‘Sarcopenia’ threatens the health of 100-year-olds… Professional exercise therapy and nutritional management are required

[이데일리 이순용 기자] Sarcopenia is one of the diseases receiving attention as the aging society accelerates. Sarcopenia is literally a decrease in muscle mass. As you get older, body changes occur in which body fat increases and muscle mass decreases without realizing it. The main causes are degenerative changes in the musculoskeletal system, changes in the nervous system and hormones, reduced activity, imbalance in nutritional status, and persistent chronic diseases. It is common enough to have sarcopenia in more than 50% of those over 80 years of age, and caution is required because there is a risk of lowering the quality of life due to falls, osteoporosis, and dysfunction. Let’s learn more about the diagnosis and prevention of sarcopenia with Professor Seungdon Yoo, Department of Rehabilitation Medicine, Kyunghee University Hospital, Gangdong.

◇ Diagnosed with decreased gait speed and grip strength

Low muscle mass does not make a diagnosis of sarcopenia. In patients with reduced muscle mass due to BIA (InBody, etc.), the diagnosis of sarcopenia is when the walking speed falls to 1.0 m/s from a 6-meter walking in 2019 Asian standards and the hand grip strength decreases to less than 28 kg for men and 18 kg for women. do. However, it is difficult for ordinary people to recognize sarcopenia because it is not easy to accurately measure hand grip strength, walking speed, and muscle mass.

Professor Yoo Seung-don said, “Recently, it is necessary to first classify the calf circumference or sarcopenia self-diagnosis questionnaire (SARC-F), and try to get up from a chair 5 times (more than 12 seconds) with hand grip strength and then accurately diagnose sarcopenia in hospitals. It is recommended,” he explained.

◇ When calves are reduced, weight loss, depression, or falls occur, a professional diagnosis is required.

Sarcopenia usually occurs due to aging or diseases such as stroke, osteoporosis, and dementia. In the case of aging, more attention is required because the patient cannot recognize it and it worsens. In the elderly with chronic diseases such as heart failure, chronic lung disease, diabetes, and kidney disease, physical function declines, weight loss, depression, poor concentration, or frequent falls should be suspected. In particular, if the calf circumference is less than 34 cm for men and less than 33 cm for women, and if there is an abnormality in the sarcopenia self-diagnosis questionnaire (SARC-F), it is recommended to undergo a sarcopenia evaluation at a hospital.

◇ Sarcopenia increases the risk of falls, malnutrition, and depression

The reason senile sarcopenia is dangerous is that sarcopenia does not simply mean a decrease in muscle mass. This is because it can be an important factor in the development of disease. In fact, the relationship between skeletal muscle mass and muscle strength and the occurrence of physical disability is continuous, and as the skeletal muscle mass and muscle strength are low, the occurrence of disability may increase, and as a result, the risk of death may increase. Professor Yoo Seung-don explained, “We should think of sarcopenia itself as a disease concept that can prevent various diseases, rather than simply accepting it as aging.”

◇ “Rehabilitation for resistance muscle improvement, etc.” Treatment and prevention must be combined with professional exercise therapy and nutritional management

As for physical activity, resistance strength improvement and rehabilitation training are known to increase muscle mass. It is good to train the thigh muscles, calf muscles, back muscles, and abdominal muscles mainly with large muscles. However, since incorrect exercise has a side effect of reducing the amount of activity by causing musculoskeletal disease or pain, it is recommended that the elderly or musculoskeletal disorders increase muscle mass through appropriate exercise prescription.

Nutrition is also an important factor, but the effectiveness of nutritional management without exercise is unclear. Protein intake, vitamin D, unsaturated fatty acids, and antioxidant nutritional supplements are helpful. To prevent sarcopenia, nutritional status, exercise amount, and activity amount should be optimized for muscle building. Protein needs sufficient protein intake, such as black beans, meat, fish, tofu, and eggs. For general adults, it is recommended to consume 0.9 g of protein per 1 kg of body weight per day.

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