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Issue 05 * 30 December 2023

Sarcopenia: The Hidden Epidemic Affecting Older Adults

From the age of 30, there is a gradual loss of muscle strength, function, and mass. It often goes unnoticed until we cannot get up from the floor as easily as we used to or we have a harder time going up a flight of stairs. If not recognised and treated, this gradual loss of strength, function, and muscle mass, known as sarcopenia, becomes a serious health issue that can lead to falls, fractures, a loss of independence, and premature death.

David Propst

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Sarcopenia can be quite common; however, most people, including healthcare providers are unaware of this condition. An estimated 10% of adults over 50 years of age have sarcopenia with numbers further increasing with increasing age. With the global ageing population, the numbers are set to rise. By 2050, sarcopenia is expected to impact one in three individuals over the age of 65, creating a public health challenge.

01 The Risks

The risks associated with sarcopenia can be devastating. Sarcopenia is associated with an increased risk of nearly all chronic health conditions and with worsening outcomes of those conditions. Sarcopenia can rob an individual of the ability to perform their daily activities, resulting in a decline in quality of life, including increased hospitalisations.

Detecting sarcopenia early is where the SARC-F questionnaire comes into play (DOI: 10.1002/jcsm.12048). It's a simple tool used by healthcare providers to screen for signs of this muscle condition. The SARC-F assesses strength, required assistance in walking, rising from a chair, climbing stairs, and history of falling. However, the effectiveness of this tool depends on the threshold score used to flag potential sarcopenia.

Enter the study led by David Propst (Master of Physician Assistant Studies, Physician Assistant-Certified), which takes a deep dive into the optimal SARC-F cutoff score for identifying sarcopenia (DOI: 10.1101/2023.10.31.23297840). The research, corroborated by prior studies, suggests that the traditional cutoff score of ≥4 might be too high, missing many who could benefit from early intervention.

Propst's findings reveal that a lower cutoff of ≥2 offers a more balanced approach, accurately identifying those at risk while minimising false alarms. Furthermore, the study bolsters the argument for an even lower threshold of ≥1, enhancing the tool's sensitivity to detect probable sarcopenia early on. This is crucial because the sooner sarcopenia is identified, the sooner it can be addressed.

02 Prevention and Treatment

The primary method for the prevention and treatment of sarcopenia is progressive resistance exercise. Lifting weights, performing resistance band exercises, or bodyweight workouts are proven beneficial to boost muscle mass and strength. Resistance exercise is not just recommended for those diagnosed with sarcopenia but for all older adults as a preventive measure.

Nutrition also plays a critical role. A diet sufficient in protein supports muscle growth and repair, which is essential in the fight against sarcopenia. Sleep, too, is vital, as it's during rest that our bodies recover and build muscle. The supplement, creatine monohydrate, has also been shown beneficial. However, protein, sleep, and creatine are only effective when combined with resistance exercise

The study's conclusion is clear: using the SARC-F questionnaire with a lower threshold is an effective strategy for detecting sarcopenia. By identifying sarcopenia earlier, treatments can begin sooner, potentially reversing or halting the progression of muscle loss. These findings align with the latest clinical guidelines, which emphasise the importance of early detection and intervention.

03 Detecting Sarcopenia

If you have noticed a decrease in your strength, muscle mass, or the ease with which you perform your daily activities (such as rising from your chair or climbing stairs), and think you might be at risk for sarcopenia, ask your healthcare provider about the SARC-F screening tool.

Progressive resistance training is recommended for most older adults, including those with health conditions. Goldster offers a range of resistance exercise classes for both beginners and more active adults. These classes are always supervised by expert trainers who are able to modify exercises for those living with health conditions, such as sarcopenia.