As we age, we loose muscle
mass, this is called sarcopenia. If we take a look at the tight of a younger adult,
we will see that the muscles occupy almost all space, and here in the middle there is the bone.
Now, if we look at the thigh of a 70 year old person, of the same weight and height, this is
what we see, most of the space is occupied by fat tissue, and the muscles are reduced in size.
The consequences of sarcopenia can be devastating, like increased risks of falls, reduced
physical capacity, disability, depression, less participation in societal
activities and enjoyment of life. So, today I will answer some common questions
that people ask me about sarcopenia: 1. How can I tell if I have sarcopenia?
2. How is sarcopenia diagnosed? 3. Can we prevent sarcopenia?
4. Once it happens, can we revert sarcopenia and build up muscles like
the younger versions of ourselves? 5. What treatments are available for sarcopenia?
6. How can I support a loved one with sarcopenia? So, let’s talk about sarcopenia today.
In 2016, sarcopenia has been officially recognized as a disease by the International Classification
of Diseases, or ICD version 10. It is a condition of loss of muscle mass and function with age.
The world population is getting older and older, which is a fabulous thing, but then, more
people are seeking medical care because of the consequences of sarcopenia.
One of the first signs of sarcopenia is a noticeable decline in muscle strength.
However, sarcopenia happens little by little, so the person may not notice right away. But
if they compare their strength to 10 years ago, they may remember that doing certain activities
was easy, and now it is becoming difficult, like carrying the laundry load upstairs. The
person never had difficulty doing that, now they can’t do anymore. Of they can do it, but it
requires a lot of effort and they get very tired. They may also have difficulty
Lifting objects, climbing stairs, and getting up from a seated position.
Another way of checking for sarcopenia is testing for weakness in their hands with a grip strength,
or being able to hold on objects securely. The second sign of sarcopenia is
fatigue. The person will fell exhaustion, even during routine activities that were once
manageable. They will feel a general sense of tiredness or they may feel specific muscles tired
during tasks that require repetitive movements, like making bread, gardening, washing
the car, or pushing a shopping cart. Fatigue really impacts their ability to
participate in daily activities with energy and enthusiasm, so they avoid social interactions.
The third sign that the person has sarcopenia is a diminished physical performance.
This can manifest in poor coordination, balance and mobility issues. They will notice
that they can’t maintain their balance while walking or standing. They can’t bend, reach
or turn anymore. These activities become challenging to perform with ease and precision.
The fourth sign that a person has sarcopenia is their body shape. It is often noticeable
and includes loss of muscle mass and replacement by body fat. They notice a loss
of muscle bulk, particularly in the arms, legs and abdomen. It gives them an appearance
of frailty or less toned. It is common also to accumulate fat tissue, which can make the
sense of fatigue and weakness even worse. Can a doctor diagnose sarcopenia? Is
there any test that can be ordered? Healthcare professionals in some specialities,
like physiatry, neurology, geriatrics medicine, and rheumatology are able to say if the
person has sarcopenia doing a physical assessment. They will look at the body composition, look
for muscle wasting or weakness, assess posture and gait, and they may measure waist circumference
and calculate a body mass index, or BMI. Normally, it is not necessary to order imaging
studies, or blood tests. A physiotherapist or occupational therapist can be involved in more
severe cases, and they can do specific muscle strength tests, using a dynamometer, which
measures the grip strength. They can also assess specific tasks like chair stands, get up
and walk test, leg press and other activities that may impact a person’s functional abilities.
If we suspect the person may have osteoporosis, we may order a bone density study, but these studies
are specific to the bones, not to the muscles. The healthcare professional will also assess
the person for any risk factor that could be accelerating the sarcopenia, things like
medications, mental health, dietary intake, use of alcohol, presence of diabetes,
chronic infections, and thyroid problems. I prepared a summary for you that contains
all the information in this video. Go to the description of this video below, there
is a link for you to download this FREE summary Can sarcopenia be prevented?
