What is it called when you lose muscle when you get older? An overview of sarcopenia

Experts estimate that beginning around age 30, a person can lose 3–5% of their muscle mass per decade. The medical term for this progressive age-related loss of skeletal muscle mass and strength is sarcopenia.

Quick Summary

An overview of sarcopenia, the medical term for the age-related loss of muscle mass and strength. It covers the symptoms, causes, diagnosis, and management options.

Key Points

• Sarcopenia is Age-Related Muscle Loss: The medical term for the progressive, age-associated loss of skeletal muscle mass and strength is sarcopenia.

• Prevalence Increases with Age: While some muscle loss begins around age 30, the condition becomes more prevalent in adults aged 60 and older, with increasing rates in octogenarians.

• Causes are Multifactorial: Factors include hormonal changes, chronic inflammation, reduced nerve cells, physical inactivity, poor nutrition, and chronic diseases like diabetes and cancer.

• Symptoms Impact Daily Function: Key signs include muscle weakness, loss of stamina, slow walking speed, difficulty climbing stairs, poor balance, and an increased risk of falls.

• Resistance Exercise is Key: The most effective strategies for prevention and management are lifestyle modifications, with resistance-based training and a high-protein diet being the most important.

• Diagnosis is Comprehensive: Diagnosis requires a multi-step assessment that includes screening questionnaires, measuring muscle strength (e.g., handgrip), and assessing muscle mass and physical performance.

What is sarcopenia?

Sarcopenia is a progressive, age-related condition characterized by the loss of skeletal muscle mass and strength. The name comes from Greek words meaning 'flesh' and 'poverty'. While some muscle loss is normal with aging, sarcopenia involves a more significant decline that can lead to physical disability and reduced quality of life. It is increasingly common in older adults and has notable health and economic impacts. Sarcopenia is recognized as a specific geriatric syndrome with its own diagnostic code (ICD-10-MC code M62.84) since 2016.

Causes and risk factors of age-related muscle loss

Several factors contribute to sarcopenia:

• Aging: Natural changes include a decrease in motor neurons and shrinking of fast-twitch muscle fibers, along with reduced muscle repair capabilities.
• Hormonal Changes: Lower levels of hormones like testosterone, estrogen, and IGF-1, which support muscle maintenance, are common with age.
• Inactivity: Lack of physical activity or prolonged rest accelerates muscle loss.
• Chronic Inflammation: Low-grade, persistent inflammation in older age (inflammaging) can hinder muscle growth and increase breakdown.
• Poor Nutrition: Insufficient calorie and protein intake, particularly lack of essential amino acids, impairs the body's ability to build and repair muscle.
• Chronic Illnesses: Conditions like kidney disease, heart failure, cancer, and diabetes are linked to sarcopenia and can interfere with muscle protein synthesis.

Signs and symptoms of sarcopenia

Symptoms of sarcopenia can significantly affect daily life and include:

• Muscle weakness (difficulty lifting objects).
• Reduced stamina and easy fatigue.
• Trouble performing daily tasks like standing or climbing stairs.
• Slower walking speed.
• Increased risk of falls due to poor balance and weakness.
• Noticeable decrease in muscle size.

Distinguishing sarcopenia from other conditions

Sarcopenia should not be confused with cachexia or frailty:

Feature	Sarcopenia	Cachexia	Frailty
Primary Cause	Age-related or other factors.	Underlying chronic illness with inflammation.	Cumulative age-related decline.
Key Characteristic	Loss of muscle mass and strength.	Weight loss, inflammation, and anorexia.	Overall vulnerability and reduced resilience.
Inflammation	Low-grade chronic inflammation.	High-grade systemic inflammation.	Contributes, but not the main feature.
Associated Weight Change	Weight may be stable or increase if fat replaces muscle.	Progressive weight loss.	Unintentional weight loss is possible but not always present.

Diagnosis of sarcopenia

Diagnosing sarcopenia involves several steps, as recommended by groups like EWGSOP:

1. Screening: Initial assessment using questionnaires like the SARC-F.
2. Muscle Strength: Measuring handgrip strength or using the chair stand test.
3. Muscle Mass and Quality: Using imaging such as DXA, BIA, MRI, CT, or ultrasound.
4. Physical Performance: Evaluating gait speed or using the Short Physical Performance Battery (SPPB).

Management and prevention of sarcopenia

The progression of sarcopenia can be slowed through exercise and nutrition.

Exercise strategies

• Resistance Training: Best for building and maintaining muscle mass. Includes weights, bands, or bodyweight exercises, recommended at least twice weekly.
• Aerobic Exercise: Supports heart health and stamina.
• Balance Exercises: Improves balance and reduces fall risk.
• Progressive Overload: Gradually increasing exercise intensity is important.

Nutritional support

• Adequate Protein: Aim for 25–30 grams of protein per meal to support muscle synthesis.
• Supplements: Vitamin D, creatine, and omega-3 fatty acids may be beneficial when combined with diet and exercise.
• Sufficient Calories: Ensure enough calories to prevent unintentional weight loss.

Other interventions

While no specific FDA-approved medications exist for sarcopenia, research is ongoing. Addressing underlying health conditions is also part of a comprehensive plan.

Conclusion

Sarcopenia is the medical term for age-related muscle loss and weakness, impacting independence and quality of life. It results from aging, hormonal changes, inactivity, poor nutrition, and chronic diseases. Early recognition and proactive steps are crucial. Resistance exercise and a high-protein diet are highly effective strategies to manage and slow sarcopenia's progression. While medications are being studied, lifestyle changes begun earlier in life can significantly help preserve muscle function and promote healthier aging. For more information, visit the National Institutes of Health.(https://newsinhealth.nih.gov/2025/04/slowing-sarcopenia)

Frequently Asked Questions

At what age does sarcopenia typically begin?

While some muscle mass loss can start as early as age 30, the rate of decline and the prevalence of diagnosed sarcopenia significantly increase after the age of 60.

Can sarcopenia be prevented?

You cannot completely prevent sarcopenia as it is a natural part of aging, but you can significantly slow its progression and manage symptoms through regular exercise, especially resistance training, and proper nutrition.

What is the best exercise to prevent or manage sarcopenia?

Progressive resistance-based strength training is considered the most effective exercise for building and maintaining muscle mass and strength, which directly counteracts sarcopenia.

What foods help with sarcopenia?

A diet rich in high-quality protein is crucial for supporting muscle health. Experts recommend consuming 20 to 35 grams of protein with each meal. Ensuring adequate vitamin D and omega-3 fatty acid intake is also beneficial.

Is sarcopenia the same as cachexia?

No, while both involve muscle loss, they are distinct. Sarcopenia is primarily age-related, whereas cachexia is a metabolic wasting syndrome caused by underlying chronic illness and often involves systemic inflammation and significant fat loss.

How is sarcopenia diagnosed?

Diagnosis typically involves a multi-step process including a screening questionnaire (SARC-F), physical tests to measure muscle strength (e.g., handgrip) and performance (e.g., gait speed), and imaging (e.g., DXA) to measure muscle mass.

Are there any medications to treat sarcopenia?

Currently, no medications are approved by the FDA specifically for treating sarcopenia. Treatment focuses on exercise, nutrition, and managing any underlying health conditions.