Wednesday 12 January 2022

Sarcopenia

Here are two interesting articles on the dangers of Sarcopenia which came to me via Whatsapp. 

Sarcopenia is a condition affecting older persons. As we age, we begin losing muscle mass and strength which if unchecked, will eventually lead to the inability to move by ourselves and have to use wheelchairs.

The alarming point is that my schoolmates and I are soon to reach 70 years of age in two to three years, and yet many are unaware of this creeping condition in our lives.

Admittedly, I was unaware of it until recently. For years now, I have been puzzled over my own gradual weight loss. Eight years ago, I used to weigh almost 80 kg but now, I'm happy enough to tilt the scales at 69 kg. I see my upper arm muscles gradually decreasing in bulk. The deltoid muscles have lost mass. It had to take some comments from my barber before I started to realise about this deteriorating health condition. Thus, it is time that we take some control over this area of our physical well-being.

So to convince anyone that sarcopenia is a real condition, here is the first of two stories, and it comes courtesy of someone in Taiping.

𝑺ᴏᴍᴇ IMPORTANT 𝑨ᴅᴠΙͺᴄᴇ ᴏɴ π‘―α΄‡α΄€ΚŸα΄›Κœ κœ°α΄Κ€ 𝑺ᴇɴΙͺᴏʀ𝒔!πŸ˜±πŸ™

Today I want to share a condition that many seniors suffer from. It may appear trivial but can result in dangerous consequences. It may start with only a drop in appetite and then  walking becomes progressively weaker. The body feels less enthusiastic and less energetic. This is the beginning of the disease of most elderly people suffer from - namely muscle wasting and weakness.

As you may be aware... the leading cause of death for many elderly people at the age of 65 and above is not a strange disease. The main cause of parental death starts with slips and falls - either in the room, bathroom/toilet or going up/down the stairs.

This is related to the weakening of the muscles experienced by the elderly... so that they are prone to poorer balance and falls.

All of us will slowly and not so consciously experience a physical decline with significant changes to the body over the next 10 years  A simple example is we start to eat less and become less agile in our movements.

Please note that by the age of 50 we have already started to experience 1-2% muscle weakness with up to 30% muscle loss by the age of 60 and up to 50% by the age of 80 years old.

This situation can only be prevented by two main things namely a sensible diet and exercise (physical activity). These two things you should still do as much as possible no matter how old you are.

Keep eating enough... even though your teeth aren't as strong as they used to be... and you don't have much appetite either... keep eating. 

Try not to just eat vegetables. You should also eat eggs and meat regularly because it builds muscle together with daily exercise. For this reason, I have vegetarian friends who have started to eat meat again. 

Whatever the type of sport, no matter how light the sport is, whether you want to jog, cycle or just take a leisurely walk. Try to continue to have sports activities as often as possible.

And lastly don't forget to get enough sunlight for Vitamin D and hygiene reasons (eg kill bacteria or reduce/remove odours). Older people really need Vitamin D to prevent bone loss and muscle weakness.

However, don't just rely on the sun and buy a Vitamin D supplement especially if you are not the outdoor type. The skin of older people may have difficulty in absorbing and creating Vitamin D from the sun alone.

Let's share care & live well ❤️

And here is the second story from the other side of the world. I have made changes to some spellings in order to de-Americanise the story and make it more understandable to non-American eyes. Also, I converted some weights and measurements to the universal metric system.

What’s the worst health problem that can happen to you? I’m sure many readers would say cancer, stroke or Alzheimer’s Disease. I agree these are all frightful diseases. But there’s another one that occurs gradually as we age. It’s called sarcopenia (the loss of muscle mass), and this creeping frailty forces many elderly into nursing homes because their muscles are so weak they can no longer get off the toilet.

A recent report from Tufts University in Boston says sarcopenia robs people of their independence and often leads to the risk of falls resulting in serious injury. Visit any nursing home and you’ll see multiple examples of sarcopenia.

Studies show that sarcopenia begins around age 45 and increases at the rate of one percent a year. That means that by age 65, sedentary people have lost half of their muscle mass. And you cannot lose muscle mass without losing muscle strength. Women are at greater risk than men as they start out in life with one-third less muscle mass than men. Moreover, since they live longer there’s longer duration of muscle loss.

So what can you do at an early age to prevent ending your life in a wheelchair? As the elderly age they tend to shy away from strenuous tasks that cause discomfort. This sets the stage for sarcopenia.

First, don’t neglect sufficient protein. Dr. Paul Jacques, director of Tufts nutritional programme, says, “It’s estimated that 20 percent of people between the ages of 51 to 70 have inadequate protein intake.” But the Tufts report also states that most North Americans get plenty of protein, but they obtain it the wrong way. Cheeseburgers and fried chicken provide protein, but they also provide too much saturated fat and calories. Researchers stress another important point. You should not only get adequate protein at dinner, but also at other meals.

So what’s the appropriate protein math to prevent sarcopenia? The proposed average is 40 to 70 gm a day depending on body weight (0.8g of protein per kilogram). So a 50 kg woman would require 40 gm and a 80 kg man 64gm. In addition, the amount depends on daily activity.

What about exercise? It’s been known for decades that weight lifting and working on resistance machines increases muscle mass and strength in young people. But when this approach was tried on older people their muscles did not get larger.

The reason for these poor results was the initial fear that to push older people too hard is unwise. I say “amen” to that, because I’ve seen cases of snapped tendons due to the loading of excessive weights. But there is a positive side if weightlifting is done with caution and not pushed to the limit. When researchers used increasing weights for those between 60 to 72 years it doubled their strength in 12 weeks of training. Some frail 90-year-olds tossed their canes away in 8 weeks of graduated exercise.

There are other benefits to preserving muscle mass. During an illness the body withdraws protein from muscles to aid in the healing process and produces antibodies to fight infection. When sarcopenia is present, there’s less ammunition to fight illness. Dr. William Evans, at the University of Arkansas, cites a study in Finland in which men in their late 60s who had lifted weights for years, had muscle mass similar to non-athletes in their 20s. Joggers however, are not protected from sarcopenia as the stress produced by this sport can’t compete with lifting weights.

The message is here is that to maintain muscle mass you require an adequate dietary intake of protein along with exercise, preferably using weights. This is not news I like to hear. I’ve enjoyed sports, but not lifting weights. But reluctantly I keep a pair of weights close to my computer and intermittently use them. I also enjoy replenishing my protein with a six-ounce steak (63 gm) and baked potato with skin (5 gm). And to ease my anxiety that I may be protein deficient I enjoy 5 ounces of red wine (0.3 gm of protein).

And finally, I shall urge everyone not to miss an educational and informative session which Diabetic Malaysia has arranged for this Sunday at 2pm. Consultant Geriatrician Dr Ong Ing Wei from University of Malaya shall give a talk on Sarcopenia on the Zoom platform. Use this link and login information below to attend: 

https://us02web.zoom.us/j/89608230939?pwd=M3haSlZOUWdRanM1SEVNTXNHck05dz09

Meeting ID: 896 0823 0939

Passcode: 323121

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