Yes, absolutely. Sarcopenia can be slowed down using a variety
of lifestyle modifications and interventions. You may find many seniors on the internet, in
social media, on YouTube, who are examples of what I am talking about. They are in their seventies,
eighties, nineties and even in their hundreds, and they have minimal sarcopenia.
Their bodies are capable of doing things that many younger individuals, in
their thirties or forties cannot do. They have minimal pain and they can tell you, that
if pain affects them, they are ready to take charge of their body. These older adults, when
they get sick, like if they have an injury, a disease and they end up in hospitals, they are
the ones who recover faster, and survive longer. Anyone who is hospitalized for a few
weeks will lose muscle mass, we all do, it is a natural process. However, if we get
2 seniors, same age, same weight and height, same gender, and one has sarcopenia, the other
don’t, guess who will lose less muscle mass during hospitalization and will recover faster?
Yes, the person who has more muscle mass at baseline will have a better chance of survival
and quality of life after hospitalization. So, think about this, you need
to be in good shape to get sick. On sunny days you prepare for the rainy days.
Before I continue, let me remind you that this video is not medical advice, the intent is for
educational purposes only. If you suspect you have a medical condition like sarcopenia, please
talk to your doctor or ask your physiotherapist. If there is an emergency, please call an ambulance
or go to the nearest emergency department. We know that the person has the maximum muscle
mass in early adulthood, in their twenties. And they keep these muscles until they reach 40
years of age, and then sarcopenia takes over. And there is a substantial decline that starts
in their fifth decade. Sarcopenia is a normal consequence of aging, however, it was recognized
as a disease in 2016, mainly due to the fact that it can be prevented and treated.
OK, let’s go back to the question, how can we prevent sarcopenia?
Here are 5 tips for anyone who is entering their forties.
1. Regular exercises, especially resistance training. Engaging in regular physical activity,
particularly resistance training or strength training exercises, is essential for preventing
sarcopenia. Resistance training involves using weights, resistance bands, or body weight
exercises to challenge the muscles and stimulate growth. This type of exercise helps increase
muscle mass, strength, and endurance, reducing the risk of muscle loss associated with aging.
2. Maintain an adequate protein intake. Protein is the building block of muscle tissue, and
insufficient intake can contribute to muscle loss over time. Older adults should aim to include
high-quality protein sources in their diet, such as lean meats, poultry, fish,
eggs, dairy products, legumes, nuts, and seeds. There is not a lot of consensus from
the scientific literature about how much protein a person needs to avoid muscle loss due to
aging. A good recommendation is around 1.6 to 1.8 g of protein per kilogram of body weight
per day. So, if the person weights 60 kilograms, they need 96 to 108 grams of protein per day.
These can be animal sources of protein like eggs, milk, meat, fish and poultry, or processed sources
of animal protein like whey and casein. There are many sources of plant-based protein like
soy, beans, peanuts, nuts, seeds and wheat. It is really important to consult your
physician, especially if you have a chronic kidney disease or liver disease.
In these cases the person may be limited the amount of protein they can ingest per day.
3. Avoid a sedentary lifestyle. It's essential to avoid prolonged sitting and incorporate
regular physical activity into daily routines. Even light to moderate activities such as walking,
gardening, or household chores can help maintain muscle mass and mobility. Aim for at least 150
minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity activity
each week, along with muscle-strengthening activities on two or more days per week.
4. Stay hydrated. Dehydration can impair muscle performance and recovery, making it harder
to maintain muscle mass and strength. Older adults should aim to drink an adequate amount of
fluids throughout the day, focusing on water and other hydrating beverages such as herbal teas,
infused water, and low-sugar electrolyte drinks. 5. Get sufficient sleep. Quality sleep is crucial
for muscle recovery and repair. During sleep, the body undergoes essential processes that
help rebuild and regenerate muscle tissue. Chronic sleep deprivation or poor sleep
quality can interfere with these processes and contribute to muscle loss over time. Aim for
7-9 hours of quality sleep per night to support optimal muscle health and overall well-being.
Now, the next question is very interesting. Once it happens, can we revert
sarcopenia and build up muscles like our younger versions of ourselves?
