As we age, many of us become more conscious of the changes in our bodies. One such change that often goes unnoticed but has significant impacts on health and quality of life is sarcopenia. Sarcopenia, derived from the Greek words “sarx” (flesh) and “penia” (loss), refers to the gradual loss of muscle mass and strength that occurs with aging. This condition is not only common but also a major contributor to disability, falls, and loss of independence among older adults. In this blog, we will delve into what sarcopenia is, why it happens, the rate at which it occurs, its risk factors, and most importantly, how it can be addressed and overcome, particularly through exercise.

What is Sarcopenia?

Sarcopenia is characterized by the progressive loss of muscle mass, strength and function. It is a condition that predominantly affects older adults, although it can begin as early as the fourth decade of life and accelerates thereafter, particularly into our sixth decade and beyond. This muscle loss can lead to weakness, reduced stamina, and decreased ability to carry out everyday activities.

Why Does Sarcopenia Happen?

The exact mechanisms behind sarcopenia are complex and multifactorial. The key contributing factors include:

1. Aging Process: As we age, our bodies undergo numerous physiological changes. There is a natural decline in the production of muscle proteins, which results in a decrease in muscle mass and function.
2. Hormonal Changes: Hormones such as testosterone, estrogen, and growth hormone play significant roles in muscle maintenance. The decline in these hormones with age also contributes to sarcopenia.
3. Decreased Physical Activity: A sedentary lifestyle is a significant contributor to muscle loss. Lack of regular exercise accelerates the reduction in muscle mass and strength. Whilst many people may be aware of the World Health Organisation’s (WHO) recommendation that adults should get 150 minutes of moderate aerobic exercise per week, what is not as well known is that within this recommendation WHO also state that adults should be doing strength training exercises for all major muscle groups at least twice a week. It is this lack of strength and resistance training that can be a key contributor to the rate of sarcopenia in older adults.
4. Nutritional Deficiencies: Inadequate protein intake and poor nutrition can exacerbate muscle loss. Older adults often consume less protein than necessary for muscle maintenance.
5. Chronic Diseases: Conditions such as diabetes, heart disease, and inflammatory conditions can increase the risk of sarcopenia.

Rate of Sarcopenia

Research indicates that muscle mass declines by about 3-8% per decade after the age of 30, with this rate increasing again from 50 years of age, and really accelerating after the age of 60. By the age of 80, it is estimated that individuals can lose up to 50% of their muscle mass. This loss significantly impacts strength and functional capacity, leading to increased risk of falls and fractures.

Risk Factors for Sarcopenia

Several risk factors can increase the likelihood of developing sarcopenia, including:

– Age: The risk increases with age, as early as 40 – 50 years of age, but particularly after 60.
– Gender: Men tend to have a higher muscle mass than women and therefore can experience greater % losses, but both genders experience sarcopenia.
– Physical Inactivity: Lack of regular physical activity is a primary risk factor.
– Poor Nutrition: Inadequate intake of protein and calories can contribute to muscle loss.
– Chronic Illnesses: Diseases like diabetes, cardiovascular disease, and arthritis can increase the risk.
– Medications: Certain medications can accelerate muscle loss.

Addressing and Overcoming Sarcopenia With Strength Training

The good news is that sarcopenia is not an inevitable part of aging and can be addressed effectively – it just takes a bit of knowledge, a bit of effort, and a regular exercise routine. The cornerstone of preventing and treating sarcopenia is exercise, particularly resistance training. Here’s how exercise can help:

1. Resistance Training: Also known as strength training, resistance training involves exercises that cause muscles to work against an external resistance. This can include weights, resistance bands, body weight, bottles filled with water, sand bags anything you can get your hands on. Studies have clearly shown that resistance training can increase muscle mass and strength, improve bone density, and enhance overall functional capacity in older adults.

– **Frequency and Intensity: The American College of Sports Medicine recommends older adults engage in resistance training at least two to three times per week. It’s essential to start with lighter weights and gradually increase the intensity to prevent injury.

2. Aerobic Exercise: While resistance training is crucial for muscle strength, aerobic exercise is essential for cardiovascular health and overall fitness. Activities such as walking, swimming, and cycling can improve endurance and contribute to muscle maintenance.
3. Balance and Flexibility Exercises: Incorporating exercises that improve balance and flexibility can reduce the risk of falls and enhance mobility. Many good exercise classes incorporate balance exercises in the routine.

Nutritional Support

Alongside exercise, proper nutrition plays a vital role in combating sarcopenia. It is beyond my level of expertise to give nutritional advise, but the key things in a good diet that can help combat sarcopenia include:

1. Adequate Protein Intake: Good sources of protein include lean meats, fish, eggs, dairy products, legumes, and nuts.
2. Vitamin D: Vitamin D is important for muscle function and bone health. Ensuring sufficient vitamin D levels through sun exposure, diet, or supplements can help maintain muscle strength.
3. Overall Balanced Diet: A diet rich in fruits, vegetables, whole grains, and healthy fats supports overall health and muscle maintenance.

Conclusion

Sarcopenia is a significant health concern for older adults, but it is not an unavoidable part of aging. Understanding the factors that contribute to muscle loss and implementing strategies to combat it can greatly enhance quality of life and independence. Regular resistance training, aerobic exercise, and a balanced diet rich in protein and essential nutrients are key components in the fight against sarcopenia. By taking proactive steps, it is possible for older adults to maintain their muscle mass, strength, and overall functional capacity, leading to a healthier and more active life.

SSPC Group Classes

At SSPC we run approximately 60 classes per week – a combination of Clinical Pilates, Strength & Conditioning, Osteoarthritis, and Hydrotherapy classes. All classes have a focus on resistance training and strength gains. Check out our class timetable here.

Anthony Lance
SSPC Physiotherapist

References available on request