Aging is a natural stage of life, in which the body's functions, including strength and stability, are progressively lost.
The muscles provide strength to the body and generate movements that allow various activities such as walking, sitting, etc., but if these are not used, a process of degeneration or atrophy occurs and over time they lose their normal functions.
This process of progressive loss of muscle mass and strength, associated with disability and limitation of daily activities related to age, is known as sarcopenia, derived from the Greek words sarcos (meat) and penia (loss).
This condition is very common in older adults and it is estimated that after age 50 at least 3 out of 10 people will suffer from it, increasing by 50% of the population after 80 years of age.
Causes of sarcopenia
According to the European Working Group on Sarcopenia in the Elderly, the origin of sarcopenia due to age is multifactorial, with other causes such as age-related cell degeneration, a decrease in some hormones such as estrogens, testosterone, insulin and growth hormone , inadequate nutritional status (low consumption of animal proteins and decreased levels of vitamin D), increase in pro-inflammatory substances, consumption of some medications, little physical exercise during adulthood, prolonged stay in chairs and beds, presence of affective disorders, chronic diseases that contribute to bed rest and disorders of ambulation or mobility.
The diagnosis is made by the doctor, with the support of a nutritionist, who evaluates three criteria: low muscle mass (according to weight and percentage of muscle mass), low muscle strength and the impact on physical performance.
The physician assesses the patient's muscle strength by performing a detailed physical examination that includes the patient's gait, gait speed, movements, climbing stairs if possible, and evaluating the ranges of movement of their joints, as well as muscle tone. .
Similarly, the doctor must perform laboratory studies (measuring electrolytes, muscle enzymes and creatinine clearance in urine) and images (resonance and tomography) that allow him to visualize the patient's muscles and evaluate them with greater precision.
It is important to differentiate sarcopenia related to advanced age from that generated by other causes such as the presence of chronic diseases such as cancer, immunological diseases, hypothyroidism and advanced stages of lung, kidney and heart diseases; in addition to the bedridden caused by diseases such as cerebrovascular accidents that cause muscle paralysis; in addition to states of severe malnutrition and pathologies that generate cachexia.
1. Sarcopenia versus cachexia
Cachexia is the loss of both muscle mass and fat mass, a product of the breakdown of muscle proteins, either due to malnutrition or due to some disease (for example, cancer) that produces an increase in muscle metabolism.
A person with cachexia (extremely thin) probably has sarcopenia, but a person with sarcopenia does not necessarily have cachexia.
2. Sarcopenic obesity
In fact, there are obese people who with advanced age have loss of muscle mass and strength (that is, sarcopenia) but retain their weight in fat mass. In general, this occurs mostly in the female population and, as old age passes, they also lose the fat content of their body.
Medically, sarcopenia is classified according to its severity to establish treatments and prognosis in each patient.
- Pre-sarcopenia: it is the initial loss of muscle mass, without generating limitations in muscle mobilization.
1.Sarcopenia: it is the decrease in muscle mass with impairment of muscle strength that conditions insufficient physical performance.
1.Severe sarcopenia: when there is a significant decrease in muscle mass and strength that causes physical inability to perform movements, they generally require family assistance for mobilization.
The patient with sarcopenia has greater limitations and disability to perform basic movements and daily tasks, so they deserve family help for their mobilization. For all this, these people have a high risk of falls, and indirectly greater risk of death.
Prevention must be carried out from the first stages of life and must be based on a good diet (with an adequate intake of protein and vitamin D) and a correct physical activity that includes cardiovascular and aerobic exercises to promote the increase in mass. Muscular.
How is sarcopenia treated
Once advanced, sarcopenia is very difficult to reverse, so the emphasis is on prevention and treatment in early stages, including physical rehabilitation at least three times a week, improvement of nutritional status with protein and vitamin supplements, and the psychological and family support of the patient already in stages of physical disability.
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