Many people are familiar with osteopenia and osteoporosis, which are conditions characterized by moderate and severe bone density loss, respectively, that can occur as you age. However, sarcopenia, the age-related decline in muscle mass and function, is less commonly known.
Sarcopenia has not been as extensively studied, and its exact causes are still uncertain, but it is linked to frailty and a loss of independence in older adults.
The good news is that there are effective strategies to prevent sarcopenia and improve your condition if you are already experiencing its effects.
Here’s what to know about slowing down age-related muscle loss.
[READ: Best Exercises for Preventing Falls in Older Adults.]
What Is Sarcopenia?
Sarcopenia is a musculoskeletal disease characterized by the gradual loss of muscle, strength and function.
As you get older, you start losing muscle faster than you gain it. Muscle mass typically declines beginning in your 30s and continues to progress in your 60s or 70s.
“Sarcopenia is a natural process,” says Dr. Theodore Strange, the chair of medicine at Staten Island University Hospital, a division of Northwell Health, in New York City.
For those who are healthy and athletic, this may not be a major health issue. For instance, the kind of decline that makes a lifelong runner go from a very fast running pace time to a slightly slower one in his 60s is not a big medical concern. However, for those who are sedentary with comorbidities — such as a frail elderly person — sarcopenia can increase the risk of falls and injuries from daily activities and often necessitates a higher level of senior care if an individual becomes unable to perform basic everyday tasks.
[READ: Best At-Home Chair Exercises and Balance Exercises for Older Adults]
Risk Factors for Sarcopenia
The precise causes of sarcopenia aren’t fully understood, but several potential contributing risk factors can accelerate the process.
These risk factors include:
— Age, which is considered the leading cause of sarcopenia
— Sedentary lifestyle or lack of physical activity
— Poor nutrition
— Obesity and being overweight
— Certain health conditions, like diabetes, stroke or surgery
— Smoking
[READ 6 Expert-Approved Tips to Make Exercise a Habit]
Signs and Symptoms of Sarcopenia
Symptoms of sarcopenia can substantially affect an older adult’s ability to perform everyday activities.
Signs and symptoms of age-related muscle loss include:
— Loss of muscle mass
— Reduced strength and decreased endurance
— General physical weakness
— Fatigue
— Impaired physical performance
— Difficulty performing activities of daily living, such as difficulty walking, climbing stairs, getting out of a bed or chair or lifting objects
— Issues with balance or coordination
— Slowed metabolism
[Read: 6 Tips for Aging Alone]
Health Implications of Sarcopenia
Sarcopenia can significantly impact quality of life of older adults by increasing the risk of various health issues, including:
— Falls
— Injuries and bone fractures
— Reduced mobility
— Functional dependence
— Depression, anxiety and other psychiatric conditions caused by physical limitations and dependency
— Chronic illness, such as osteoporosis, diabetes and cardiovascular disease
— Hospitalization
— Prolonged illness and/or surgery recovery
— Mortality
Sarcopenia Diagnosis
Early detection and proactive management are key to reducing the health risks associated with age-related muscle loss.
In order to diagnose sarcopenia, your health care provider will likely begin by conducting a physical exam and asking a series of questions about your symptoms.
There are a variety of evaluation methods used to assess a patient’s muscle strength and function.
SARC-F questionnaire
The SARC-F is the most widely used screening tool that uses a questionnaire to identify:
— Strength: Do you have difficulty lifting or carrying objects that weigh at least 10 pounds?
— Assistance in walking: Do you need help walking across a room?
— Rise from a chair: Do you have difficulty rising from a chair or the bed?
— Climb stairs: Do you have difficulty climbing the stairs?
— Falls: How many falls have you had in the past year?
Physical fitness tests
Your provider may perform additional series of testing to determine the presence and severity of sarcopenia, enabling them to develop appropriate treatment and/or management plans. Depending on your symptoms, questionnaire responses and physical exam, these may include:
— Six-minute walk test. One way to evaluate muscle strength is with a simple walk test. Your doctor will first check your oxygenation levels when you first arrive at your appointment to determine a baseline, then you’ll walk up and down the hallway for six minutes. At the end of the test period, your doctor will assess the distance you walked and your oxygenation level.
— Gait-speed test. This may be used to assess mobility by measuring how quickly a person can walk a short distance.