We know that sarcopenia is a disease, it has been recognized by the International
Classification of Diseases or ICD-10 in 2016. But how do we treat it? Is there any medication?
Well, because we still do not fully understand how sarcopenia happens, it is
hard to develop a treatment, most specifically, a drug, that reverts that.
There are some targets for drugs that the pharmaceutical industry is trying to
develop. They include the following: Myostatin. This is a substance found in the
muscles that inhibits muscle cell growth. There are some drugs in development that inhibit
myostatin, one of them is called stamulumab, another one is landogrozumab,
and another one called trevogrumab which is an antibody against the myostatin.
Another drug in study is ramatercept. These drugs are being tested in children
who have a genetic form of muscle dystrophy. Another target for sarcopenia
is the Activin receptor. One drug that is being developed is bimagrumab.
But we don’t have any conclusive results yet. There are also drugs that try to produce
the same benefits of exercises. They would be like “exercise pills”. That would be good
for those people who cannot do exercises for some other reasons, like a nerve injury or
paralysis. But we don’t have any drug yet. Metformin, a drug commonly used to treat
diabetes type 2 has some effects on muscles, but its effect on sarcopenia is still under debate.
Hormones, like testosterone or anabolic steroids have been studied in some clinical trials.
But there were side effects and specially women developed some male-related body changes.
So, once the person is diagnosed with sarcopenia, currently the treatment involves the same
things that we mention to prevent sarcopenia: exercise programs, nutrition with
high protein intake, avoid a sedentary lifestyle, hydration, and quality sleep.
If you like this video so far, subscribe to this channel and turn on the notifications button, so
you will be alerted when I post new videos here. And finally, how can you support a loved
one who is demonstrating sarcopenia? Supporting a loved one with sarcopenia
involves offering practical assistance, encouragement, and emotional support
to help them manage the condition and maintain their overall well-being. Here are
some tips for family members or caregivers: 1. Encourage your loved one to engage in regular
physical activity, particularly exercises that focus on building and maintaining muscle strength,
such as resistance training. Offer to accompany them on walks, attend exercise classes together,
or participate in activities that they enjoy. Providing companionship and motivation can help
them stay consistent with their exercise routine. 2. Offer assistance with everyday
tasks that may become challenging due to muscle weakness or fatigue. This could
include household chores, grocery shopping, meal preparation, or transportation to medical
appointments. Providing practical support can alleviate stress and help your loved one
conserve energy for activities they enjoy. 3. Ensure that your loved one is following a
balanced diet that includes adequate protein, vitamins, and minerals to support muscle
health. Offer to help plan and prepare nutritious meals together, and encourage
them to stay hydrated throughout the day. Consider consulting a registered dietitian
for personalized dietary recommendations based on their individual needs and preferences.
4. Provide Emotional Support. Listen attentively to your loved one's concerns and feelings
about living with sarcopenia. Offer empathy, validation, and reassurance, and let them know
that you're there to support them every step of the way. Encourage open communication
and provide a safe space for them to express their emotions without judgment.
5. Offer Encouragement and Motivation. Offer words of encouragement and praise for
their efforts to maintain an active lifestyle and adhere to their treatment plan. Celebrate
their achievements, no matter how small, and remind them of the progress they've made.
Encourage a positive mindset and focus on their strengths and abilities rather than limitations.
6. Facilitate Social Connections. Encourage your loved one to stay socially engaged
and connected with friends, family, and community activities. Arrange social
outings, invite friends over for visits, or participate in group activities or clubs
that align with their interests. Social support and meaningful connections can contribute
to overall well-being and mental health. 7. And finally. Educate Yourself about Sarcopenia.
Take the time to learn more about sarcopenia, its causes, symptoms, and management strategies.
Stay informed about the latest research and treatment options, and communicate openly
with healthcare providers to advocate for your loved one's needs and preferences.
Now it is your turn to answer a question. Write the answer in the comments box below:
What is your experience with sarcopenia? Write a comment that will help other
people who are struggling with sarcopenia. Thank you for watching today.
Good bye.
