A geriatric condition wherein individuals experience loss of muscle mass and strength with aging is called sarcopenia. It means that the strength, quality, and mass of the skeletal muscles start to decline as people reach the age of 50 and beyond. Although it can take place independently on its own, this disorder can be a component of other major diseases such as cachexia and frailty syndrome. To understand it better, here is a closer look at the different aspects of sarcopenia including its symptoms, treatments, and prevention.
Symptoms of Sarcopenia
Muscle atrophy or loss of muscle mass and reduced muscle tissue quality are the two primary symptoms of sarcopenia. It means that patients experience a significant decrease in the size and quality of their muscles. The contributing factors include neuromuscular junction degeneration, oxidative stress, and changes in the metabolism of muscles. Also contributing to this are the increased fibrosis and fat replacing muscle fibers. Once these elements add up, the results are progressive muscle function loss and incapacity.
The initial muscle mass count is the first determining factor behind sarcopenia. The second is the rate at which muscle mass is lost due to aging. Pathologically speaking, the threshold wherein the wasting of muscles becomes a disorder varies from one person to another.
It is also challenging to identify if an individual has severe sarcopenia because data extracted from a simple measurement of the circumference is not enough. Another known symptom is the circumference reduction of distinct muscle fiber types. The type 2 muscle fiber circumference is reduced during sarcopenia. Meanwhile, the type 1 muscle fiber circumference has minimal to zero reduction.
Treatment for Sarcopenia
One of the significant risk factors for sarcopenia is the lack of exercise. The effects of this condition are felt even by athletes who are highly trained. They experience a progressive loss in the strength and mass of their muscles after years of continuous competition and training. Once they go beyond the age of 30, there is a progressive drop in the strength and speed records they have set during events.
Throughout their lives, highly trained athletes sustain high fitness levels. However, there is a drop in the performance of weight lifters and marathon runners once they go beyond the age of 40. By the age of 80, the peak levels of these master athletes have already dropped by roughly 50 percent. By 50 years old, they may already have experienced a moderate decline in muscle fibers.
There is an interest in how exercise will affect sarcopenia treatment. Based on the evidence, a short-term resistance exercise can trigger an improvement in the skeletal muscle’s capacity and ability to synthesize proteins. There is also evidence that muscular strength and physical performance improved in older adults after going through progressive resistance training.
A medication has yet to be approved specifically for sarcopenia treatment but B-hydroxy B-methyl butyrate has exhibited effectiveness in stopping the decrease in muscle mass. Right now, it is only marketed as a dietary supplement but there is increasing evidence supporting its effectiveness against the decrease of muscle strength, muscle function, and muscle mass in cancer cachexia and other states of hypercatabolic disease.
Nowadays, experts endorse the inclusion of B-hydroxy B-methyl butyrate in the treatment and prevention of muscle wasting and sarcopenia. This will serve as a supplement together with a high-protein diet and regular resistance exercise. According to a meta-analysis, the use of B-hydroxy B-methyl butyrate as a supplement seems to be useful as a treatment for older adults who want to preserve their lean muscle mass.
Anabolic steroids like testosterone are also being studied as a treatment for sarcopenia. It appears to have a positive impact on muscle mass and strength. However, it has been linked to various side effects and has been tied to virilization in women and prostate cancer in men.
Several approved drugs are also being studied as potential sarcopenia treatments. The list includes eicosapentaenoic acid, angiotensin-converting enzyme inhibitors, vitamin D, and ghrelin.
Preventing the Onset of Sarcopenia
Physical activity and protein intake are significant stimuli for the synthesis of muscle proteins. According to expert groups, the onset of sarcopenia can be slowed down or prevented by raising the dietary protein allowances for older people. Older adults should also have nutrient supplementation to prevent incapacity and sarcopenia. This is a more preferable approach given that this treatment is cheaper and has no major side effects.
Based on a study of older adults in the UK, the prevalence of sarcopenia is 7.9 percent in women and 4.6 in men. In a similar study in the United States, the prevalence of sarcopenia is 36.5 percent among older adults aged 70 years old. In New Mexico, approximately half of the individuals who are over 80 years old are suffering from sarcopenia.
Sarcopenia is a growing health concern because of the increased longevity and reduced physical activity of industrialized populations. The condition may progress to the point wherein older individuals may lose their ability to live on their own. This disorder is a key predictor of disability tied to fractures, falls, gait speed, and poor balance in population-based trials. The substantial incapacity found in the elderly population is the result of combining sarcopenia and osteoporosis.
Further research is needed to better understand sarcopenia’s cellular and molecular mechanisms. Doing so would boost the use of a life course approach to understand etiology as well as the best timing of interventions. The transition of research findings into a clinical setting remains a challenge in the field.
Nutrition’s role in sarcopenia treatment and prevention is still unclear. Further studies on the combination of exercise and nutrition are necessary. The best approach, for now, is to base nutritional guidance on available evidence. Findings point to the use of severe sarcopenia as a predictor of negative outcomes. This is comparable to currently available data on frailty syndrome.
The strength of an individual’s handgrip can be considered a clinical marker of sarcopenia. It is a good predictor, cost-effective, and simple. The only problem is the inability to provide more extensive details.