Problem Statement
Unlike Osteoporosis, Sarcopenia seems to be a subject many older adults know nothing about. In fact, many do not even know the definition of Sarcopenia. According to MacIntosh, Gardiner, and McComas (2006), “the loss of muscle mass in the aged is known as sarcopenia, and this condition is accompanied by several changes in functional capabilities. “Of these, the loss of strength is the most profound” (p.325). I once had a professor who told us that sarcopenia literally meant puny muscles. Sari Stenholm, PhD, Tamara B. Harris, MD, MS, Taina Rantanen, PhD, Marjolein Visser, PhD, Stephen B. Kritchevsky, PhD, and Luigi Ferrucci, MD, PhD, (2008) stated that the word “sarcopenia comes from the Greek words sarx (meaning flesh) and penia (meaning loss)” (Searching For a Definition Based on Pathophysiology and Associated Risk section, para. 3), although I’ve also heard that penia meant poverty.
Every day, people are growing older and living longer. We live in the time of the Baby Boomers. Instead of being able to retire at a nice comfortable age of 55, people are working well into their 70’s both because they are living longer than past generations and because we are all going through an economic recession. With this though, many older adults do not take proper care of themselves. As discussed earlier, muscle mass is lost as we age. We tend to slow down and do less, especially when it comes to exercise. When this happens, older people are more likely to live less healthy lives and may suffer more health problems than others, even die sooner. By just learning a bit about nutrition and exercise, many older adults can live more fulfilling and happy lives with less risk of injury or illness and decrease their chance of developing sarcopenia.
After interviewing my father, I could not really find any one particular thing about aging that would be of use for a good topic, mainly because he seemed to be in such great shape. He had no diseases, no illnesses, no medications to take, and no doctor visits or bills to manage. Then I realized this was because of the fact that he is fairly active and goes to the gym daily to work out. His muscle mass has not decrease, but actually increased more than it has been in past years. With this, he feels more lively, younger than his true age and capable of doing anything he wishes without any assistance. So, I decided to do my research on the relationship between sarcopenia and exercise.
Review of the Literature
As we age, our metabolism decreases and at this time many tend to exercise less. This is the beginning of loosing healthy muscle and therefore increasing a person’s risk of falling and/or injuring themselves. In a 42 week long study that was done by McCartney, Hicks, Martin, and Webber, men and women between the ages of 60 and 80 participated in weight-lifting training as well as endurance training, bone mineral density, and peak power output. It has been shown in many studies that muscle loss increases the likelihood of a fall, while also increasing the risk of injury. In this particular study, exercises were kept at a reasonable difficulty (the max the individual could safely complete) to ensure that there could not be any serious risk of injury from performing them. McCartney et al (1995) reported that after “Collapsing the data across age, gender, and exercise type, 30% of the increase in dynamic strength occurred in the initial six weeks, or 15% of the total training time; 47% of the increase had developed by 12 weeks, or 30% of the training time” (pg. B97). McCartney et al (1995) suggested that strength training was very beneficial for older adults overall quality of living while helping them stay more independent.
Dennis R. Taaffe and Robert Marcus (2000) stated that changes in the aging adult was caused by inactivity of the individual and not entirely on getting older (p. 245). Most of the exercise that is prescribed to older adults is walking and although this is a good exercise, especially for those who have problems with perhaps their knees or other joints, this does not help with gaining or keeping much muscle. When older patients are in the hospital being treated for certain injuries, it is very likely that the cause was because they fell, and many times it is because they did not have the muscle to keep their balance or strength resulting in their body just giving out. Taaffe and Marcus (2000) noted that when it came to younger adults, periods of inactivity and muscle loss was not that much within a 12 week period and was easier to gain back than it was for older adults in even less time (p. 248). They did find that although there was muscle loss from inactivity, those who had gone through this period were more likely to recover quicker from their injuries and such if they participated in strength-gaining activities both before and after this time (p. 249). It was also mentioned that even doing weight-baring exercises just one or two days a week could be sufficient in accruing muscle mass and staying independent in their lives (p. 252).
Jeffrey M. Willardson (2004) stated that although men have more muscle mass and are more likely to show signs of sarcopenia, women may end up greatly more impacted then men in the long run since women outlive men (p. 27). Willardson believes that when strength-training exercises and other types of exercises are compared, the latter “do not provide sufficient overload to produce increases in muscular size and strength” (p. 30) while he does recommend that the exercise program be done more frequently than Taaffe and Marcus. While cardiovascular exercise is still very important in both the young and old, muscular strength does play a part in how much exercise one had really do (p. 27). Once muscle strength is diminished most people, if not everyone’s, cardiovascular health decreases along with many other factors of health, well being, and independence. There are some who have fallen or sustained an injury and as a result now avoid the activity that that resulted in a fall for fear of repeating it. There are also some that just will not do anything that they consider will cause them to fall. According to Dawn Skelton and Susie Dinan (2007), persons who are doing this will not only limit their daily activities but also create ” — isolation, depression, and further lack of stimulation” (pg. 11). This only adds to not just their physical imbalance in their health/wellness continuum but also in their mental, emotional, spiritual, and social aspects as well.
