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The Truth About Sarcopenia

Move It or Loss It!


Senior Lifting

We all know someone, or perhaps even ourselves, who have been blaming the lack of activity and physical strength on the effects of aging.  We hear them say things like, “I just don’t have the strength I use to” or “I’m not as young as I use to be” as a reason for not doing the things that they once loved.  If only they knew that the loss of physical stamina and strength that they are experiencing may be the result of a condition that could have been prevented and could now be reversed!

We have all heard of the age related conditions such as Menopause and Osteoporosis, one which is bound to happen eventually and one that can be prolonged or reversed.  Not as many of us have heard about another age related condition that affects between 13 – 24% of the population between the ages of 60 – 70, and over 50% of those aged 80 and above.  Research shows that of those affected, if action is not taken, the women have a 3.6 times higher rate of becoming disabled and the men show a 4.1 time higher rate of disability.

In 1931, Dr. Critchley noted that with aging there was a loss of muscles mass, mostly marked in the appendicular skeletal muscles of the arms and legs.  It wasn’t until 1989 that Dr. Irving Rosenberg from Tufts University gave this age related loss of muscle mass a name.  From the Greek word meaning “poverty of the flesh” Sarcopenia is defined as a degenerative loss of skeletal muscle mass and strength.

The facts show that after the age of 50 muscle mass decreases at an annual rate of 1 – 2%, while muscular strength declines by 1.5% between the ages of 50 and 60 and increase 3% annually thereafter.  At the tissue level, there is an increase in the amount of fat and connective tissue within the muscle.  Also, the size of the type 2 or fast twitch muscle fibers decrease with aging while the type one or slow twitch muscle fibers remain unaffected.  This could be the early indications of Sarcopenia.  Once these things begin to occur, if we do not do something about them, they result in weakness, decreased mobility, increased risk of falling, loss of independence, disability and frailty.

One should not confuse Sarcopenia with Frailty.  Sarcopenia is the decline of skeletal muscle mass, strength and lean body tissue.  Frailty is defined as; the condition of being frail, fragile or easily damaged; the predisposition toward increased risk of injury, illness, disability and/or death.  There are five characteristics of frailty: 1) Unintended weight loss of more than 10 pounds in a year. 2) Sarcopenia 3) Fatigue and exhaustion 4) Slow walking pace 5) Low physical activity.  Any three of these increase the risk of falls, disability, hospitalization and even death.

Pre-Frailty, the presence of any of the two above characteristics carries a high risk of becoming frail. So, since Sarcopenia is a characteristic for indentifying Pre-Frailty and eventually Frailty, it begins to manifest itself early enough for us to begin to do something about it.

There are many studies with evidence linking Sarcopenia to an age related decline in the production of testosterone, human growth hormone, DHEA and estrogen, with correlating studies in the effects of supplementing these hormones, but the only agreed upon proven method of preventing and/or reversing the signs of Sarcopenia is physical activity with a focus on strength training.

Why the focus on strength training?  This is a direct result of the findings of the decrease in size of the type 2 (fast twitch) muscle fibers during the aging process.

There are two broad types of voluntary muscle fibers, fast twitch and slow twitch.  Slow twitch, or type one, muscle fibers contract for long periods of time, but with little force.  Slow twitch muscle fibers are dense in capillaries and are rich in mitochondria and myoglobin.  They can carry more oxygen and helps sustain “aerobic” activity such as walking, swimming, running, etc.  Aerobic means “with oxygen”.   Aerobic or “cardio” exercise improves fitness, reduces ones risk of lifestyle diseases and helps with weight management.

Fast twitch, or type two, muscle fibers contract quickly and powerfully but fatigue very rapidly.  Fast twitch muscle fibers are less dense in mitochondria and myoglobin, can contract more quickly and with a greater amount of force than oxidative muscle, but can sustain only short, “anaerobic” burst of activity before muscle contraction becomes painful.   Anaerobic means “without oxygen”.   Anaerobic exercise is short-lasting, high intensity, where our bodies demand for oxygen exceeds the oxygen supply available.  This type of exercise relies on the energy sources stored in the muscles and are not dependant on oxygen in the air.  Examples of anaerobic activity are; any rapid burst of hard exercise such as strength training, sprinting, interval training and isometrics.

In a cross sectional study in 1990, Klitgaard compared men with a mean age of 69 who have been either running, swimming or strength training for a period of 12 – 17 years with a group of young and elderly sedentary men.  Although the older swimmers and runners exhibited similar declines in strength as the sedentary elderly, the older men who had been strength training had maximal isometric strength and muscle cross sectional areas similar to the younger control group.

In 2009 a study of the elderly documented in the Cochrane Database System shows that progressive resistance training performed 2 – 3 times per week was shown to improve gait speed, timed get up and go, stair climbing ability and overall muscular mass and strength.

It is never too late to begin a strength training program.  A study by Fiatarone found that even the frail, elderly; nursing home patients in their 90’s retained the plasticity of muscle in response to training.  In fact, in a Tuft University study involving 87 – 96 year olds who were introduced to a weight training program testing revealed a 300% increase in muscle tone within an 8 week period.   The seniors also reported improvements in their coordination and balance, but most importantly, their confidence in their abilities to be active returned.  The value of reclaiming dignity and independence cannot be and should not be underestimated!

So – In conclusion; I firmly believe that the old saying, “Move It or Loss It” is not a myth but is indeed a fact that we should not deny.  I say, “Get up, Get moving, Get involved in your own health and well being” It is never too late!

Written by:  Barbara Nobles; CPT, CES, E-RYT-200

“We are never too old to be fit.  We must accept responsibility for our health.  We must realize living is an art, and life is an achievement.  Life is not a gift or possession, it is our final battle.”  The late Dr. George Sheehan

“I would rather wear out instead of rust out.”  The Late Jack Lalanne

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