As early as the age of 30, people start to lose muscle mass and strength at a gradual pace. For some, this happens at a much steeper rate – a condition known as sarcopenia, which is, unfortunately, more common among older adults.

Humans naturally lose muscle as they get older, making it harder to do such things as lifting heavy objects or walking long distances. Sarcopenia, literally meaning “lack of flesh”, is a disease that weakens the skeletal muscles over time, leading to muscle loss that, in turn, can cause problems such as frailty, absentmindedness, and even death.

Those with sarcopenia experience a more significant onset of muscle weakness and shrinkage, slow walking speeds, greater risk of falling, and difficulty performing daily activities.

A recent study shows that one in 20 adults in Malaysia (5%) aged 60 and above has sarcopenia, with 3.6% experiencing it severely. More concerning is that older people with sarcopenia are 80% more likely to have cognitive impairment than those without; and, accordingly, those with severe sarcopenia are at a much higher risk of having trouble thinking and remembering.

While advancing age is a risk factor, studies have shown that other factors may contribute to the onset of sarcopenia as well. These include:

• inadequate caloric and protein intake;
• immobility and muscle disuse, which leads to accelerated muscle loss and increasing weakness. This could arise from prolonged bed rest or immobilisation after injury or illness;
• chronic inflammatory conditions such as rheumatoid arthritis, inflammatory bowel disease, and chronic obstructive bowel disease. Inflammation disrupts the normal balance of muscle breakdown and growth, resulting in net muscle loss;
• other conditions such as obesity, smoking, diabetes, and non-communicable diseases such as chronic kidney or liver disease.

Although the link between sarcopenia and cognitive impairment is not yet fully understood, studies are ongoing to better understand the connection.

What is known is that as humans age, the body goes through many changes that can lead to muscle weakness and cognitive decline. These include loss of neurons, and changes in the brain and the way muscles work.

Sarcopenia is preventable through regular exercise, and even reversible through resistance training. The World Health Organization recommends 150 minutes per week of moderate physical activity such as brisk walking, or 75 minutes a week of vigorous exercise such as jogging.

Resistance workouts include the use of a resistance band, weights, or exercises that use your own body weight such as squats, planks, or push-ups. These should be done twice weekly in 48-hour intervals, repeated six to 12 times in up to three sets with increasing weight load.

Diet also plays a big part in keeping sarcopenia at bay. Protein intake is required to stimulate muscle growth, but muscles become more reistant to these signals over time.

This means, as people age, they need to consume a higher amount of protein – at least 1g per kg of body weight is recommended. In addition, vitamin D has been found to protect against sarcopenia by increasing muscle strength.

As the population continues to age, it is increasingly important to create awareness of this disease and how it impacts older Malaysians. By promoting “gaya hidup sihat” such as exercise and good nutrition, we can work towards preventing sarcopenia and ensuring older people continue to enjoy a high quality of life.

This article was written by Dr Karthikeyanathan Ramoo and Professor Dr Noran Naqiah Hairi of the Public Health Department at Universiti Malaya.