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Sarcopenia is … [5 of these apply] … a component of the frailty syndrome, an Eastern Europe nation, a disease associated with the aging process, most prevalent in Europe, an undiagnosed condition in older adults, a member of the EU, a noun.  

At some point in your 30’s, you begin to lose muscle mass and function. Even if you are active, you will still experience some muscle loss. Physically inactive people can lose as much as 3% to 5% of their muscle mass per decade after age 30. It’s called age-related sarcopenia or sarcopenia with aging.  

Sarcopenia is associated with the aging process. Loss of muscle mass and strength affects balance, gait and overall ability to perform tasks of daily living. Is sarcopenia a disease, or is it a process? Are there potentially alterable physiological or genetically programmed events?  

Although there is no generally accepted test or specific level of muscle mass for a diagnosis of sarcopenia, any loss of muscle mass has consequences because it means loss of strength and mobility. Sarcopenia typically accelerates around age 75 although it can happen to people aged 65 or 80. In older adults, it is a factor in the occurrence of frailty and the likelihood of falls and fractures. 

As one ages, hormone levels change, protein requirements alter, motor neurons die, and we tend to become more sedentary. Most commonly seen in inactive people, it also affects those who remain physically active throughout their lives, indicating that a sedentary lifestyle is not the only sarcopenia factor in the disease.  

The primary treatment is exercise, specifically resistance training or strength training. Exercise with weights or resistance bands that increases muscle strength and endurance has been shown to be useful for both the prevention and treatment of sarcopenia. Resistance training has been reported to influence positively the neuromuscular system, hormone concentrations, and protein synthesis rate. A program of progressive resistance training exercises can increase protein synthesis rates in older adults in as little as two weeks.  

Even individuals who maintain their fitness through exercise do not appear to be immune to sarcopenia. Scientists have long believed muscle loss and others signs associated with aging are an inevitable process. Researchers are looking for ways in which the aging process can be slowed, specifically in relation to loss of muscle mass and strength. 

When sarcopenia is coupled with other diseases associated with aging, its affects can be more pronounced. Frailty is a common geriatric syndrome that has been recognized for centuries.  

When patients suffer from both sarcopenia and osteoporosis, the risk of falling and subsequent fracture incidence is higher. How are falls and osteoporosis linked? One out of 5 falls among older adults causes serious injury such as a broken bone. Vitamin D deficiency is a risk factor for both falls and broken bones. Regular physical activity and exercises that combine weight, muscle strengthening and balance help reduce the risk of falls and actually improve the health of bones.  

Sarcopenia involves two factors: the initial amount of muscle mass and the rate at which it declines with age. The rate of muscle loss with age appears to be fairly consistent, approximately 1%–2% per year past the age of 50 years. 

Sarcopenia is a component of the frailty syndrome. And it is often a component of cachexia, or wasting syndrome—weight loss, muscle atrophy, fatigue, weakness, and significant loss of appetite in someone who is not actively trying to lose weight. Although physical activity and exercise status are important factors in the onset of obesity with age, the decline in muscle mass and gain in body fat are evident even in active older adults If it is an inevitable process occurring over time, at what point does a person lose enough muscle mass to cross a threshold for disability (disease)? With advancing age, there are significant changes in body composition. Body fat increases while modest losses are observed in muscle mass. The average adult can expect to gain approximately one pound of fat every year between ages 30 to 60, and lose about a half pound of muscle over that same time span; that change in body composition is equivalent to a 15-pound loss of muscle and a 30-pound gain in fat.  

Two basic strategies for optimizing muscle mass are (1) exercise and (2) nutrition programs.

Sit and Be Fit is a great example of relevant exercise programs. It has been around since 1987. Mary Ann Wilson is an American registered nurse in the field of geriatrics and post-polio rehabilitation. She is also the founder and host of this award-winning exercise show, broadcast in Canada and on PBS television stations across the United States, including the Bay Area’s KCSM Channel 60. 

Wilson includes a variety of exercises for the elderly and people with limited mobility. The program revolves around exercises that can be done with little effort while sitting in or using a chair, although some of her movements are standing up. The half hour exercise program is designed for older adults and those needing slow gentle movement. Sit and Be Fit is recognized by the National Council on Aging (NCOA) as a Best Practices program in health promotion and aging.  

Whatever they are called, exercise classes (or groups) should be available without charge at least once a week to all senior citizens in senior centers and senior housing. It may be necessary to rely on volunteer instructors who have related training and or experience. A weekly routine of yoga and meditation may strengthen thinking skills and help to stave off aging-related mental decline, according to a study of older adults with early signs of memory problems. 

Berkeley’s two senior centers list in The Nugget, their monthly program: gentle stretch, acupressure for arthritis relief, qi-gong, iyengar yoga, gentle yoga, Feldenkrais 1x1, t’ai chi chih, holistic fitness/yoga, yuan ji dance/t’ai chi, chair exercise, and mindfulness meditation. Not all are free, however. Tenants at at least one of Berkeley’s senior/disabled housing projects -- Lawrence Moore Manor – enjoy a volunteer-led exercise class strong on yoga and meditation.  

Combining physical activity with meditation may intensify the benefits of both yoga and meditation. "Yoga May Be Good for the Brain" writes Gretchen Reynolds in the New York Times. People with depression who meditated before they went for a run showed greater improvements in their mood than people who did either of those activities alone!  

Some weakening in mental function appears to be inevitable as we age. After age 40, and your mind and especially your memories begin to fade.  

Emerging science suggests that it might be possible to slow and mitigate the decline by how we live and, in particular, whether and how we move our bodies. Studies have found that people who run, weight train, dance, practice tai chi, or regularly garden (I have never quite understood the garden one, however) have a lower risk of developing dementia than people who are not physically active at all. 

But many people do not have the physical capacity or taste for running or other similarly vigorous activities. 

Researchers at UCLA and some other institutions tested whether yoga -- a relatively mild, meditative activity -- could alter people’s brains and fortify their ability to think.  

They began by recruiting 29 middle-aged and older adults who were anxious about the state of their memories and who were found to have mild cognitive impairment, a mental condition that can be a precursor to eventual dementia. 

The volunteers also underwent a brain scan that tracks how different parts of the brain communicate with one another. They were then divided into two groups. One began an established brain-training program that involves a weekly hour of classroom time and a series of mental exercises designed to bolster memory; volunteers were asked to practice at home for about 15 minute a day. 

For an hour each week, they visited campus to learn Kundalini yoga, which involves breathing exercises and meditation as well as movement and poses. People who are out of shape or new to yoga usually find these classes easy.  

The yoga group also was taught a type of meditation known as Kirtan Kriya, which involves repeating a series of sounds — a mantra — while simultaneously “dancing” with repetitive hand movements. They were asked to meditate in this way for 15 minutes daily. 

The total time commitment was equivalent for both groups. The volunteers practiced their programs for 12 weeks. Then they returned to the university’s lab for another round of cognitive tests and a second brain scan. By then, all were able to perform significantly better on most tests of their thinking. 

But only those who had practiced yoga plus meditation showed improvements in their moods — they scored lower on an assessment of potential depression than those in the brain-training group — and they performed much better on a test of visuospatial memory, important for balance, depth perception and ability to recognize objects and navigate the world. 

Yoga plus meditation had equaled and then topped the benefits of 12 weeks of brain training. The Alzheimer’s Research and Prevention Foundation, which partially funded this study, provides information on its website about how to start meditating in this style. 

Several nutrients, including creatine, vitamin D and whey protein, have shown promise in combating sarcopenia.

The muscle atrophy commonly seen in older adults comes mainly from a loss of muscle fibers that are recruited during such high-intensity movements as weight lifting and sprinting. These are the fibers most profoundly affected by the dietary supplement creatine. Studies have found that when creatine is given to older adults who are participating in resistance exercise training, it helps to increase strength and lean body mass. 

Vitamin D helps support both muscle and bone tissue. Low vitamin D levels seen in older adults may be associated with poor bone formation and muscle function. Thus, ensuring adequate vitamin D intake may help reduce the incidence of both osteoporosis and sarcopenia in aging people. Daily vitamin D and calcium supplements are associated with reduced falls and fewer broken bones in older adults. Just how much vitamin D is right for you should be determined by your physician with you.  

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Tai chi (TIE-CHEE, also called tai chi chuan) helps reduce stress and anxiety while also helping to increase flexibility and balance.

Originally developed for self-defense, it has evolved into a graceful form of exercise now used for a variety of health conditions. Often described as meditation in motion, tai chi promotes serenity through gentle, flowing movements. 

It involves a series of movements performed in a slow, focused manner and accompanied by deep breathing. Moreover, it is a noncompetitive, self-paced system of gentle physical exercise and stretching. Each posture flows into the next without pause, ensuring that your body is in constant motion. 

Tai chi differs from yoga, another type of meditative movement. Yoga includes various physical postures and breathing techniques, together with meditation. It appeals because it is inexpensive and requires no special equipment. It can be done anywhere, indoors or outside, alone or in a group class. Although tai chi is generally safe, women who are pregnant or people with joint problems, back pain, fractures, severe osteoporosis or a hernia should consult their health care provider before trying tai chi. Modification or avoidance of certain postures may be recommended.