What Is Sarcopenia And How Can It Be Prevented ?

Along with the classical signs of ageing such as wrinkled and sagging skin, loss of coordination, hair loss, stooped posture and trembling extremities, there is also one common disease that occurs in most people and it is called muscle degeneration or Sarcopenia. Associated with weakness, it is the reason behind progressive loss and damage of muscle cells. Even a lean body that loses any amount of muscle mass, is considered to be important as muscle mass is intricately associated with strength.

Sarcopenia is a condition of the ageing process in which, the aged person loses balance, his gait is changed and his overall ability to perform daily tasks are affected by loss of muscle mass and strength.¹

For a very long time, even in the recent past, there was a strong misconception amongst the scientists that ageing caused by muscle degeneration is an inevitable process. Although it is a common process that can be seen to have started in people, who are within the age group of above 60s, it can be delayed and the extent can be reduced. The fact is that after you turn to your 30s, the growth of your muscles to larger and fuller fibers stops. Then starts the reduction of muscle mass and as every decade passes, you start to lose 3 to 5 % of your total muscle mass, especially for inactive people. Those, who are active, will lose the muscle mass to a lesser extent. As you reach 65 to 80, you begin to become frail and you are more likely to have fractures, because of the total loss of strength caused by the degeneration of the muscle mass.

Muscle atrophy or decreased muscular volume or size is the first sign of Sarcopenia. However, there are visible signs of this disease and they are:

• Walking Difficulties – As the large muscles of buttocks and legs get degenerated, there are prominent difficulties which are visible while walking.¹
• Muscle Fatigue–As the muscle mass decreases, the workload is distributed on the rest of the muscle and hence, these remaining muscles become fatigued.
• Loss of Strength–Sarcopenia can be characterized by the replacement of the muscle fibers with fat, which is also known as fibrosis. Due to this replacement, the muscle metabolism experiences a tremendous amount of metabolic change and hence, the overall strength of the muscle is reduced to a great extent.

All of these symptoms also lead to degeneration of the neuromuscular junction, increase in the oxidative stress and the gradual occurrence of frailty and the progressive loss of muscle functionality.

This is a disease that has multifunctional causes behind it. The most common ones are –

1. Loss of Neuromuscular Function–When, any kind of injury occurs in the muscles, the mononuclear satellite cells get activated and help the injured muscles to maintain its functionality.² Basically, the mechanism that works behind this process is that when the fast twitch or FT neurons die off, once they have served the predetermined life span of that organism,the muscle atrophy occurs. As every neuron divides itself for a fixed number of times and once it has met that number, it dies and hence, the muscle fibers that it was destined to command, also gets deteriorated, losing its strength.
2. Loss of Skeletal Muscle–This is yet another reason for Sarcopenia. Lack of regular physical activity, change in the protein metabolism, decrease in growth hormone (GH), increase in cortisol and cytokines, alterations in the endocrine milieu etc. are also reasons for this.
3. Traits in Gene–According to one school of belief, this muscular degeneration can also be a result of high levels of lifelong sedentary behavior that the modern lifestyle demands and that the Late Paleolithic age had obligation to. This might have created a very high level of obligatory muscular effort that still continues in the genes of the modern man.

The individuals within the age group of 65 and 80 are more likely to be impacted by this disease. Although this condition does not have any harmful impact on the health or the overall condition of the body, apart from the physical conditions like loss in muscle mass, it indeed has some other kinds of consequences. They are:

• Decreased mobility in conducting the movements of the body especially limbs.³
• Functional limitation in practicing and conducting the daily tasks.
• Overall disability of movement in extreme conditions and being bedridden.

As stated earlier, Sarcopenia is not an inevitable process and hence, it can be delayed as well as reduced. However, in case the disease has already had its toll on an individual, diagnosing it is mandatory to make sure that the condition doesn’t worsen and frailty of the body can be prevented to occur.

DEXA or Dual Energy X-ray Absorptiometry is used to compare lean body mass to a normal reference population. The assessment is done by considering the strength, muscle mass and functionality of the muscles. The functionality includes gait speed, get-up-and-go test and also the handgrip strength. When the walking speed is below 0.8 m/s in the 4-m walking test or when the muscle mass is less than normal in an average age group, it is determined that the person has had Sarcopenia.

1. Exercise to Prevent Sarcopenia-

   As people age, those who live a sedentary lifestyle are more likely to experience Sarcopenia. Lack of activity is the most common reason behind this condition. The fibers are more likely to tear up fast when the FT neurons do not get the scope to command them. As a consequence, their muscle mass gets reduced. Resistance training or exercise is the best preventive treatment for Sarcopenia.

   30 minutes of moderate daily exercise that includes walking and jogging works wonders to keep the cardiopulmonary system working and fit. Another concept that has worked in the increase of muscle masses is the use of growth hormones that enhances muscle protein synthesis.However, no agent has still been invented which works as a treatment for this condition.

2. Nutritional Strategies To Prevent Sarcopenia–

   Sometimes, nutritional strategies prove to be quite useful in preventing this condition, apart from regular exercise and activity sessions.

   • Creatine supplements have shown vivid results in the aged and elderly people in maintaining and increasing the muscle mass.
   • Vitamin D, on the other hand, has significant impacts on maintaining the bone and muscle tissues.
   • Whey protein contains amino acids in proper proportions that the human body requires and this helps the body to preserve the body mass.

Following these preventive measures and treatment procedures will help in dealing with Sarcopenia.

In a nutshell, Sarcopenia can be prevented following the above mentioned measures. However, if left untreated, Sarcopenia can cause serious musculoskeletal health issues in victims.

References: