Beware of this disease that is easily ignored by the elderly - sarcopenia

As the saying goes, "It is more expensive to be thin in old age than to be fat." Many middle-aged and elderly people are worried that obesity will cause various diseases. For the sake of health, they will deliberately stay thin by eating less, dancing in the square, practicing Tai Chi, etc. So, are the elderly really healthier the thinner they are? The answer is of course no.

In life, we often see elderly people around us who have lost weight, their limbs have become slimmer, but their waistlines have not changed. However, their mental state, coordination, physical strength, etc. are not as good as before. Many people think that this is very natural. As we age, "the legs age first", so we have no strength to walk; "old age is more valuable than thinness", so people are getting thinner and thinner. But if we observe carefully, we will find that they are much thinner than when they were young, but they are prone to fatigue, falling, and even fractures. In fact, this is likely a sign of a disease: sarcopenia - a health killer that is easily overlooked!

Getting Started

Sarcopenia refers to the decline in skeletal muscle mass and muscle strength or physical function associated with aging, which is more common in the elderly. Due to its high prevalence, insidious progression, gradual aggravation, severe adverse prognosis, and wide-ranging effects on the body, it has a huge impact on my country's family medical burden and social public health expenditure.

Studies have found that the prevalence of sarcopenia in the elderly over 70 years old is about 20%, while it can be as high as 50% in the elderly over 80 years old. The older you are, the higher the prevalence of sarcopenia and the more serious the accompanying diseases. Studies have shown that muscle mass can decrease by 15% each year after the age of 70.

Advanced small class

How to determine whether it is sarcopenia?

The elderly can judge by these methods:

1. Limb skeletal muscle mass (ASM) is a key indicator for evaluating muscle mass. Dual-energy X-ray absorptiometry (DXA) is the gold standard for its measurement, and bioelectrical impedance analysis (BIA) is simple and convenient.

2. Currently, the most commonly used indicator for evaluating muscle strength is upper limb grip strength; knee flexion and extension strength is the most accurate method for evaluating lower limb muscle strength, and the 5-repetition sit-up test can be used as a simple alternative method.

3. Gait speed is the simplest way to evaluate physical function, while the Simple Physical Profile Board (SPPB), Timed Up and Go (TUG) and long-distance walking are more comprehensive and integrated indicators for evaluating physical function.

4. Calf circumference is a simple method to assess the skeletal muscle mass of the limbs, and can objectively reflect the muscle content and muscle function of the lower limbs.

5. Simple self-test method for calf circumference at home: Put your thumb and index finger around the thickest part of your calf. If you can’t wrap your thumb and index finger around it, it means your calf muscles are full. If your two fingers can completely wrap around your calf, it means your calf muscles are not full enough and you should go to the hospital for treatment.

How to prevent sarcopenia

1. Improve health awareness and avoid falls

The elderly should raise their health awareness and, when falls occur, especially repeated falls, conduct sarcopenia and fall risk assessments and take active interventions to avoid physical harm.

2. Pay attention to sarcopenia screening

Elderly people with sarcopenia may experience symptoms such as weakness, falls, difficulty walking, slow gait, thin limbs and weakness. Therefore, it is recommended that men with a calf circumference less than 34 cm and women with a calf circumference less than 33 cm undergo a professional assessment for sarcopenia.

3. Develop good exercise habits

The elderly should adhere to aerobic exercise, resistance exercise and whole-body coordination exercise, such as sitting leg raises, static wall squats and elastic band pulling, etc., to effectively improve muscle quality, strength and physical function. In addition, it is advisable to participate in more outdoor activities and increase the time of sun exposure.

4. Pay attention to dietary nutrition and weight changes

Eat a healthy diet, increase protein intake appropriately, maintain a proper weight, and avoid being overweight or underweight or having large fluctuations in weight. If your weight has dropped by more than 5% recently (within six months), you should pay attention and seek medical attention in time.

5. Manage chronic diseases well

During regular physical examinations, professional doctors will conduct holistic and individualized management based on comprehensive assessment results to detect and intervene in high-risk acute and chronic diseases that lead to sarcopenia at an early stage.

END
Author: Ning Jiaqiong (Wenjiang District People's Hospital, Chengdu)

Reviewer: He Zhaoxia (Deputy Director of Wenjiang District People's Hospital of Chengdu, Vice Chairman of the Health Management Committee of the Chinese Rehabilitation Medicine Association)

Editor: Jia Jing (Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine)