Being thin in old age is not always good! Beware of this health killer that is easily ignored by the elderly - sarcopenia

Inadvertently

We often hear

…

Uncle Zhang: They say that it is worth more than money to be slim in old age. I have lost a lot of weight recently. My arms and legs have become thinner, but I have more and more fat on my belly, and I am not as energetic as before.

Uncle Wang: Oh, I’m old. In recent years, I don’t have the strength to do anything as before.

Aunt Li: I have been feeling very tired lately. I have become thinner and thinner, and the flesh on my body has become looser and looser. I also keep falling down.

Grandma Tian: After I was discharged from the hospital due to pneumonia, it became increasingly difficult for me to walk. I didn’t dare to walk far and could only stay at home and watch TV or listen to the radio.

Aunt Liu: I am not as agile as before. I can’t even lift my legs after climbing 2 flights of stairs. I’m afraid of falling.

In life, they walk slowly and mistakenly think that they are old and it is normal to walk slowly. If we observe carefully, we will find that they are much thinner than when they were young, get tired easily, fall easily, and even have fractures.

In fact, this could be a sign of a medical condition:

Sarcopenia is a health killer that is easily overlooked by the elderly!

What is sarcopenia? ● Sarcopenia, also known as sarcopenia, is defined as an age-related loss of muscle mass, accompanied by a decrease in muscle strength and/or physical function. In October 2016, sarcopenia was officially included in the International Classification of Diseases ICD-10 disease code, marking that the medical community regards it as a disease with independent characteristics.

Sarcopenia has a high prevalence, insidious progression, gradual aggravation, and severe poor prognosis. 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 the age, the higher the prevalence of sarcopenia and the more serious the accompanying diseases.

● Muscles are important life organs. Skeletal muscle mass reaches its peak at the age of 30, and then decreases by 1%-2% each year, and skeletal muscle strength decreases by 1.5%-3% each year. Muscle function decline may begin around the age of 35, accelerate after the age of 50, progress more rapidly after the age of 60, and peak after the age of 75.

Studies have shown that muscle mass can decrease by 15% each year after the age of 70. Muscle atrophy and decreased strength are important causes of disability in the elderly and are also the root cause of many elderly people's falls. Therefore, "saving money is not as good as saving muscle", and you can improve the peak value of muscle and bone by strengthening nutrition and exercising when you are young.

What are the hazards of sarcopenia? ● Sarcopenia reduces the mobility of the elderly, making it difficult to complete daily activities such as sitting, walking, lifting, and climbing, and gradually develops staggering, difficulty getting out of bed, and inability to stand upright. Because sarcopenia often coexists with osteoporosis, it makes the elderly prone to falls and fractures, followed by disability and death. For example, falls caused by sarcopenia can cause hip fractures in the elderly, resulting in long-term bed rest, followed by a series of complications such as lung infections and lower extremity venous thrombosis, which ultimately make the elderly lose their ability to live independently.

● Sarcopenia can easily lead to malnutrition and decreased immunity. Skeletal muscle is the body's most important motor organ, the largest protein storage depot, and an important glucose metabolism organ. When skeletal muscle is reduced, malnutrition and immune system damage are likely to occur, causing endocrine and metabolic abnormalities and increasing the risk of influenza, pneumonia, tumors, etc. in the elderly.

● Sarcopenia is significantly associated with poor prognosis of chronic clinical diseases such as chronic obstructive pulmonary disease, diabetes, tumors, heart failure, etc. Complex changes in body composition (muscle, fat, bone) related to age may cause a variety of complications, produce synergistic effects, and impose multiple burdens on the body.

● Because elderly people with sarcopenia have poor resistance and coping ability to various stressful events, a small adverse event can produce a series of domino effects, leading to falls, fractures, infections and deaths, etc., seriously endangering the health of the elderly and increasing the care burden and medical expenses of society and families. The harm cannot be underestimated and requires early prevention and treatment.

Who are at high risk of sarcopenia? Which high-risk groups need special attention?

● People with chronic protein deficiency or malnutrition;

● Chronic wasting diseases such as asthma, chronic bronchitis, tumors, heart and kidney failure, etc.

● Patients with immune rheumatic diseases and osteoporosis;

● Diseases of the nervous system or bone and joint system lead to reduced activity, resulting in muscle atrophy due to disuse;

● People who are bedridden, immobilized or lack exercise for a long time;

● Those with concurrent depression or cognitive impairment;

● Those who walk slowly or have fallen recently;

● People who lose weight for no apparent reason.

What are the clinical manifestations of sarcopenia? Sarcopenia lacks specific clinical symptoms, and often has the following manifestations:

● Slow walking and impaired mobility: such as lack of energy in walking;

● Decreased grip strength: For example, towels cannot be wrung dry or bottle caps cannot be opened;

● Weakness and fatigue: For example, feeling tired all the time, prone to falling and fractures;

● Related complications may occur: such as bedsores, pneumonia, cardiovascular disease, etc.

How to detect sarcopenia early? my country currently has insufficient knowledge of sarcopenia. AWGS2019 recommends the "screening-assessment-intervention" diagnosis and treatment process.

my country recommends the following steps for screening and evaluating sarcopenia:

Elderly people can conduct self-screening for sarcopenia based on symptoms and using methods such as the "ring test", SARC-F questionnaire, and calf circumference measurement.

｜Symptom Screening｜

Self-screen against these five symptoms:

● Feeling of decreased physical strength, obvious inability to do things, and difficulty in activities;

● Repeated falls;

● Weight loss without apparent cause;

● Slower pace;

● Other chronic diseases such as diabetes, chronic heart failure, chronic obstructive pulmonary disease, chronic kidney disease, arthritis and tumors.

｜Screening by “Ring Test” method｜

Raise your hands and use your index finger and thumb to make a circle around the thickest part of your non-dominant calf. If the calf circumference is the same size as the circle, or smaller, it means you are at risk of sarcopenia.

｜SARC-F Questionnaire Screening｜

Currently, the International Clinical Practice Guidelines for Sarcopenia (ICFSR) recommend the use of the SARC-F questionnaire for screening for sarcopenia.

S - Strength:

Do you have difficulty lifting or carrying 10 pounds (about 4.5 kg)?

0 points - no difficulty

1 point - slightly difficult

2 points - Very difficult or impossible to complete

A-Assistance walking:

Do you have trouble walking across the room and need help?

0 points - no difficulty

1 point - slightly difficult

2 points - Very difficult, need to use assistive devices, need help from others

R - Rise from a chair:

Do you have difficulty getting up from a chair or bed and do you need help?

0 points - no difficulty

1 point - slightly difficult

2 points - Very difficult, need to use assistive devices, need help from others

C-Climb stairs:

Is it difficult to climb 10 steps?

0 points - no difficulty

1 point - slightly difficult

2 points - Very difficult or impossible to complete

F - Falls:

Falls in the past year

0 points - no history of falls in the past year

1 point - 1 to 3 falls in the past year

2 points - 4 or more falls in the past year

The total scores of the above five items are added together. The higher the score, the worse the physical fitness. If the total score of SARC-F is ≥ 4 points, it indicates the risk of sarcopenia and further muscle strength assessment is required.

｜Calf circumference measurement｜

The measurement method is to use a non-elastic band to measure the maximum circumference of the calf on both sides, which can be used as a substitute for muscle mass. AWGS2019 recommends that the calf circumference cutoff for screening sarcopenia is: Male