— Climbing stairs. Doctors may ask patients to climb stairs. However, if the patient reports getting winded on stairs or they weren’t able to complete a six-minute walk test, there’s likely no need to have them climb stairs.
— Grip-strength test. Some doctors may use a hand-held dynamometer to measure handgrip strength, which correlates with overall muscle strength.
“Some people become protective about what their deficiencies are and try to fake it,” says Dr. Mary Jo Voelpel, a board-certified hematologist osteopathic physician based in Lake Orion, Michigan.
However, it’s crucial to be honest with your health care provider about your symptoms and condition in order to conduct physical tests to help accurately assess your functioning levels.
Imaging tests and body composition analysis
In some cases, your doctor may also do imaging scans or a body composition analysis to measure muscle mass and body fat to assess your overall body composition.
Methods include:
— MRI
— CT
— Dual-energy X-ray absorptiometry (DEXA) scan
These methods are used for a more detailed and accurate assessment, which can be critical for establishing baseline data and monitoring the progression of the condition over time. It can also help determine the severity of muscle loss.
Muscle Loss Prevention and Management
There is no medically approved treatment available for sarcopenia. However, when it comes to the activities of daily living or everyday activities related to personal care, like dressing or bathing, making key lifestyle changes can help you prevent and manage the condition to help your body maintain strength as you age.
You’re not going to “turn the clock back 40 years,” Strange says, but you can reverse some of the muscle loss through physical activity and a well-balanced diet.
Physical activity
The tool that everyone agrees works to shore up muscles: exercise, at every age. Ideally, that includes:
— Aerobic exercise
— Strength training
While strength training — also referred to as weight training or resistance training — helps build muscle, it also helps keep older adults stable, surefooted and strong enough to perform basic activities, like getting out of a chair or using the toilet. What’s important is building strength and stamina — not lifting the heaviest weights at the gym.
“I usually always start with a bigger minimum,” Voelpel says. By this, she means that she works with patients to make small, incremental improvements over time rather than making drastic changes. For example, she’ll establish a baseline to see how long it takes a patient to walk a mile, then she’ll have them walk a mile in that timeframe everyday for a month. Next month, work on walking that mile two minutes faster.
Outside of the gym, simply adding movement into your daily routine is going to make a difference as well.
“Taking the steps as opposed to the elevator, putting your car at the end of the parking lot as opposed to the beginning of the parking lot — all of these little things which increase activity are important,” Strange says.
Something as simple as walking will not only decrease your risk of muscle decline, but it’ll also reverse some of the effects, he adds.
Adults should aim to get at least 150 minutes of moderate-intensity physical activity and at least two days of muscle-strengthening activity each week, according to the Centers for Disease Control and Prevention’s Physical Activity Guidelines for Americans.
Diet and nutrition
Insufficient protein, especially if it’s accompanied by insufficient caloric intake in general, can contribute to sarcopenia. While there’s no “magic” number for how much protein you should consume to keep sarcopenia at bay, a simple rule of thumb is to aim for 4 ounces of quality protein — such as fish, chicken, beef or dairy products — three times a day to maximize muscle growth.
While these animal proteins contain all nine essential amino acids to make a complete protein, there are various plant-based protein sources as well, including soy, hempseed, quinoa and buckwheat. Alternatively, you can combine protein-rich foods like rice and beans to complement the essential amino acids found in animal protein.
Just remember: Four ounces isn’t much — about the size of a deck of cards — so there’s no need to go overboard.
Supporting an Aging Loved One
Whether you’re mindful of your own movement or caring for a loved one, keeping both the body and mind active is essential for healthy aging.
For example, Voelpel’s 99-year-old mother, who lives with her, still participates in ballroom dancing.
“Does she exercise? No,” Voelpel says. “But I make sure that there are activities on the upper level, lower level and the very bottom level of the house, so she is navigating stairs at least five times a day, and that helps with strength in her legs.”
While regular physical activity, especially strength training, is known to enhance cognitive function and promote brain health, regular social activity and engagement can also help keep their minds sharp.
“Taking her out to dinner to interact with other people, rather than just being at home all the time, is another thing we do to help her stay engaged,” Voelpel adds.
She encourages younger family members to stay engaged with older relatives to avoid social isolation and loneliness, which can be detrimental to both their physical and mental health.
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