Sarcopenia: Symptoms, Causes, and Ways to Manage It

As you age, you tend to get frail, and may also experience reduced mobility. This is mostly due to loss of muscle mass and strength. There are several reasons for this such as metabolic alterations and hormonal changes that naturally occur in the body as you age. Sarcopenia is a condition that refers to age-related loss of muscle mass and subsequent decrease in their functions.

What is sarcopenia?

The term sarcopenia is derived from the Greek words “sarx”, meaning flesh, and “penia” meaning loss. This age-related condition causes progressive and generalized decrease in skeletal muscle mass, strength, and function. It increases the risk of falls, leads to physical disability, and also affects the quality of life. 

Although loss of muscle mass with advancing age is normal, sarcopenia is characterized by severe muscle loss, beyond the normal extent.

Sarcopenia is primarily caused by aging. Secondary sarcopenia can be defined as a case in which more than one cause is associated with the condition such as prolonged bedridden state owing to a disease or a surgery.

What causes it?  

The precise cause of sarcopenia is not clearly known. In some people, the condition may be associated with a single cause, while in others, specific causes may not be evident. Therefore, it is a multifaceted syndrome. 

Risk factors

Inactivity: People who lead an active lifestyle tend to have relatively more muscle mass as they age. Although low levels of physical activity throughout the day is one of the most common causes of sarcopenia, however, in rare cases, active individuals may also get affected.

Lifestyle diseases: Sarcopenia has also been associated with conditions like osteoporosis, type-2 diabetes, insulin resistance, and obesity.

Poor nutrition: Low intake of calories and proteins can lead to loss of muscle mass and function. Deficiency of other nutrients such as vitamin D may also be associated with reduced functionality, especially among the elderly. 

Consequences of sarcopenia

Sarcopenia is an adverse health condition that can cause further debilitation. Data indicates that sarcopenia may increase the risk of:

• Physical limitation and may subsequently lead to disability
• Other comorbidities due to reduced ability to be physically active
• Frailty among the elderly due to a decrease in muscle mass
• Poor endurance, reduced mobility, and slow gait speed
• Frequent falls in the elderly may lead to fractures and other injuries
• Hospitalization and long-term care

How to manage sarcopenia 

Exercise

An active lifestyle and doing regular exercise can help manage sarcopenia. Studies suggest that resistance training, which involves the use of resistance bands and is tailored to improve muscle strength and stamina, can be especially beneficial for individuals with sarcopenia.

Such workouts must be designed and customized with the help of a trained physiotherapist. This will ensure proper intensity and frequency, and help one get maximum benefits and also reduce the risk of injuries.

Performing resistance training workouts may also aid in improving hormonal balance. Research indicates that it can enhance the body’s ability to convert protein into energy in older people.

However, it must be noted that such a training program must be developed and implemented under the supervision of a physical therapist or a qualified trainer.

Nutrition

Proteins are digested in the body to form amino acids. Essential amino acids help in the production of muscle protein synthesis. Owing to metabolic changes, older adults may not be able to produce as much muscle protein as young individuals from the same amount of protein intake. Therefore, the elderly may be advised to increase their protein intake either through their diet or by taking supplements. It is also recommended to spread the protein intake evenly throughout the day by consuming equal amounts during breakfast, lunch, and dinner. Since the elderly mostly have associated comorbidities like diabetes, hypertension, kidney disease etc, a certified dietician may be consulted for adjusting the diet accordingly.

Research suggests that consuming 20g-40g of protein before, during and/ or after resistance training may help in stimulating enhanced protein synthesis. Studies show that proteins with a high leucine content tend to be digested well and can have the highest protein quality. 

Other nutrients such as vitamin D, creatine, omega-3 fatty acids, polyunsaturated fatty acids (PUFA) may also help in better muscle building. 

Managing comorbidities

If you suffer from chronic diseases like diabetes, follow your physician’s advice to manage the condition.

Prevention of sarcopenia

1. Since physical inactivity is considered to be one of the causes of sarcopenia, it is strongly advised that people lead an active lifestyle.

2. The World Health Organization recommends 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise every week. To help maintain fitness, perform at least 30 minutes of moderate-intensity exercise five times a week. 

3. Workouts must be supplemented with good nutrition. Consuming adequate protein may be helpful in reducing the risk of developing sarcopenia in older adults. Certain supplements may also aid in maintaining muscle mass and function. For instance, whey protein helps in maintaining body mass, creatine helps in increasing and maintaining muscle mass, and vitamin D helps in maintaining bone and muscle mass. The dose and frequency of supplements will vary from person to person and therefore must only be taken as prescribed by the physician.

By eating a healthy and balanced diet and maintaining an active lifestyle, you will not only reap short-term benefits, but also improve the quality of your life and add years to it.    

References
1. Santilli V, Bernetti A, Mangone M, et al. Clinical definition of sarcopenia. Clin Cases Miner Bone Metab 2014; 11: 177-80.
2. Wackerhage H. Sarcopenia: Causes and Treatments. Dtsch Z Sportmed 2017; 68: 178-84.
3. Morley JE, Argiles JM, Evans WJ, et al. Nutritional recommendations for the management of sarcopenia. J Am Med Dir Assoc 2010; 11: 391-6.