Introduction

After the age of 30, the number and size of muscle fibres progressively decline, resulting in a decrease of skeletal muscle mass and thus lean body mass. This process is termed “sarcopenia”. This process may be hastened by sedentary life. The muscle mass can still be increased or maintained at older age with regular exercise. There are also several factors that may involved in development of sarcopenia like age related reduction in nerve cells, reduction in growth hormones, reduction in body’s ability to synthesize protein and inadequate protein or calorie intake to sustain muscle mass.

In healthy young people, 30% of body weight is muscle, 20% is adipose tissue (fat) and 10% bone. Muscle accounts for 50% of lean body mass and about 50% of the total amount of body nitrogen.  At 75 of age, about ½ of the muscle mass has disappeared with 15% of body weight is muscle, 40% adipose tissue and 8 % is bone.

The proportion of body fat to total weight doubles between the ages of 25 and 75. The body does not lose fat with age but redistributes it from just under the skin to deeper parts of the body. Women are more likely to store it in the lower body, the hips and thighs whilst men favour the abdominal area.

• In men – body weight increases until the mid-fifties, then declines, accelerating in the late sixties and seventies.
• Women – body weight increase until the late sixties, then declines at a rate slower than men.

Symptoms and Signs

• Sarcopenia will present with muscle weakness and loss of stamina as it gets worse.
• More obvious symptoms if associated with diseases of muscle in the elderly include myositis, myopathy and myasthenia.

Watch out for the following warning sign:

• Painful and/or weak muscle (usually affecting the large muscles group like shoulder and the thigh muscle).
• Skin rash (in some myositis).
• Symptoms may occur with relation to medication or alcohol intake (eg. steroids, traditional medications and certain antibiotics).
• Lost of weight and appetite.
• It is an indication for medical attention if any of the warning signs exist.

Complications

Weakness may lead to difficulty in walking or total bed bound if left unaddressed

Treatment/ Prevention

• Management will begin with assessment to exclude possible cause of sarcopenia beside normal aging. If possible cause is identified, you will be referred to specialist for further management.
• Continue maintaining healthy life style and regular exercise can reduce the fat content in body and maintain the muscle mass.
• Resistance training or strength training – exercise that increases muscle strength and endurance with weights or resistance bands – has been shown to be useful for both the prevention and treatment of sarcopenia.
• For optimal benefits with minimal risk of injury, the proper number, intensity, and frequency of resistance exercise is important.