Sarcopenia

What is sarcopenia?

The medical definition of sarcopenia is the gradual loss of muscle mass, strength and function. The condition commonly affects the elderly population and is thought to occur due to aging. Sarcopenia can greatly impact your quality of life by reducing your ability to perform daily tasks. It can lead to the loss of your independence and the need for long-term care.

Sarcopenia affects your musculoskeletal system and is a major factor in increased frailty, falls and fractures. These conditions can lead to hospitalizations and surgeries, which increase the risk of complications including death.

Sarcopenia can also affect people with a high body mass index (BMI), in a condition called sarcopenic obesity. People with obesity and sarcopenia have a greater risk for complications than with obesity or sarcopenia alone.

Who does sarcopenia affect?

Sarcopenia most commonly affects people ages 60 and older. The rates increase with age. The disease affects both sexes equally. Studies on affected ethnicities are inconsistent. The rates of the condition increase in people with chronic disease.

How common is sarcopenia?

Studies are inconsistent, and many people don’t receive a diagnosis or treatment for sarcopenia. But rates of the condition range from 5% to 13% in people ages 60 and older. The estimates increase to 11% to 50% in people ages 80 and older.

How does sarcopenia affect my body?

A decrease in both the number and size of your muscle fibers causes your muscles to thin (muscle atrophy).

As you age, your body goes through certain changes that play a major factor in developing sarcopenia. For instance, your body doesn’t produce the same amount of proteins your muscles need to grow. When this happens, your muscle cells get smaller.

In addition, as you grow older, changes in certain hormones — like testosterone and insulin-like growth factor (IGF-1) — affect your muscle fibers. This can lead to sarcopenia.

What are the symptoms of sarcopenia?

The most common symptom of sarcopenia is muscle weakness. Other symptoms may include:

• Loss of stamina.
• Difficulty performing daily activities.
• Walking slowly.
• Trouble climbing stairs.
• Poor balance and falls.
• Decrease in muscle size.

What causes sarcopenia?

The most common cause of sarcopenia is the natural aging process. You gradually begin losing muscle mass and strength sometime in your 30s or 40s. This process picks up between the ages of 65 and 80. Rates vary, but you may lose as much as 8% of your muscle mass each decade. Everyone loses muscle mass over time, but people with sarcopenia lose it more quickly.

Although aging tends to be the dominant factor, researchers have discovered other possible risk factors for sarcopenia. These may include:

• Physical inactivity.
• Obesity.
• Chronic diseases such as chronic obstructive pulmonary disease (COPD), kidney disease, diabetes, cancer and HIV.
• Rheumatoid arthritis.
• Insulin resistance.
• Reduction in hormone levels.
• Malnutrition or inadequate protein intake.
• Decrease in your ability to convert protein to energy.
• Decline in the number of nerve cells that send messages from your brain to your muscles telling them to move.

How is sarcopenia diagnosed?

Your healthcare provider may diagnose sarcopenia after performing a physical exam and asking you about your symptoms. You may complete a questionnaire based on your self-reported symptoms called the SARC-F. SARC-F stands for:

• S — Strength.
• A — Assistance with walking.
• R — Rising from a chair.
• C — Climbing stairs.
• F — Falls.

You score each factor with a number between 0 and 2. The highest maximum SARC-F score is 10. A SARC-F score of 4 or more warrants more testing.

What tests will be done to diagnose sarcopenia?

There is no single test that can diagnose sarcopenia. Your healthcare provider may recommend several tests to diagnose and then determine the severity of sarcopenia.

Muscle strength tests

• Handgrip test: Handgrip strength draws a parallel to the strength in your other muscles. Providers use it to identify shortages in overall muscle strength.
• Chair stand test: Providers use the chair stand test to measure your leg muscle strength, especially your quadriceps. The chair stand test measures the number of times you can stand and sit from a chair without the use of your arms in 30 seconds.
• Walking speed test: The walking (gait) speed test measures the time it takes for you to travel 4 meters (about 13 feet) at your usual walking pace.
• Short physical performance battery (SPPB): With the SPPB test, you take three timed tasks: chair stand test, standing balance test and walking speed test.
• Timed-up and go test (TUG): The TUG test measures the time it takes for you to rise from a chair, walk 3 meters (about 10 feet) away from the chair, walk 3 meters back to the chair, and sit back down in the chair.

Imaging tests for measurement of muscle mass

• Dual-energy X-ray absorptiometry (DEXA or DXA): This type of imaging test uses low-energy X-rays to measure your muscle mass, fat mass and bone density.
• Bioelectrical impedance analysis (BIA): The BIA test is less expensive and more widely available than DEXA. It measures your body fat in relation to your lean body mass.

How is sarcopenia treated?

Treatment for sarcopenia typically includes lifestyle changes. These modifications to your lifestyle behaviors can treat and help reverse sarcopenia.

• Physical activity: Your healthcare provider may recommend progressive resistance-based strength training. This type of exercise can help improve your strength and reverse your muscle loss.
• Healthy diet: When paired with regular exercise, eating a healthy diet can also help reverse the effects of sarcopenia. It’s especially important to increase your protein intake through food or supplements.

What medications are used to treat sarcopenia?

Researchers are studying the possibility of using hormone supplements to increase muscle mass. But there aren’t currently any FDA-approved medications to treat sarcopenia.

How can I prevent sarcopenia?

You may not be able to completely prevent sarcopenia since the condition happens as part of the natural aging process. But you can take steps to slow the progression of the disease. These include:

• Make healthy food choices: Maintain a healthy diet that includes high-quality proteins. Aim for 20 to 35 grams of protein in each meal.
• Exercise: Maintain a physically active lifestyle that includes exercises such as resistance training.
• Routine physicals: See your healthcare provider regularly, and let them know about any changes in your health.

What can I expect if I have sarcopenia?

The outlook for sarcopenia primarily depends on your age. Rates of the condition increase as you grow older. In addition, the outlook for the condition varies based on your health and lifestyle.

The disease can greatly affect your quality of life. You may be able to reverse the effects of the condition with lifestyle changes. If you don’t make recommended changes, the disease will continue to weaken your muscles. Over time, you may need full-time care to live your life.

Is sarcopenia a disease?

In 2016, the Centers for Disease Control and Prevention (CDC) declared sarcopenia a specific disease by creating an International Classification of Disease (ICD) 10 code for the condition. This designation made sarcopenia a reportable disease by healthcare providers. Therefore, it increased the diagnosis and treatment of the disease. This label helps distinguish sarcopenia from similar diseases and allows researchers to begin collecting valuable data about the condition.

What’s the difference between sarcopenia and muscle atrophy?

Sarcopenia is a type of muscle atrophy that specifically affects people as they grow older. Muscle atrophy is the loss of muscle tissue. The two conditions share common features of muscle loss, but the processes behind them are different. A decrease in the size and number of your muscle fibers causes sarcopenia. With muscle atrophy, there’s a reduction in the size of the fibers, but the amount of fibers stays the same.

A note from Cleveland Clinic

Everyone experiences some amount of muscle loss as they age. But with sarcopenia, this muscle loss happens faster. The good news is, there are ways to treat and even reverse the effects of the condition. If you’ve experienced muscle weakness, loss of endurance or any other symptoms of sarcopenia, call your healthcare provider. They can diagnose the condition and develop a treatment plan for you to revert the muscle loss and improve your condition.