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Muscle atrophy is the loss or thinning of muscle tissue. Age-related muscle atrophy, also known as sarcopenia, is a natural part of aging. The loss of muscle mass typically begins in one's 30s or 40s and accelerates between the ages of 65 and 80. Sarcopenia can greatly impact one's quality of life by reducing the ability to perform daily tasks and increasing the risk of falls and fractures. While aging is the dominant factor, other risk factors for sarcopenia include physical inactivity, malnutrition, nerve damage, and chronic diseases. The good news is that sarcopenia can be treated and even reversed through progressive resistance training, nutritional changes, and other therapeutic measures.
| Characteristics | Values |
|---|---|
| Name of condition | Sarcopenia |
| Definition | Age-related progressive loss of muscle mass and strength |
| Muscle loss | 3-5% per decade after age 30 |
| Muscle loss after age 80 | 11-50% of people have sarcopenia |
| Muscle loss after age 65 | Up to 8% of muscle mass lost per decade |
| Cause | Natural aging process, physical inactivity, unhealthy diet |
| Risk factors | Chronic diseases (COPD, kidney disease, diabetes, cancer, HIV), rheumatoid arthritis, insulin resistance, reduction in hormone levels, malnutrition, inadequate protein intake, nerve cell decline |
| Treatment | Progressive resistance training, diet changes, supplements (omega-3, creatine), calistrophic exercises, walking |
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Sarcopenia
The main 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. Sarcopenia is also strongly associated with an increased risk of fractures. The hallmark sign of sarcopenia is the loss of lean muscle mass. In population studies, body mass index (BMI) is seen to decrease in ageing populations while bioelectrical impedance analysis (BIA) shows an increase in body fat. Changes in weight, limb, or waist circumference are not reliable indicators of muscle mass changes.
The most common cause of sarcopenia is the natural ageing process. Typically, people begin losing muscle mass and strength sometime in their 30s or 40s. This process picks up between the ages of 65 and 80. Rates vary, but one may lose as much as 8% of their muscle mass each decade. While ageing tends to be the dominant factor, researchers have discovered other possible risk factors for sarcopenia. These may include physical inactivity, 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, and a decline in the number of nerve cells that send messages from the brain to the muscles.
The degree of sarcopenia is determined by two factors: the initial amount of muscle mass and the rate at which muscle mass declines. Due to variations in these factors across the population, the rate of progression and the threshold at which muscle loss becomes apparent is variable. Immobility dramatically increases the rate of muscle loss, even in younger people.
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Neurogenic atrophy
- Amyotrophic lateral sclerosis (ALS) or Lou Gehrig's disease
- Guillain-Barre syndrome
- Carpal tunnel syndrome
- Spinal cord injury
- Multiple sclerosis
The symptoms of neurogenic atrophy include reduced muscle mass, weakness, numbness, and tingling in the limbs. It can also lead to trouble walking or balancing, difficulty swallowing or speaking, and loss of movement.
Unlike physiologic atrophy, neurogenic atrophy typically cannot be reversed because of the physical damage that has been done to the nerves. Treatment for neurogenic atrophy may include physical therapy, ultrasound therapy, and, in some cases, surgery to correct a contracture. An exercise program, including exercises in a swimming pool to reduce muscle workload, may also be recommended to help treat the condition.
It is important to consult a healthcare provider for a proper diagnosis and treatment plan for neurogenic atrophy, as the specific approach may vary depending on the underlying cause and the individual's health condition.
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Physiologic atrophy
Muscle atrophy is the loss or thinning of muscle tissue. Physiologic atrophy, also known as disuse atrophy, is caused by not using muscles enough. If you stop using your muscles, your body will stop expending energy on maintaining them. Instead, it will begin to break them down, causing a decrease in muscle size and strength.
The amount of time it takes for physiologic atrophy to occur depends on age, fitness level, and cause of atrophy. If atrophy is due to disuse, the process can begin within two to three weeks of not using the muscles. However, even reducing daily activity can induce atrophy and cause muscle loss.
Age-related muscle atrophy appears to be caused by a combination of behavioural and physiological factors, including inactivity and immobilization, resistance to anabolic stimuli, and a failure to fully recover from muscle loss. Physiologic atrophy can be treated and even reversed through progressive resistance training, nutrition changes, and other therapeutic measures.
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Inactivity and ageing
The loss of muscle mass and strength due to ageing is specifically called sarcopenia. It is a natural part of the ageing process and typically begins around the age of 30, with an average loss of 3-5% of muscle mass per decade. However, the rate of loss can vary, and some individuals may lose up to 8% of their muscle mass every ten years. Sarcopenia can significantly impact an individual's quality of life, making it difficult to perform basic daily activities such as getting out of chairs or carrying groceries.
The risk factors for sarcopenia include inactivity, an unhealthy diet, and certain medical conditions. An inactive lifestyle accelerates muscle loss, and the condition can be further exacerbated by inadequate protein intake, as protein is essential for building muscle. Chronic diseases such as chronic obstructive pulmonary disease (COPD), kidney disease, diabetes, cancer, and HIV can also contribute to sarcopenia. Additionally, a decline in nerve cells responsible for transmitting signals from the brain to initiate muscle movement is associated with sarcopenia.
To counteract the effects of inactivity and ageing on muscle atrophy, progressive resistance training (PRT) is recommended. PRT involves gradually increasing workout volume, weight, repetitions, and sets as strength and endurance improve. This continuous challenge helps build muscle and prevent plateaus. Additionally, consuming sufficient calories, high-quality protein, and supplements like omega-3 and creatine can slow down muscle loss and improve overall muscle health.
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Malnutrition
In older patients, malnutrition can lead to changes in body composition, resulting in functional impairment and poor clinical outcomes. Low muscle mass due to malnutrition increases the risk of falls and fractures, lowers quality of life, and increases morbidity and mortality. Malnutrition has been found to be associated with acute muscle wasting in frail older patients during hospitalization, with malnourished patients experiencing a significant decline in muscle mass and strength.
The impact of malnutrition on muscle atrophy is not limited to the elderly. In a study by Van Ancum et al., older patients with lower muscle strength and mass at hospital admission were found to be at risk of malnutrition, falls, and functional disability. This suggests that malnutrition, combined with physical inactivity, may adversely affect muscle strength and physical functioning in older individuals. Therefore, routine nutritional assessment and early recognition of malnutrition are crucial for the treatment and management of malnutrition in this population.
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Frequently asked questions
Muscle atrophy is the loss or thinning of muscle tissue.
Sarcopenia is a type of muscle atrophy that occurs as people grow older. It is the age-related progressive loss of muscle mass and strength.
Sarcopenia is mainly caused by the natural aging process. Other factors that contribute to sarcopenia are physical inactivity, unhealthy diet, chronic diseases, rheumatoid arthritis, reduction in hormone levels, and nerve cell decline.
Sarcopenia is rare before the age of 60. However, studies suggest that between 11% and 50% of people have sarcopenia after the age of 80.
Yes, sarcopenia can be treated and reversed through progressive resistance training, nutritional changes, and other therapeutic measures. Staying active and consuming sufficient calories, protein, and supplements can also help fight sarcopenia.
