Sarcopenia is a condition of progressive and generalised loss of muscle mass and strength, resulting in progressive disability. It is an age-related process, affecting muscles, akin to osteoporosis, which is depletion of bone density with ageing. It is usually linked to advancing age, but the process can start as early as 35 to 40 years of age.

Normally muscle mass declines with ageing but with sarcopenia, the decline is extreme. For a long time, researchers believed that loss of muscle mass is inevitable with ageing. But now it is known that this disabling condition can be prevented and even reversed to some extent.

A common cause for sarcopenia is lack of physical activity. People who are mostly sedentary are more vulnerable to this condition. Apart from this, those with diabetes, arthritis, obesity, are also more susceptible to this condition. It is rare for physically active people to have sarcopenia, while getting old, though exceptions always exist. 

Not consuming enough calories and proteins necessary to maintain muscle bulk and strength is yet another cause for sarcopenia. This could be due to multiple reasons like, reduced appetite and or chronic dyspepsia, due to any chronic illness and or medication or depression due to any reason. The process of converting protein into energy, also slows with advancing age and is one of the factors for sarcopenia.   Reduction in number of nerve cells, with increasing age, that send signals to muscles for moving, is also said to be one of the factors causing sarcopenia. Lowering of hormone levels with ageing also contributes to sarcopenia.

Due to sarcopenia, an individual has difficulty in maintaining balance, carrying out small daily chores, as every activity involves use of muscle strength to some extent. Forcibly carrying out any activity can result in pain. Difficulty in moving results in reducing physical activity further, thus aggravating sarcopenia. Overall, it reduces an elderly person’s efficiency and even self-confidence, which can even lead to depression in some. This creates a vicious cycle where due to depression, the affected person may lose interest in efforts to try to improve this condition.

Regular physical activity is very useful in preventing sarcopenia. Best way is to do as much physical activity as possible by every individual. Swimming, light jogging, brisk walking, yoga, are some of the best exercises which are beneficial in maintaining and enhancing muscle strength. Muscle resistance exercises like push ups, lunges, squats are also useful in preventing sarcopenia. But one should be cautious in this regard. Many elderly people also suffer from chronic diseases like hypertension and cardiac problems, and so muscle resistance exercises are harmful in this case, as they induce release of adrenalin, which can augment blood pressure and pulse rate. Ideally, a person should consult a physical trainer, who can individualise an exercise programme, as per one’s individual build, overall health and lifestyle.

Diet is yet another important factor in preventing sarcopenia. Diet should include adequate amount of proteins and calories. Grilled beef, fish like salmon, tuna, yoghurt, cheese, beans, avocado, chia seeds, etc. are some of the foods which are healthy sources of protein or fat for elderly people. Amount consumed should be as per the person’s gender, level of physical activity and presence or absence of comorbidities. Protein intake is restricted in those suffering from kidney and or liver failure. Those suffering from reduced appetite should try to fulfil their need of necessary nutrients by taking small frequent meals, taking healthy snacks in-between. One can consult a professional dietitian to get an individualised diet chart.

Regular physical activity and proper diet, also help in treating and reversing sarcopenia. Hormone replacement therapy has been suggested to treat sarcopenia, but its use has been guarded due to the various side effects that can occur.

Increased awareness about sarcopenia and adopting preventive measures for it, since middle years begin can help prevent it.

Dr Rachna Pande,Specialist internal medicine

rachna212002@yahoo.co.uk