Sarcopenia

Sarcopenia is an age-progressive syndrome involving the loss of muscle mass, muscle strength, and physical performance. It is currently recognized as a disease entity included in the international ICD-10 classification. This process involves not only a reduction in skeletal muscle volume but also a deterioration of their quality, regenerative capacity, and metabolic functions. Sarcopenia leads to the weakening of the body, increases the risk of falls, fractures, disability, and the loss of independence in old age. Modern medicine treats it as one of the most important health problems of aging societies, as it affects both longevity and quality of life. The loss of muscle tissue can develop gradually over many years and often remains unnoticed until a significant decline in physical performance occurs.

Sarcopenia – what is it?

Sarcopenia is a complex biological process associated with the loss of skeletal muscle and the weakening of its functions. The name originates from the Greek language: sarx means flesh, and penia means deficiency. The disease develops as a result of an imbalance between the synthesis and breakdown of muscle proteins.

Nowadays, a distinction is made between:

primary sarcopenia – resulting mainly from the aging process,
secondary sarcopenia – developing under the influence of chronic diseases, malnutrition, lack of physical activity, or chronic inflammation.

Muscle tissue performs far more functions than just enabling movement. Muscles are responsible for:

posture stabilization,
protection of the osteoarticular system,
glucose metabolism,
hormonal balance,
maintaining normal body temperature,
the production of myokines, i.e., substances that influence the functioning of the entire organism.

In the course of sarcopenia, there is a reduction in the number and volume of muscle fibers, especially fast-twitch fibers responsible for strength and movement dynamics. Additionally, muscles are partially replaced by adipose and fibrous tissue, which impairs their performance.

The diagnosis of sarcopenia is currently based not only on the assessment of muscle mass but primarily on the analysis of muscle strength and the patient's functional performance. Diagnostics include, among others:

body composition analysis,
DXA densitometry,
bioelectrical impedance,
handgrip strength measurement,
gait speed test.

Sarcopenia – when does it start and how does it progress?

The process of muscle mass loss begins much earlier than is commonly thought. The first metabolic and structural changes can appear as early as after the age of 30. It is estimated that after the age of 40, a person loses an average of about 0.5–1% of muscle mass annually, while after the age of 60–70, the pace of this process clearly accelerates.

The most significant factors are:

a decrease in physical activity,
a reduction in the production of anabolic hormones,
chronic inflammation,
insulin resistance,
impairment of muscle protein synthesis.

Muscle aging is multifactorial in nature. This includes, among others:

a decrease in the number of motor neurons,
deterioration of muscle innervation,
a drop in the levels of testosterone, growth hormone, and IGF-1,
mitochondrial dysfunction,
an increase in oxidative stress.

Sarcopenia develops in stages. Initially, a reduction in muscle strength appears, followed by a decrease in muscle mass, and in a more advanced stage, there is a clear limitation of physical mobility. Patients begin to have difficulties with daily activities such as:

climbing stairs,
getting up from a chair,
maintaining balance,
longer periods of walking,
carrying groceries.

This process can proceed faster in hospitalized or chronically ill individuals, or those leading a sedentary lifestyle. Long-term immobilization is particularly unfavorable, as even a few weeks of lack of movement can cause a rapid loss of muscle strength.

Sarcopenia – symptoms and consequences

Symptoms of sarcopenia develop gradually and can remain unnoticed for many years. Patients often interpret the first symptoms as “natural aging,” while they already represent signs of deteriorating muscle function.

The most common symptoms include:

muscle weakness,
faster fatigue,
deterioration of physical performance,
difficulty maintaining balance,
slowed gait,
reduced manual dexterity,
weight loss,
problems with performing daily activities.

In a more advanced form, the following may occur:

frequent falls,
postural stability disorders,
limited independence,
increased susceptibility to injuries,
osteoporotic fractures.

