Treating Sarcopenia

Sarcopenia is, in its most literal sense, the loss of muscle mass, strength and function related to aging.  Most commonly seen in inactive people, sarcopenia also affects those who remain physically active throughout their lives. This indicates although a sedentary lifestyle contributes to this disease, it's not the only factor. In addition, as we age:

• hormone levels change
• protein requirements alter
• motor neurons die
• and we tend to become more sedentary 

 

These factors in combination are thought to cause sarcopenia. The figure shows normal muscle mass on left, muscle wasting on right.

 

There are currently no approved drug treatments for sarcopenia. Research is now focusing on the role of physical activity, nutrition, supplements, and potential future medications that may be used to treat or prevent sarcopenia.

In a review of literature, worsening sarcopenia followed trends in losses of muscle strength as well as impairment of daily functioning. In one study, the prevalence of sarcopenia increased dramatically with age from 4 % of men and 3 % of women aged 70-75 to 16 % of men and 13 % of women aged 85 or older.

More importantly, when sarcopenia is coupled with other diseases associated with aging, its effects can be even more pronounced. Loss of muscle mass and strength is a significant risk factor for disability in the aging population. When patients suffer from both sarcopenia and osteoporosis, the risk of falling and subsequent fracture incidence is higher. Therefore, treating sarcopenia will in turn help to lessen its burden on co-existing diseases.

 Exercise

After a program of resistance training is introduced, research shows that motor neuron firing and protein synthesis (both of which are needed in building muscle mass) increase even in the elderly. These changes indicate it is possible to rebuild muscle strength even at an advanced age.

Aerobic exercise also appears to aid in the fight against sarcopenia.

Nutrition

Adequate nutrition plays a major role in treating sarcopenia. Research has shown older adults may need more protein per kilogram than their younger counterparts to maintain proper levels that reinforce muscle mass. Protein intake of 1.0-1.2 g/kg of body weight per day is probably optimum for older adults. This theory, coupled with the fact that older adults tend to take in fewer calories in general, may lead to pronounced protein deficiency as well as deficiency of other important nutrients. Therefore, maintaining adequate protein intake as well as adequate caloric intake is an important facet of the treatment of this disease.

Diets rich in acid producing foods (meat and cereal grains) and low in non-acid producing foods (fruits and vegetables) have been shown to have negative effects on muscle mass. As mentioned above, protein is important, but a diet high in meat and cereal grains should be balanced with a diet high in fruits and vegetable (nonacid-producing foods) in order to be effective in treating sarcopenia.

Supplements

There is some evidence to support that creatine supplements can also aid in muscle development for older adults that are following a resistance training program.

Maintaining appropriate blood levels of vitamin D may also aid in maintaining muscle strength and physical performance.

http://www.iofbonehealth.org/what-sarcopenia

http://www.iofbonehealth.org/preventing-sarcopenia

Similarities in Acquired Factors Related to Postmenopausal Osteoporosis and Sarcopenia

“Sarcopenia, that is, muscle wasting, and osteoporosis,

that is, fragile bone disease, are significant health burdens

among the postmenopausal women. The prevalence of sarcopenia

has been reported to be 10% to 40% in postmenopausal

population depending on the reference method used and the population.

Osteoporosis affects approximately 30% of (the) female population

over 50 years (of age). Sarcopenia results in decline in activities of

daily living, quality of life, and self-rated health and increases falls and related

skeletal fractures which have been estimated to have deep impact of social

and healthcare-related costs of the postmenopausal population.”

“The present paper focuses on similarities in acquired

factors associated with postmenopausal osteoporosis and

sarcopenia concentrating on decades after the menopausal

transition. Consequently, essential aspects on the effects of

aging on sarcopenia and osteoporosis will be covered.”

“Postmenopausal women are at risk of both osteoporosis

and sarcopenia. There is evidence that these two conditions

coexists and share similar risk factors. Both sarcopenia

and osteoporosis are strongly linked not only to aging

but also to estrogen depletion and thereby to menopausal

transition. This makes the postmenopausal population a

significant target group for prevention of both sarcopenia

and osteoporosis.”

“While the associations between muscle strength, muscle

mass, and functional capacity with clinically relevant endpoint

of osteoporosis, that is, BMD and fractures, have been

reported, there are no studies addressing the associations

between three stages of clinical sarcopenia, that is, presarcopenia,

sarcopenia, and severe sarcopenia. The associations

of the three modalities of sarcopenia with osteopenia,

osteoporosis, and severe osteoporosis remain unexplored.

An essential part of the diagnosis of both osteoporosis

and sarcopenia includes DXA, which allows simultaneous

assessment of both conditions. The future research should

concentrate on exploring the clinically relevant dimensions

and interactions of sarcopenia and osteoporosis.”

To read the full review article by Joonas Sirola and Heikki Kröger:

http://www.hindawi.com/journals/jos/2011/536735/