If your calf circumference is lower than this number, you are in danger! 2 ways to help you prevent it →

“Money can’t buy you slimness in old age.” As people age, the health problems caused by “middle-aged obesity” seem to be worthy of attention. However, for another group of elderly people, they become thinner as they get older. Because they don’t gain “middle-aged obesity,” it is often seen as a sign of health.

However, watching my parents getting thinner and thinner, panting when climbing stairs, and even falling...it seems that being "thin in old age" is not a good thing.

In fact, being thin as you get older is not necessarily a normal phenomenon . One of the common reasons is sarcopenia .

What is sarcopenia?

Sarcopenia is closely related to aging. As people age, their organ functions decline, their hormone levels change, and their activities decrease, all of which can lead to decreased athletic ability, loss of muscle mass, and reduced muscle strength.

This type of sarcopenia that is only related to age is called primary sarcopenia, and it usually occurs in the elderly population. The prevalence of sarcopenia in people aged 80 years and above is as high as 67% [1] . It is associated with increased disability, falls, fractures and mortality.

Some people may ask: Is sarcopenia a completely old age disease?

Not entirely, young people can also get it . Secondary sarcopenia refers to sarcopenia caused by exercise, nutrition and disease. It may occur in people of all ages and is closely related to many underlying diseases.

What are the symptoms of sarcopenia?

How is sarcopenia diagnosed?

Symptoms of sarcopenia include weakness, difficulty walking, slow gait, easy falls, thin limbs, and disability .

Whether you have an elderly person at home or an adult who is too thin, you can use the following method to do a preliminary self-assessment:

1

Initial Self-Screening

The simplified five-item SARC-F questionnaire was used as a preliminary self-screening tool:

If the SARC-F scale is ≥4 points, you need to go to a medical institution for further evaluation.

2

Measure your calf

Calf circumference can reflect muscle mass to a certain extent, so a working group recommends that the SARC-F scale combined with calf circumference would be more accurate in screening people at high risk of sarcopenia.

If the calf circumference is less than 34 cm for men and less than 33 cm for women [3] , or the SARC-F scale is ≥ 4 points , then it is recommended to seek further evaluation at a medical institution.

3

Go to a medical institution for professional testing

Other tools for assessing physical function include the 400-meter walk test, five sit-ups, the Simple Physical Fitness Chart (SPPB), and the Stand-and-Go Timed Test. Doctors will select these screening and diagnostic tools based on the specific circumstances of the elderly.

The specific process is as follows [2-3]:

Parents are getting thinner

What other reasons could there be?

There are many reasons why parents lose weight. In addition to parents' subjective and deliberate weight control, other possible reasons for elderly people's gradual weight loss include [4]:

● Economic poverty or poor eating habits leading to inadequate nutritional intake;

● Long-term bed rest and lack of strength training lead to muscle disuse atrophy;

● Physical factors such as malignant tumors, diabetes, infection, chronic kidney disease, and gastrointestinal diseases;

● Psychological factors such as dementia and depression;

● Physiological factors such as decreased sense of smell and taste, and delayed gastric emptying in the elderly;

● Drugs such as diuretics, digoxin, etc.

Therefore, it is necessary to comprehensively investigate the specific reasons why the elderly become thinner, weaker, and more prone to falling.

How to prevent and treat sarcopenia?

The way to prevent sarcopenia is the "health preservation" and "exercise" that we often talk about:

1. Improve unhealthy lifestyles and habits, such as quitting smoking and drinking, and avoiding long periods of sitting; dietary intervention, such as eating a balanced diet and avoiding picky eating. It is recommended that the clinical nutrition department assess the nutritional status and develop a nutritional treatment plan when necessary [5];

2. Exercise intervention: appropriately increase resistance and aerobic exercises, such as swimming, Tai Chi, stretching and balance exercises, to improve physical function.

Can starting active exercise now prevent sarcopenia in old age?

Exercise is effective at any time and can reverse or prevent the occurrence of sarcopenia[6-11].

Exercise appears to be the most effective way to improve quality of life and function in older adults, even the very elderly or frail.

Resistance exercise can increase muscle mass and strength , especially through progressive resistance exercise such as squats, rows, pull-ups, planks, etc. It is recommended to increase the intensity as physical fitness improves.

Resistance exercise can improve physical function in the elderly.

If the elderly have cardiopulmonary diseases or other contraindications that are not suitable for resistance exercise, they can choose aerobic exercises such as slow walking, aerobics, Tai Chi, etc., which are beneficial to improving cardiovascular health and increasing endurance.

The combination of aerobic exercise and resistance exercise can further improve muscle strength and muscle function, which is very important for the prevention and treatment of sarcopenia.

As for the treatment of sarcopenia, it is relatively limited. Currently, there is not enough evidence-based support for drug treatment of sarcopenia.

Some studies suggest that protein supplementation, growth hormone, testosterone replacement therapy, and certain selective androgen receptor modulators are promising potential treatments, but further evidence-based research is needed before they can be applied clinically [12].

Therefore, it is very important to prevent problems before they occur. This requires children to pay attention to their parents' conditions in a timely manner and use self-screening tools to detect abnormalities early.

References

[1]. UPTODATE database: Elderly nutrition: Nutritional issues for the elderly

[2]. Wittert GA, Chapman IM, Haren MT, et al. Oral testosterone supplementation increases muscle and decreases fat mass in healthy elderly males with low-normal gonadal status. J Gerontol A Biol Sci Med Sci 2003; 58:618.

[3]. European revised definition and diagnosis of sarcopenia (EWGSOP2).

[4].UPTODATE database: Sarcopenia.

[5]. Chinese Medical Association Osteoporosis and Bone Mineral Disease Branch. Consensus on Sarcopenia[J]. Chinese Journal of Osteoporosis and Bone Mineral Disease, 2016, 26(11): 1689-1693.

[6]. N. Montero-Fernandez, JA Serra-RexachRole of exercise on sarcopenia in the elderly, Eur J Phys Rehabil Med, 49 (2013), pp. 131-143

[7]. TJ Marcell Sarcopenia: causes, consequences, and preventions J Gerontol A Biol Sci Med Sci, 58 (2003), pp. M911-M916

[8]. V. Malafarina, F. Uriz-Otano, R. Iniesta, L. Gil-Guerrero Sarcopenia in the elderly: diagnosis, physiopathology and treatment

[9]. CJ Liu, N. Latham Can progressive resistance strength training reduce physical disability in older adults? A meta-analysis study, Disabil Rehabil, 33 (2011), pp. 87-97

[10]. LA Burton, D. Sumukadas Optimal management of sarcopenia. Clin Interv Aging, 5 (2010), pp. 217-228

[11]. MD Peterson, MR Rhea, A. Sen, PM Gordon. Resistance exercise for muscular strength in older adults: a meta-analysis. Ageing Res Rev, 9 (2010), pp. 226-237.

[12]. Dalton JT, Barnette KG, Bohl CE, et al. The selective androgen receptor modulator GTx-024 (enobosarm) improves lean body mass and physical function in healthy elderly men and postmenopausal women: results of a double-blind, placebo-controlled phase II trial. J Cachexia Sarcopenia Muscle 2011; 2:153.

Planning and production

Source: Yihe Science

Author: Chen Yangpu, Doctor of Geriatrics, Qinghai University Affiliated Hospital

Reviewer: Ji Gang, deputy chief physician of orthopedics, the First Hospital of Hebei Medical University

Editor｜Yang Yaping

Proofread by Xu Lai and Lin Lin

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