What Is Sarcopenia?

Sarcopenia is a progressive, age-related loss of muscle mass, strength, and motor function. This muscle disorder affects balance and mobility, leading to falls and impacting your ability to live independently. Sarcopenia typically occurs in people over age 65 and is seen in 33% of people living in nursing homes. Certain lifestyle changes can help you manage this issue.

This article provides an overview of this condition, including the causes, diagnosis, treatment, and what it's like to live with sarcopenia.

What Are the Symptoms of Sarcopenia?

Since sarcopenia affects your muscles and motor neurons (nerve cells associated with strength and mobility), it primarily impacts your ability to move. This condition is progressive, advancing gradually and worsening over time. Common signs include:

• Loss of muscle mass
• Fatigue
• Weakness
• Loss of motor coordination
• Difficulty maintaining balance
• Loss of walking and standing ability
• Reduced fertility

What Causes Sarcopenia?

Sarcopenia is a natural process. As you age, the muscles in your body lose mass and function and can waste away (atrophy). This process starts in your 30s and becomes progressively worse over time. It is especially prominent among people age 60 and older.

The condition arises due to an imbalance between the body’s natural production and the breakdown of muscle cells. Along with aging, this condition is linked to several factors, including:

• Insufficient exercise: Research has shown that leading a sedentary lifestyle can cause sarcopenia and accelerate its development. It’s considered a primary modifiable factor of this condition.
• Insufficient nutrition: Malnutrition (not getting enough necessary nutrients) can contribute to sarcopenia. Studies have found strong links between sarcopenia and inadequate protein and vitamin D intake, with some evidence indicating low levels of vitamins C and B12 may contribute to disease development.
• Insufficient testosterone: As you age, your production of certain hormones diminishes, including testosterone (considered the male sex hormone since it is the major sex hormone in people assigned male at birth). Studies have found that lower levels of testosterone are associated with reduced muscle mass and the development of sarcopenia.
• Chronic inflammation: Chronic inflammation (the immune system’s response to infection or damage) is associated with sarcopenia. Inflammation can arise from certain health conditions or as a natural result of aging, leading to weakened or lost muscle mass. 

How Is Sarcopenia Diagnosed?

There is no singular test to detect sarcopenia, so diagnosis involves measuring muscle mass, strength, and your ability to perform physical activities. Healthcare providers use various imaging techniques to measure muscle mass and assess the scope of your sarcopenia, including:

• Dual-energy X-ray absorptiometry (DEXA): This type of X-ray imaging serves as the gold standard for diagnosis. DEXA measures fat content, muscle and bone density, and muscle mass.  
• Bioelectrical impedance assessment (BIA): BIA relies on low-level electrical signals to analyze body composition and measure muscle mass.
• Computed tomography (CT) scan: In some cases, a healthcare provider may opt for a CT scan (a specialized X-ray that can produce accurate two- or three-dimensional images of the inside of the body) to observe muscles and assess the scope of sarcopenia.
• Magnetic resonance imaging (MRI): MRI relies on magnetic and radio waves to develop accurate images of structures in the body. A healthcare provider uses it to analyze muscle structure and mass in diagnosis.

In addition, a healthcare provider may ask you to perform specific strength tests to assist them in making a diagnosis, such as:

• Handgrip strength: In this test of hand and forearm strength, you’ll be asked to squeeze a special device called a dynamometer while seated during a series of tests on each arm.
• Lower limb strength: Dynamometer devices can help providers assess your leg strength. A provider may consider this if you have arthritis or excessive weakness.
• Repeated chair stands test: During this test, you’re timed as you stand up and sit back down five times in a row. This is another means of assessing your lower limb strength.

Lastly, various tests help providers assess how much sarcopenia has affected your motor function and physical coordination. These include:

• Gait speed assessment: During this test to measure balance and walking abilities, you’ll be timed as you walk approximately 12 feet on a flat floor.
• Short physical performance battery: This battery (set) of tests assesses gait speed, balance, and your ability to stand up and sit down (results of a repeated chair stands test).  
• Timed up and go test: From a seated position, you’ll be asked to stand up, walk approximately 10 feet, turn around, return, and sit back down.  
• Walk tests: These are tests of walking ability. The distance you can cover in six minutes may be measured or timed as you walk approximately 0.2 miles.
• Stair climb power test: In this assessment of lower limb strength, you’ll be timed as you walk up 10 stairs with the help of a handrail.  

How Is Sarcopenia Treated?

Sarcopenia is the natural result of aging and can’t be reversed. However, it is possible to slow the progression of this condition under medical guidance. Currently, there are no approved medications for sarcopenia, so treatment strategies typically involve periodic medical assessments and lifestyle strategies.

The primary approach to treating sarcopenia is focused on promoting fitness and physical activity. Resistance training, using bands or weights to build muscle strength, is considered a first-line treatment. Healthcare providers recommend two weekly sessions focusing on upper and lower body strength.  

In addition, a healthcare provider may recommend dietary changes as part of treatment. Since malnutrition can spur sarcopenia, monitoring your diet and ensuring you’re getting enough to eat is essential. Some evidence suggests that specific vitamins and minerals can help, including:

• Vitamin D
• Vitamin C
• Vitamin B12
• Selenium
• Magnesium

Some studies have found that increasing dietary protein above the recommended amount can help manage sarcopenia. This may mean increasing meat consumption, consuming more dairy, or using supplemental protein powders.   

Coping With Sarcopenia

Living with sarcopenia can significantly impact your quality of life, making daily functions more challenging. The raised risk of falls and related disabilities is particularly concerning among people with sarcopenia. Along with making lifestyle adjustments to manage this condition, changing your home environment to make it safer can help prevent the worst. Tips for fall-proofing include:

• Ensure you have handrails installed on all stairways.
• Make sure your home is well-lit.
• Keep your home orderly, tidy, and free of trip hazards.
• Don’t use area rugs; ensure carpets are well-affixed to the floor.
• Install grab bars near the toilet and shower.
• Keep kitchen implements, pots, pans, and utensils in easy-to-reach areas.

Summary

Sarcopenia is an age-related loss of muscle mass, strength, and function. Lifestyle factors spur its progress, including malnutrition, insufficient physical activity, low testosterone levels, and chronic inflammation. Medical testing can help a healthcare provider detect the condition. Lifestyle changes and supplements are recommended to help slow the progression of this disorder.