As we age, various conditions can impact our health and independence. One of the most prevalent and detrimental is sarcopenia. This musculoskeletal disease is defined by the progressive loss of skeletal muscle mass and strength in the context of aging. Skeletal muscle mass—the voluntary type of muscle—is crucial for performing joint movements like standing up from a chair, lifting objects, or squatting.
The Impact of Sarcopenia
Loss of muscle mass and strength is directly linked to:
- Increased fall and fracture risk
- Loss of independence
- Poor quality of life
- Higher hospitalization rates
- Unfavorable outcomes post-major surgeries
Starting at age 30, muscle mass and strength peak. Afterward, we experience a 3-5% reduction in skeletal muscle mass per decade. By 80, you may have 15-25% less muscle mass and significantly reduced strength compared to your younger self.
Causes of Sarcopenia
Several age-related changes contribute to sarcopenia:
- Declines in Anabolic Hormones: Lower levels of testosterone, human growth hormone (HGH), and IGF-1 impair muscle tissue development and maintenance.
- Neurodegeneration: Aging affects alpha motor neurons, peripheral nerve fibers, and neuromuscular junctions, reducing muscle fiber recruitment and strength.
- Inflammation: Elevated markers like C-reactive protein and interleukins have a catabolic effect on muscles.
- Insulin Resistance: Aging alters body composition, increasing fat and reducing muscle. This change exacerbates insulin resistance, diminishing glucose uptake by skeletal muscles.
- Comorbidities: Conditions like COPD, heart failure, kidney disease, diabetes, HIV, and cancer elevate the risk of sarcopenia.
Diagnosing Sarcopenia
The European Working Group on Sarcopenia in Older People (EWGSOP2) categorizes sarcopenia into three stages:
- Probable Sarcopenia: Indicated by decreased muscle strength.
- Upper body: Grip strength <27kg (males) or <16kg (females)
- Lower body: Five-time sit-to-stand test ≥15 seconds
- Confirmed Sarcopenia: Low muscle strength and mass.
- Appendicular muscle mass <20kg (males) or <15kg (females), measured via DEXA, MRI, CT, or bioelectrical impedance analysis.
- Severe Sarcopenia: Combines low muscle strength, mass, and physical performance.
- Gait speed ≤0.80m/s, timed up-and-go ≥20 seconds, or SPPB score ≤8.
Preventing Sarcopenia
Prevention is a lifelong effort:
- Early Life: Focus on developing muscle mass and strength to establish a high physical peak.
- Middle Age: Maintain muscle mass and strength with proper physical activity and diet.
- Late Adulthood: Minimize losses through optimal nutrition, hydration, and exercise.
Nutrition and Hydration
Older adults should aim for 1.2g of protein per kg of body weight daily. Studies show this reduces muscle mass loss by 40% over three years and protects grip strength. Sufficient water intake—as muscle mass is 75% water—also supports cognitive and physical function. Dehydration, common among older adults, can exacerbate muscle loss.
Role of Supplements
While supplements like protein, amino acids, HMB, and creatine can support muscle building, their effectiveness is maximized when combined with resistance training.
The Power of Resistance Training
High-quality resistance training is the cornerstone of sarcopenia prevention. Defined as periodic exercise involving weights or internal load, it promotes muscle mass and strength. A 2015 meta-analysis by Borde et al. recommends:
- Frequency: Three sessions per week
- Volume: 2-3 sets per exercise
- Repetitions: 7-9 per set
- Intensity: 50-70% of the one-rep max (1RM)
Take the Next Step
If you’re at risk or struggling with age-related muscle loss, visit one of our clinics. Our therapists can create a personalized program to address your needs and help you achieve your health goals. Take control of your strength and independence today!
