Ageing comes with a slew of geriatric problems, one of the most common being unintentional weight loss. While this could be due to various factors — among them undiagnosed diabetes, an underlying malignancy and malnutrition — one overlooked cause is sarcopenia or age-related loss of muscle mass.
An 84-year-old doctor from Bengaluru recently consulted a geriatrician after noticing that his clothes had started to appear baggier over a period of a few months.
“The weight loss was very gradual — it happened over six to eight months. Being a doctor, he became concerned about his weight loss,” says Dr Anoop Amarnath, consultant, geriatric medicine, Manipal Hospitals, Bengaluru, who treated the man.
“Whenever weight loss occurs in the elderly, there is a standard set of investigations that we do. All these specific investigations were run and most of those tests came back normal — there was no malignancy.”
The octogenarian was diagnosed with sarcopenia, which Dr Amarnath says is very common among older adults.
“If an older adult is experiencing weight loss and loss of muscle mass, it would be good to investigate sarcopenia as one of the causes,” he says.
Speaking on the ‘Importance of proteins in healthy ageing’ at the recent ‘The Edge of Nutrition’ summit organized by Happiest Health, Dr Nandan Joshi, head of medical affairs, nutrition, India & Emerging Markets, Dr Reddy’s Laboratories, said that the human body’s muscle mass decreases by 3% to 8% per decade after the age of 30 and this rate of decline is higher after one crosses the age of 60.
Dr Joshi pointed out that the loss of muscle mass in older people can affect their mobility and increase the risk of falls, lead to breathing problems, increased risk of insulin resistance, reduced life expectancy, cardiovascular issues and prolonged hospitalisation.
What is sarcopenia?
Dr Amarnath says sarcopenia is a reduction in muscle mass as a person ages.
“There is a correlation between protein intake and sarcopenia,” he says. “So, it is important that as we age there is an adequate amount of protein intake to prevent sarcopenia from happening.”
Importance of proteins in healthy ageing
In 2014, an expert group of the European Society for Clinical Nutrition and Metabolism (ESPEN) recommended increasing the protein intake in the elderly population compared to younger adults, coupled with routine exercises and physical activity.
Dr Amarnath says that rather than sticking to a standard recommended dietary allowance (RDA) for protein intake, one should look at an older adult’s overall energy expenditure.
“If it is an elderly person who is quite active, going for daily walks, not skipping daily exercises, etc, their protein requirement would be on the higher side,” he says. “If it is a very elderly person, a category of people we refer to as the ‘old elderly’ — someone in their 80s, someone who is confined to their house or their bed — their intake could be slightly lower. The recommended intake depends on their overall energy expenditure and physical activity.”
Another speaker at ‘The Edge of Nutrition’ summit, Dr Anura Kurpad, professor of physiology, St John’s National Academy of Health Sciences, Bengaluru, said, “Make sure that the food that the elderly eat is more of the nature of legumes, milk, eggs, meat — foods that contain over 20% or more protein. If you look at cereals, they contain 7% protein, so they’re not good for the elderly. You’ve got to mix and match.”
Treatment of sarcopenia
Dr Amarnath says sarcopenia can be controlled to a large extent. “It is not only nutrition that plays a role here though,” he says. “Exercise also matters in muscle mass. This is why a combination of both a good diet and exercise is important — this combined strategy would work best in addressing sarcopenia.”
He also recommends combining dietary modifications with resistance exercises using dumbbells to help delay the progression of sarcopenia and loss of muscle mass and strength in older adults.
Dr Joshi said one should also start being mindful about their protein intake by logging activities in a food diary. “Write down everything you eat and circle the items with protein,” he said.
Takeaways
Sarcopenia, or age-related loss of muscle mass, is a common yet often overlooked cause of weight loss in older people. It can be controlled through dietary modifications and physical activity or exercise that help build muscle mass.
