Sarcopenia

Sarcopenia is a condition in which muscle mass, muscle strength, and muscle function decrease. It leads to weakness, an increased risk of falls, and loss of independence. Sarcopenia mainly affects older adults.

Primary and secondary sarcopenia

In healthy young people, the build-up and breakdown of muscle tissue are in balance. If you do (strength) training and eat well, you even build more muscle tissue than you break down.

As age increases, the amount of muscle mass and strength decreases. In addition, the quality of the remaining muscle tissue also declines and the muscle fibers change in composition. When this leads to problems with performing daily activities, this is called primary sarcopenia.

If sarcopenia occurs at a young age, it is the result of a disease, malnutrition or lack of physical activity. For example, due to a muscle or nerve disease, too little (protein-rich) nutrition or because someone uses a wheelchair or is in a coma . This is called secondary sarcopenia.

How it starts

The decline in primary sarcopenia is gradual. It starts at a relatively young age and accelerates after the age of 50. In the beginning, most people do not yet experience problems. Signs that may indicate primary sarcopenia are:

• Problems with getting up from a chair.
• Difficulty carrying groceries.
• Climbing stairs becomes increasingly difficult and walking speed decreases.
• Loss of strength in arms and legs.
• Falls or tripping, possibly resulting in bone fractures or other injuries.
• Faster fatigue with a slower recovery after exertion.
• Development of other chronic diseases such as cardiovascular disease or diabetes.

Risk factors

In addition to increasing age, there are a number of risk factors that promote sarcopenia.

• Too little exercise. The muscles then do not receive enough stimuli to remain strong.
• Malnutrition. As a result, the body receives too little protein, energy and vitamin D.
• Hormonal changes. The menopause (menopause) in women is a time when the muscles break down more quickly.
• Chronic diseases.
• Changes in the nervous system that controls the muscles.

Assessment

Sarcopenia is usually established by measuring muscle mass and strength, often using equipment such as a dual-energy X-ray absorptiometry (DEXA scan) or an MRI scan. A simple test is measuring handgrip strength. This provides a good estimate of muscle strength in the whole body.

Treatment options

For healthy muscles, it is therefore necessary to get sufficient physical activity, preferably training both strength and endurance. In addition, a healthy and varied diet is important, possibly supplemented with dietary supplements to make up for deficiencies. The goal is to build muscle mass and strength and to reduce the risk of falls and bone fractures.