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Sarcopenia—osteoporosis for muscles

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August 5th, 2010
YH0810_Sarcopenia
YH0810_Sarcopenia

Sarcopenia, or wasting away of the muscles, has been considered a normal part of the aging process. But experts are finding that doesn t have to be the case. [caption id="attachment_13505" align="alignright" width="280" caption="Weight-bearing exercises, also known as resistance training, help preserve muscle mass. Start light and increase weight over time. (File photo)"][/caption] It s not going to happen to everybody, and it s not inevitable, says Austin Welsh, M.D., medical director at Tallgrass Creek in Overland Park, Kans. As people age, their body composition shifts; fat and muscle redistribute due to cellular changes. Body fat may increase by as much as 30%, and while fat increases, lean body mass including muscle decreases. Although some muscle loss is normal, it shouldn t be debilitating. For example, you shouldn t have trouble walking or getting out of a chair. Sarcopenia draws attention to those who have functional losses [things that interfere with daily living] associated with their muscle loss, explains William Dale, M.D., Ph.D., chief of geriatrics at University of Chicago Medical Center. It identifies dangerous amounts of muscle loss and strength.

Dangers of losing muscle

Sarcopenia is very similar to osteoporosis [loss of bone mass], but for muscles, says Dale. The reason it doesn t get as much attention, he believes, is because people don t break a muscle. Having thin bones translates into broken bones. With muscle mass, it s a little less obvious. Sarcopenia is characterized by subtle symptoms, such as difficulty gripping objects, rising from chairs, walking, and maintaining balance. Overlooked as it may be, experts estimate that 45% of people over 60 have sarcopenia. If you are concerned about muscle loss, Dale recommends talking with your doctor, who may suggest getting a body composition study. Even the simple ones are a reasonable guide as to the amount of body fat or muscle mass you have, he says. However, there is no surefire way to determine how much is too much muscle loss. The geriatrics research community is still trying to identify how to diagnose someone with sarcopenia, says Chhanda Dutta, Ph.D., chief of geriatrics at the National Institute on Aging. Whether the diagnosis is based on function for example, the ability to get in and out of a chair or lean body mass...is now being considered. There should be a diagnostic criteria for sarcopenia in the next couple of years.

Flex your muscles to recover

The good news? Even though you tend to lose muscle as you get older, you can slow down that process or even prevent it if you exercise, says Dutta. She likens sarcopenia to osteoporosis in that you lose muscle from a peak starting point and being physically active, including strength training, can help you to preserve your muscle mass as you age. It s not only about muscle mass and strength, continues Dutta. Sarcopenia can also reflect changes in muscle quality. For example, as we get older, there s more fat in muscles. Fatty meat may be desirable in a steak, but it s not what you want in your own muscle. Physical activity can improve muscle strength and power; it can enable older people to do everyday as well as recreational activities, whether it s going hiking or playing with their grandchildren. Weight-bearing exercises are the best guard against sarcopenia, adds Dale, pointing to resistance training, which includes lifting or pushing weights. Before beginning any new exercise plan, he advises checking with your physician or consulting a physical therapist. How much and how often you do resistance training would depend on your level of fitness, says fitness specialist Michael Hernandez, who designs customized wellness regimens for people living atTallgrass Creek, the 65-plus community in Overland Park, Kans. And the road to increased muscle mass doesn t end at the gym. To maintain muscle mass, you also need protein, says Hernandez. Protein is the building block of muscle tissue. People should try to incorporate a variety of protein sources (beans, poultry, seafood, meat, dairy products, nuts, and seeds) into their diet and increase their fruit and vegetable intake.

Hormones may be involved

Another element of muscle loss is hormonal. We don t understand all the reasons why people start to waste away as they get older, but we know there s obviously some hormonal features involved, says Welsh, who notes that a decline in hormone production goes with the territory of aging. As we get older, men don t make as much testosterone, for example, and testosterone is important for keeping muscle mass on. To that end, Welsh checks his male patients testosterone levels routinely and gives men testosterone injections when warranted. Dale cautions that there is no magic pill for combating sarcopenia: Although people are working away at it, there s not a specific medication, outside of testosterone or growth hormone for those who are deficient, that will help build up your muscle. In the meantime whether you re holding a set of weights or snacking on almonds the key to preserving muscle mass is in your hands.

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