Sarcopenia and Exercise – What you need to know

Sarcopenia can affect anyone from the age of 40 but might not show it’s real signs until later years. Accredited Exercise Physiologist Matthew Hollings specialises in this area and took some time out to keep us up to date.

If you were to explain Sarcopenia to a person on the street, how would you?

Sarcopenia is the age-related decline in muscle mass, which typically sees a 3-5% loss in muscle mass each decade from age 30. We still aren’t entirely sure what causes it; whether it is the lack of muscle stimulation from physical inactivity, or the inability of the nervous system to properly ‘switch on’ each muscle fibre with age. What we do know, is that this loss of muscle mass is often associated with frailty and loss of strength in later life – which can ultimately lead to falls, hip fractures, loss of independence and premature death.

Who does it affect the most?

While sarcopenia may start from the 4th decade, the effects of this muscle loss typically aren’t evident until 70+ years. It is not until this point that at-risk men and women may start to take on a ‘frail-type’ appearance – struggling with daily tasks like getting out of a chair without using arms or assistance, opening jars and bottles, becoming unstable or losing balance easily, and a slowing in normal walking speed.

What’s the traditional treatment for Sarcopenia?

There is no medical or pharmaceutical treatment for sarcopenia, however there is some evidence to suggest that maintaining high dietary protein may alleviate the muscle loss to a point. The only known treatment, which can both prevent sarcopenia and completely reverse it, is resistance (or strength) training – which has been shown to re-grow diminishing muscle in individuals up to 101 years old, while also sidelining their overused walking frames.

How does exercise help?

While loss of muscle mass is the defining point of sarcopenia, it is in fact loss in muscular strength which is the greater health risk with aging – the quality, rather than quantity of the muscle. Unfortunately, not all exercise types are equal in the treatment of sarcopenia. By far the most potent stimulus to improve both muscle quality and quantity is high-intensity resistance training – that is, lifting a weight that you can lift only 6-8 times before fatigue.

A landmark study in 1990 by Professor Maria Fiatarone Singh from the University of Sydney, saw 10 elderly nursing home residents aged 86-96 years participate in an 8-week high-intensity resistance training program. Besides large increases in muscle strength, participants saw an average of ~10% increase in muscle mass by the end of the 8 weeks, with one participant showing a more than 40% increase. More importantly, this translated to faster walking speeds, increase in balance and some even gave away their walking canes – with no injuries or complications reported and a 98.8% session attendance rate. So they got stronger, less frail and enjoyed coming to the program!

What’s your best advice for someone living with Sarcopenia?

If you notice that you or a loved one might be slowing down, struggling with everyday tasks or frequently stumbling or falling, my best advice would be to seek guidance from the only health professional trained to treat sarcopenia, an Accredited Exercise Physiologist. A proper treatment program will involve high-intensity resistance training amongst other forms of exercise and balance training, requiring expertise in assessment and prescription, along with regular and appropriate doses for improvement – just as you would take any prescribed medication.

For those unable to access an Accredited Exercise Physiologist, try and find your own resistance stimulus around the home – whether you have a set of dumbbells, use your own bodyweight, or add your own weight (like standing out of a chair with a heavy backpack on). If unsupervised, the important rules are to lift something that will challenge you to complete 10-15 repetitions in a row (7-8/10 intensity) and may leave a burning or fatiguing sensation in your muscles towards the end. It is normal to feel ‘tender’ in targeted muscle for 2-3 days after a resistance exercise, but if it lasts longer than that or arises as pain inside a joint, it is best to seek an Accredited Exercise Physiologist’s advice to help you on your way.

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