenia

Seeing someone walk more slowly and perhaps unsteadily is a familiar sign of aging. Far too commonly, we see or hear of older adults falling over as their muscle strength gives way or they lose their balance altogether.

This could mean they have sarcopenia, a muscle wasting disease associated with weakness, higher risk of falls and fractures and increased mortality. Finally receiving greater recognition in recent years, it is very common, affecting around a third of older adults.

But although general decline is a natural part of aging as the body starts slowing down, accelerated aging and debilitating conditions such as sarcopenia can be prevented and even reversed.

When muscles waste away

Strength and mass of skeletal muscles generally start declining after 40, continuing at about 1-2% a year as we head into our 50s and can escalate to 15% per decade – especially in men – by the 70s if no preventative measures are taken.

Warning signs of sarcopenia to look out for include loss of muscle mass. In some people this may be obvious as they become more frail looking, but it can occur in people with extra body fat. Other indicators are poor strength and balance, challenges performing normal activities of daily living, unintentional weight loss and slow, unsteady walking.

Ironically, these symptoms can lead to lower activity levels and thus weaker muscles, having a spiralling effect.

Diagnosis should be made as early as possible. It is generally made based on a combination of symptoms taken during a medical history, x-rays using Dual-energy X-ray Absorptiometry (DXA) and a walking speed test. A short physical performance battery might also be done.

Sarcopenia often goes hand-in-hand with osteoporosis, a break down in bone mineral density, leading to a syndrome called osteosarcopenia. Weakened muscles can also lead to other complications including swallowing difficulties, or dysphagia.

Prevention and management

You might have heard of Ernestine Shepherd – six years ago she was known as the world’s fittest female 80-year-old. Incredibly, she didn’t start exercising until she was in her mid-50s and went on to win two body building titles. On her 80^th birthday she was still reported as waking up at 3am every day, training at 8am, and running up to 80 miles a week.

We might not all aspire to embark on gruelling routines that would put 20-year-olds to shame and win body building titles, but she and other 80-year-old body builders are proof that aging doesn’t have to mean inevitable decline – far from it.

To maintain or build strong, healthy muscles, exercise is the number one strategy.

Resistance training is particularly important for strengthening and building muscle tissue. Recent research has found that eccentric resistance exercise – engaging and lengthening muscle tissue at the same time – might be even better for older adults. These can be done at home through online tutorials.

Aerobic activities that increase breathing and heart rate can also help protect muscles against sarcopenia – 150 minutes of moderate to vigorous activity in bouts of 10 minutes or longer is recommended each week.

You could also consult a certified senior fitness trainer or other physical health professional for more individualised guidance. And of course, the importance of a healthy diet high in essential nutrients and especially protein can’t be ignored.