Perhaps going along with what Willardson mentioned earlier about women being more likely to be impacted with the results of sarcopenia than men, H.J. Martin, H.E. Syddall, E.M. Dennison, C. Cooper, and A. Aihie Sayer discovered in the findings of the Hertfordshire Cohort Study that women who reported more active types of lifestyles and participated in more sports rather than doing activities around the home were more likely to perform better physically, while it did not matter in men (2008). John E. Carlson, Glenn V. Ostir, Sandra A. Black, Kyriakos S. Markides, et al (1999) mentioned that many diseases such as diabetes, osteoporosis, and heart disease can also affect and impair a person’s ability to be physical active (p. 157). Many of these diseases can be controlled and even reversed with proper nutrition and exercise though. Muscles use up glucose for energy, so for example, someone with diabetes could help regulate their blood sugar by lifting weights and doing other strength/resistance training. Someone with osteoporosis can help increase their bone mineral density, lessening the chances of them breaking or fracturing their bones, also through strength/resistance training (p. 164). In Anne Barnett, Ben Smith, Stephen R. Lord, Mandy Williams, and Adrian Baumand’s (2003) study, they found that those who participated in the group fitness programs they created consisting of a mix of exercises (including those for balance and muscle strength), decreased their risk of falling and likelihood of injuring themselves.
Prevention and Resource Strategies
The Centers for Disease Control and Prevention (CDC) and Tufts Nutrition have a program called Growing Stronger (2002) that helps older adults start a new strength training program. In the program, you are walked through a variety of exercises to help you get started and continuing the program. They go over a few different diseases and disabilities, such as diabetes and back pain, and discuss how following the program can help alleviate the situation (p.2). There is even a work book included so that you can keep track of your progress. HealthSteps Rx (2008) discusses that with proper nutrition and resistance training it is possible to prevent sarcopenia. They go on to say that you must be using the proper amount of weights as well. If they are to light, you will not be able to increase your muscle size.
Western Washington University’s Physical Activity and Hypokinetic Disease center (n.d) also lists resistance training as a means of preventing and treating sarcopenia. WWU suggests that you do resistance training 2-3 a week, at a moderate to high intensity. They also give you more information about the frequency, intensity, and even equipment you may need.
Summary
Basically, all of the research that I was able to look up and read firmly believed and demonstrated that with exercise (specifically resistance training), you can help reduce sarcopenia in yourself from happening. As a result, other ailments that you may have (for example diabetes) may be managed more by our body’s muscle mass being able to us up the surplus glucose that is in a diabetics blood thus helping you rely less on medication and perhaps even eliminating the disease altogether. If you have more muscle mass and strength, you are also more likely to have denser bone mineral and not have osteoporosis. Those with more muscle mass/strength are less likely to have balance problems of falls. Even when someone does fall, which if you are a klutz like me will happen from time to time, they will be less likely to suffer from major injury like a fracture or broken bone. Hip replacements are very popular in older adults with frail bones.
All of these different benefits of increasing muscle mass/strength will cut down not only on illness and injury, but also cut down on medical bills such as surgery costs, mediations, and doctor visits. Let’s face it, many people either do not have health insurance or they just do not have enough to cover all their medical needs. Everyone, young and old, can benefit from resistance training. Being more physically fit and active will allow people to live their lives as independently as possible, while also allowing older adults to keep their independence and social health. Plus, who does not like having a bit of extra money in their pockets from not having to pay for medical assistance?
Conclusion
In conclusion, muscle loss is something that happens as we age, but the extent that we let it happen depends solely on us. The greater the muscle loss in a person, the greater the risk of falling and injuring themselves. Resistance training does not have to be difficult, painful, nor does it have to take over a person’s life. Between one and three times a week at a difficulty that is not too easy or too strenuous is all it takes to help reverse the effects of sarcopenia and increase your muscle mass, strength, and overall health and wellness. Within a matter of a weeks, a person with sarcopenia will have increased their strength and mass; if you were previously physically active and done some resistance training, yet had to take some time off, you would be able to do this in even less time than someone who has never done resistance training before. Regardless, a person’s quality of life will greatly improve through the use of a proper diet, strength training, and overall physical activity.