Sarcopenia affects not only the musculoskeletal system. Muscles play a key metabolic role; therefore, their loss increases the risk of:

Consequence	Clinical significance
Insulin resistance	higher risk of type 2 diabetes
Visceral obesity	metabolic and cardiovascular disorders
Osteoporosis	higher risk of fractures
Frailty syndrome	frailty syndrome in the elderly
Hospitalizations	prolonged recovery time
Mortality	higher risk of premature death

Particularly dangerous is the co-occurrence of sarcopenia and obesity, referred to as sarcopenic obesity. In such cases, the patient may have a normal or increased body weight despite a significant deficiency of muscle tissue. This condition often remains unrecognized for many years.

Sarcopenia – what accelerates the loss of muscle mass?

The development of sarcopenia is influenced by many environmental, metabolic, and hormonal factors. Of the greatest importance is chronic lack of physical activity, especially a lack of resistance training that stimulates muscles to grow.

The most important factors accelerating muscle loss include:

Lack of movement

A sedentary lifestyle leads to a rapid weakening of muscle protein synthesis. Even a dozen or so days of restricted activity can cause a noticeable decrease in muscle strength.

Protein deficiency

Older people often consume too little high-quality protein. Meanwhile, the aging body needs a higher supply of amino acids to maintain muscle mass.

Chronic diseases

Sarcopenia is favored by, among others:

diabetes,
cancers,
chronic heart failure,
COPD,
chronic kidney diseases,
neurological diseases,
inflammatory diseases.

Hormonal disorders

A decrease in levels of testosterone, estrogens, growth hormone, or DHEA limits the body's anabolic capacities.

Chronic inflammation

With age, levels of pro-inflammatory cytokines increase, which intensifies muscle protein degradation.

Vitamin deficiencies

Vitamin D deficiency is particularly important, affecting muscle function and neuromuscular coordination.

Oxidative stress and mitochondrial disorders

Cellular damage related to free radicals leads to a deterioration in muscle regeneration and their energy efficiency.

Sarcopenia – how to prevent it?

Prevention of sarcopenia is primarily based on maintaining muscle activity throughout life. Regular resistance training is most effective, as it stimulates muscles for protein synthesis and increases their strength.

The most important elements of prevention include:

Regular physical activity

The most recommended are:

strength training,
resistance exercises,
functional training,
balance exercises,
aerobic activity.

Systematic effort improves:

muscle strength,
coordination,
bone density,
glucose metabolism,
body performance.

Adequate protein intake

Older people should consume a higher amount of protein than younger people. Of particular importance are:

leucine,
essential amino acids,
proteins with high biological value.

Maintaining a healthy body weight

Both malnutrition and obesity intensify the process of muscle loss.

Vitamin D supplementation

Correcting vitamin D deficiencies can improve muscle function and reduce the risk of falls.

Treatment of chronic diseases

Controlling diabetes, hormonal diseases, and inflammatory states limits the rate of muscle degradation.

Regenerative medicine and supportive therapy

In the modern approach to the prevention of aging processes, increasing importance is attributed to actions supporting the maintenance of muscle efficiency, good tissue condition, and proper microcirculation. The foundation of sarcopenia prevention consists of regular physical activity, resistance training, a well-balanced diet, and maintaining a healthy body weight. Supplementing a healthy lifestyle can be procedures supporting tissue regeneration, lymphatic drainage, and muscle activation.

At Ambasada Urody, treatments are performed to support, among others:

muscle stimulation and improvement of muscle tone – using Schwarzy® electromagnetic muscle stimulation technology,
microcirculation and tissue regeneration – through INDIBA® radiofrequency therapy,
lymphatic drainage and reduction of swelling – using pressotherapy,
improvement of tissue metabolism and tissue mobility – thanks to ICOONE® and LPG® endermologie therapies,
improvement of skin and soft tissue condition – through procedures supporting blood supply and regenerative processes.

These procedures can be an element supporting the maintenance of body fitness, movement comfort, and high tissue quality in the aging process. However, they do not replace regular physical activity and proper nutritional management, which remain the basis of sarcopenia prevention.