Sarcopenia: the silent killer. Dr. Domenico Pratico', MD, FCPP
- praticolabalzheime
- 11 hours ago
- 4 min read
Sarcopenia is a clinical condition that is often overlooked; consequently, it can easily lead to a cascade of events that seriously compromise the general health and independence of the affected individual.
The word "sarcopenia" originally derives from the ancient Greek and is formed by the combination of two words: sarx (σάρξ), meaning "muscle" or "flesh," and penia (πενία), meaning "poverty" or "deficiency."
Thus, when we speak of sarcopenia, we are referring to a condition characterized by the progressive and generalized loss of muscle mass and strength.
Sarcopenia is often regarded as a natural phenomenon—one that intensifies from the age of 40 or 50 onwards— during which the body tends to eliminate muscle tissue, particularly the one which is not being utilized. In certain instances, sarcopenia may also stem from an unbalanced diet in which the protein intake is insufficient to sustain muscle mass.
Generally speaking, our body's muscles, like other organs, operate according to a "conservation" principle, aiming to preserve energy reserves to facilitate other essential biological functions. From this perspective, while maintaining adipose tissue (fat), for example, entails almost zero energy cost, maintaining muscle tissue requires significantly more energy and, consequently, a higher caloric expenditure.
For this reason, the body generally tends to sacrifice muscle tissue if it remains unused for a certain period specifically to reduce caloric consumption. As a result, a reduction in both muscle volume and strength occurs, accompanied by the replacement of muscle tissue with adipose and fibrous tissue. In other words, we are witnessing sarcopenia.
We must immediately make a distinction between sarcopenia and muscle atrophy. While sarcopenia is characterized by a decrease in both the size and number of muscle fibers, muscle atrophy manifests as a reduction in overall muscle size.
SYMPTOMS
Among the most common clinical manifestations resulting from sarcopenia is frailty, which presents muscle weakness, fatigue, and in certain cases falls leading to bone fractures and recurrent hospital admissions. These phenomena are often accompanied by a progressive loss of mobility independence and difficulties in performing various daily physical activities for the affected individual.
Sarcopenia can be classified as primary, if it stems from normal aging, or secondary, when it results from other factors.
Among the causes of the primary form, aging stands out above all. It has been estimated that, starting from age 50, in average there is an annual loss of approximately 1–2% of muscle mass. Other contributing factors include physical inactivity and inadequate nutrition characterized by low protein intake.
Causes of secondary sarcopenia include chronic inflammation, endocrine disorders, gastrointestinal issues, prolonged bed rest, and surgical interventions.
DIAGNOSIS
The diagnosis of sarcopenia relies exclusively on a full and detailed clinical and physical examination, which among other things must assess muscle strength (grip strength), walking speed, and muscle mass measurements of the individual.
TREATMENT
If sarcopenia is caused by underlying pathological conditions (secondary), such as those described previously, the first step is to identify and implement the appropriate therapy for the specific disease responsible for the sarcopenia.
In cases of primary sarcopenia, treatment is based on two fundamental principles: resistance training and an adequate diet (rich in protein) to halt the condition and slow its progression.
Indeed, following a diagnosis, the first measures to be adopted should be the diet, which involves a proper nutritional regimen centered on an adequate intake of protein-rich foods. Furthermore, the exercise regimen must be tailored to the patient's physical condition and current fitness level. Therefore, it is crucial to plan a schedule of regular physical activity, ideally under the supervision of a specialist.
Regarding physical exercise, it is important to emphasize that in these cases, we are generally referring to resistance training, that is, working with weights. Aerobic activities, such as jogging or walking, while beneficial for the cardiovascular system, are generally not effective for building new muscle mass. On the contrary, some studies have even suggested that such activities could potentially contribute to a further reduction in muscle mass.
PREVENTION
Prevention of sarcopenia is based on 3 major principles: implementation of general and specific resistance physical activities on a regular basis, appropriate and adequate dietary protein intake, following a general health and active lifestyle.
FINAL THOUGHTS
Sarcopenia is a clinical condition that is often overlooked; consequently, it can easily lead to a cascade of events that seriously compromise the general health and independence of the affected individual. However, we must remember that in most cases, sarcopenia can be effectively prevented and managed, and its impact on the patient's overall health significantly mitigated through proper nutrition and specific, targeted physical training and exercise.
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Check out my recent blog: The 4 Cardinal Points of Behavior Domenico Pratico', MD, FCPP
Domenico Praticò, MD, holds the Scott Richards North Star Charitable Foundation Chair for Alzheimer’s Research and serves as a Professor at the Alzheimer’s Center at Temple, as well as a Professor of Neural Sciences at Lewis Katz School of Medicine at Temple University.
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