Recommendations
My recommendations for anyone who is losing muscle mass or strength would be to not feel so overwhelmed about it. There are many different types of activities that anyone can do, either in groups or alone. I feel that, especially in older adults, it is a better idea to try to do things in groups mainly because they get to interact with people, be sociable, and see that they are not alone. I think that there are many people who are self conscious or isolated from others, especially the elderly, and participating in group fitness will help them tremendously. There are many different places a person can go to or things a person can do to increase their muscle mass and strength. Local gyms normally allow you to get a free personal trainer the first gym visit you do. This way, you can get help on finding out how to properly do some of the exercises or use the equipment that they have their; they also offer group fitness classes.
If you live in a place where they offer the community a gym, such as an apartment complex or assisted living community, take advantage of it. Let’s say that you got to have a gym membership for that trial week and decide that you do not want to pay for a full membership, you know how to do the exercises and use some of the equipment, so now you can go ahead and do them at your community gym. If you don’t want to them on your own, enlist the help of a friend. There have been studies done that show that those with workout with buddies are more likely to continue with their workouts; partners help keep each other motivated.
Citations
MacIntosh, Brian R., Gardiner, Phillip F., & McComas, Alan J. (2006). Skeletal Muscle: Form and Function. Champaign, Il.
McCartney, Neil, Hicks, Audrey L, Martin, Joan, & Webber, Colin E. (1995). Long-term resistance training in the elderly: Effects on dynamic strength, exercise capacity, muscle, and bone. Journal of Gerontology: An2, 50, B97. Retrieved April 19, 2010, from Research Library. (Document ID: 8763341).
Jeffrey M Willardson. (2004). Sarcopenia and Exercise: Mechanisms, Interactions, and Application of Research Findings. Strength and Conditioning Journal, 26(6), 26-31. Retrieved April 19, 2010, from Research Library. (Document ID: 850933171).
Skelton, D., & Dinan, S.. (2007). Explaining about… the benefits of active ageing. Working With Older People, 11(4), 10-14. Retrieved April 19, 2010, from Career and Technical Education. (Document ID: 1398107401).
Martin, H. J., Syddall, H. E., Dennison, E. M., Cooper, C., Sayer, Aihie A.Relationship between customary physical activity, muscle strength and physical performance in older men and women: findings from the Hertfordshire Cohort Study Age and Ageing, 37(5), 589-93. Retrieved April 22, 2010, from ProQuest Medical Library. (Document ID: 1551553061).
Anne Barnett; Ben Smith; Stephen R. Lord; Mandy Williams; Adrian Baumand (Jul 2003).Community-based group exercise improves balance and reduces falls in at-risk older people: a randomized controlled trial. Age and Agein;; 32, (4), 407. Retrieved April 22, 2010 from ProQuest Nursing & Allied Health Source
Carlson, John E., Ostir, Glenn V,. Black, Sandra A., Markides, Kyriakos S., et al (Winter 1999). 24, (4), 157. Retrieved April 22, 2010 from ProQuest Psychology Journals
Taaffe, Dennis R., Marcus, Robert. Musculoskeletal health and the older adult. Journal of Rehabilitation Research and Development; Mar/Apr 2000; 37, (2), 245. Retrieved April 22, 2010 from ProQuest Nursing & Allied Health Source
Sari Stenholm, PhD, Tamara B. Harris, MD, MS, Taina Rantanen, PhD, Marjolein Visser, PhD, Stephen B. Kritchevsky, PhD, and Luigi Ferrucci, MD, PhD. Sarcopenic obesity – definition, etiology and consequences (2008). Curr Opin Clin Nutr Metab Care. 11(6): 693′”700. Retrieved April 22, 2010. doi:10.1097/MCO.0b013e328312c37d.
CDC (Rebecca A. Seguin, B.S., CSCS,Jacqueline N. Epping, M.Ed. David M. Buchner, M.D., M.P.H., Rina Bloch, M.D., Miriam E. Nelson, Ph.D. Growing Stronger (2002). Retrieved April 22, 2010 from http://www.cdc.gov/physicalactivity/downloads/growing_stronger.pdf
WesternWashington University. Physical Activity and Hypokinetic Disease. Retrieved April 22, 2010 from http://www.wwu.edu/depts/healthyliving/PE511info/sarcopenia/sarcopenia%20website/ex_prescription.html
HealthStepRX. (May 2008). Resources to Improve Your Health. Retrieved April 22, 2010 from http://www.Healthstepsrx.com/resources.articles/sarcopenia.htm#treat
