As we age, our body composition changes. More specifically, it’s common for our skeletal muscle mass to decrease. This loss of skeletal muscle is referred to as sarcopenia, and it causes a loss in muscle strength as well.

Muscle weakness can lead to further health problems in elderly patients, which is why it’s important for CDPAP caregivers who are taking care of elderly patients to understand the causes and treatments of muscle weakness.

Not only can a sarcopenia patient’s healthcare costs increase by up to $2,300 a year, but the mortality rate of older adults with sarcopenia is 41% higher than those without sarcopenia. That’s why CDPAP caregivers need to become familiar with the condition.

What is sarcopenia?

Sarcopenia simply refers to muscle mass that occurs due to aging, and it affects roughly 10% of people over 50 years old and 20% of those over age 70. While we all lose some muscle mass as we age, it’s important to maintain as much as possible to avoid further adverse health effects. It can come on suddenly or develop over the course of months or even years.  

Skeletal muscle mass typically makes up 35-36% of our body, so losing it can also lead to disability. For example, it becomes harder to walk because walking requires leg muscle strength. In the elderly, this can lead to falls and further injuries. But it’s also dangerous for a person to remain sedentary since that causes muscles to weaken at a faster rate.

Even though our energy and strength can decrease as we age, it’s important to stay relatively active. People with sarcopenia have a 13.8% increased risk of needing assistance with daily activities if they develop the condition. They also tend to suffer from a poorer quality of life and an increased risk of hospitalization.

Research has found that the prevalence of sarcopenia in people over 60 is correlated to where and how they live. It is most common in:

–          11% of men and 9% of women who live at home

–          23% of men and 24% of women who are hospitalized

–          51% of men and 31% of women who are in nursing homes

Those who suffer from sarcopenia tend to have a shortened life expectancy, so keeping an eye on activity levels and helping patients work on mobility and strength are important. Those with sarcopenia have a 58% higher risk of fracture than people without the condition.

What causes muscle weakness in the elderly?

Muscle degeneration is caused by the body’s inability to balance the signals it produces to both build up and tear down muscle. When our bodies are working normally, our growth hormones and certain enzymes in our bodies act together to keep muscle growth steady. Because of this balance, we’re able to go through a normal cycle of stressing out muscles (even injuring them) and then having our bodies heal them.

In patients with sarcopenia, the cycle gets out of balance and becomes resistant to our normal muscle growth signals. When this happens, the repair portion of the cycle does not take place as efficiently and our muscles lose strength.

There are specific causes of muscle weakness that also help contribute to sarcopenia and caregivers can help elderly patients avoid them in order to stay healthier longer.

Sedentary behavior

The first cause of muscle loss is immobility. When we do not use our muscles or suddenly use them less than normal, they can break down faster than our bodies can repair them. This can bring on sarcopenia at a more rapid rate and lead to further mobility issues and a decreased quality of life overall.

Poor nutrition

Bad diet habits are another reason our bodies lose muscle, and good nutrition is a key component of building strong muscles. It’s crucial for elderly patients to get enough calories and 20-30 grams of high-quality protein for each meal to slow the rate of muscle loss. Omega-3 and creatine supplements can be beneficial as well.

Chronic inflammation

Avoiding inflammation is another way of slowing down muscle loss. Blood tests have revealed C-reactive protein, which is an indicator of inflammation, is very common in those with sarcopenia. Inflammation can be caused by many factors, but among them are chronic diseases such as chronic obstructive pulmonary disease (COPD), rheumatoid arthritis, and inflammatory bowel diseases.

Severe stress

Severe stress is also related to muscle loss. And while we all feel stress, it’s the physical stress on the body caused by serious injury or diseases like cancer or chronic liver disease that can interfere with the delicate balance that sustains muscle growth and repair.

After periods of bad diet, illness, or sedentary behavior, we may all feel muscle weakness and fatigue, but there are more specific signs to watch out for if you suspect a patient has sarcopenia. 

Symptoms of muscle weakness 

Sometimes it’s hard to know if a patient is experiencing muscle weakness, but there are some signs and symptoms that you can look for if you suspect the onset of sarcopenia.

This include:

–          Difficulty lifting things

–          Difficulty climbing stairs or getting up from a seated position

–          General body weakness

–          Unexplained weight loss (in other words, weight loss that happens without dieting)

–          Walking slowly

–          Tiring quickly

–          Becoming less interested in activities

–          Falling

–          Self-reported muscle pain or weakness

The symptoms of sarcopenia aren’t pleasant for anyone. Luckily, there are ways to improve a patient’s strength and help them regain some muscle mass.

How to reverse sarcopenia? 

Right now, proper nutrition and exercise are the only recommended strategies to prevent or slow the progression of sarcopenia. This is why family, friends, and caregivers need to encourage a healthy lifestyle involving a proper diet and daily activity, when possible. There are no recommended drug treatments.

Exercising and keeping muscles active 

As is the case for a person of any age, resistance training and weight lifting tend to build the most muscle. Fitness training and cardiovascular activity are also the keys to maintaining health and could ward off sarcopenia. However, for those who are already experiencing muscle weakness or loss, walking might be the most reasonable activity to partake in. It comes with a host of other health benefits as well.   

Eating foods that build muscles

Protein is the most important source of nutrition when it comes to muscle. It also helps increase energy, which might make exercise easier. Generally, doctors recommend 1 to 1.5 grams of protein per 1 kilogram of body weight.

It’s also important that patients get Vitamin D in their diet since those with sarcopenia tend to be Vitamin D deficient. The connection isn’t entirely clear, so there’s no recommended dosage. But supplements seem to be beneficial.

Creatine is a protein made in the liver, and while your body tends to produce enough, it’s also possible to get it from supplements or meat products to potentially boost muscle growth. Patients who take it tend to get more benefits from their resistance training, it is not effective if used without exercise.

How a CDPAP caregiver can help patients with muscle weakness 

Elderly patients who are already exhibiting signs of muscle loss or weakness may require help from a caregiver to reduce their symptoms or try to reverse the disease. Even a patient who is still strong and healthy can benefit from preventative measures.

Talk to a doctor

CDPAP caregivers can assist patients by helping them talk to their doctor about their specific symptoms. Caregivers may notice symptoms that patients themselves do not, such as slower walking.

Encourage activity

Part of a caregiver’s job is often assisting with mobility challenges, but they can also serve as cheerleaders (or just reminders) for patients who do not get enough activity. It’s important that a patient see a doctor before engaging in more strenuous exercise.

It may be important to remind patients that (doctor-approved) exercise may be hard at first but will eventually become easier and lead to less pain and muscle wasting in the long run. In addition, continuing a sedentary lifestyle can lead to more muscle weakness and disability. In fact, the risk of disability is 1.5 to 4.6 times higher in older adults with sarcopenia

than in those without the condition.

Abide by meal plans

The foods and supplements that help build muscle need to be incorporated into a patient’s meal plan. This works best, of course, when it’s done in tandem with a physician-approved exercise program.  

Sarcopenia awareness

While it’s a common condition, not many people are aware of sarcopenia. The problem with that is that a lack of awareness means people can’t take steps to prevent it. And while muscle weakness is a normal part of getting older, it does not have to change a patient’s life significantly.

In 2016 sarcopenia was officially recognized as a condition by the Centers for Disease Control, which allows healthcare providers to diagnose it and submit medical claims in order to treat it. Researchers hope that this will also help raise awareness so that treatments can be found to help slow, reverse, and prevent sarcopenia.

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