clinical focus
Are there simple things people can do to prevent it ? There are no drugs or pharmaceutical agents available to prevent muscle loss , so the three approaches we typically recommend are , firstly , trying to reduce the amount of sedentary or sitting time .
The most effective approach to prevent muscle loss and build your muscle mass and strength is undertaking resistance training , which involves typically lifting weights , but it can involve body weight resistance-type exercises .
The unique capacity of muscle is it has this remarkable regenerative capacity . It can adapt really quickly to various stimuli . And so you could undertake resistance training and actually increase your muscle mass as you get older . That ’ s by far the most effective strategy .
The third approach is really trying to ensure that your diet is well balanced and particularly contains an adequate amount of protein . It ’ s really this combination of exercise with an appropriate diet that will deliver the best benefit to try to reduce or prevent muscle loss .
Since we moved less and sat more due to COVID lockdowns , are you concerned this might become a growing issue ? Absolutely . We know that we are living longer , but unfortunately we are living longer with chronic disease . And I think the average Australian will live their last 17 to 19 years with some disability or chronic illness .
We know there is data coming out now showing that some people have been more physically active in terms of walking during COVID , but they ’ re spending much greater time sitting or being sedentary , and we know that ’ s probably one of the key factors which is contributing to muscle loss .
Unfortunately , walking is great for cardiovascular health but it ’ s actually not that great for stimulating muscle growth . So with some targeted muscle strengthening exercises you ’ ll see rapid improvements in your strength and potentially your mass over a very short period if you can start to incorporate these into your daily life .
How can aged care practitioners , providers or nurses make sure they know how to spot this ? We ’ re really trying to work on raising awareness around sarcopenia and how it can be screened , diagnosed or treated . There are some very simple tests that you can undertake to assess someone ’ s muscle strength and / or function . Muscle mass is a little bit more challenging to assess . But a simple test that we often recommend is where you literally ask someone to sit in a chair , stand up and sit down five times as quickly as they can . And if people struggle to do that within 15 seconds , it would be indicative of having impaired muscle strength , for example .
We have other tools like a hand grip strength dynamometer , which you can purchase . Again , it gives you a very simple estimate of grip strength , which is a good global indicator of a person ’ s muscle strength as well . You can also just observe someone walking and how they get in and out of a chair , or if they ’ re struggling to walk up a flight of stairs – that ’ s probably an indication that they ’ ve got muscle impairment and could need treatment .
What are some of the biggest challenges that someone might face when seeking treatment ? I think one of the biggest challenges we ’ ve got is clearly exercise is by far the most effective approach to prevent sarcopenia and muscle loss . But the problem is people don ’ t do it . And so we try to identify strategies to encourage people to do exercise , but more importantly , to do exercises which are going to target their muscle mass , strength and function , which is essentially resistance training or functional type movement exercises with some resistance element to it .
I think we need to really reshape our thinking , particularly for older people , and encourage them to undertake some muscle strengthening activities . The current recommendations are around twice per week , which gives you a 30-minute session of muscle strengthening type activities where you will see some benefits . And so that ’ s probably going to be the best approach that we can offer .
But I think we need to look into behavioural strategies of how we can encourage people to undertake these
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We need to change the mindset that resistance training is just for younger people .
types of activities . And we need to think a little bit laterally because some people might not want to do a structured resistance training program in a gym , but you can do resistance or muscle strengthening activities in your home by yourself , using body weight or bands or even milk containers that are available to overload the muscles .
We need to change the mindset that resistance training is just for younger people , and in fact , older people will get the greatest benefits probably from undertaking resistance training and they ’ ll get them very quickly if they can adhere to a program .
What are some of the improvements that we have seen in recent years in terms of identifying and treating sarcopenia ? I think the greatest improvements are around the different tools that are available to assess sarcopenia and some of the simple tools that are available . The challenge we ’ ve got at the moment is there is no clinical consensus on what the different definitions and cut points are for the different tests , which has created some challenges globally and hindered perhaps the uptake of sarcopenia in the clinical setting . Having said that , there ’ s now a wealth of data for different tests where we ’ ve got cut points which we know are clinically relevant . As a result , we can use those cut points to determine whether someone is either pre-sarcopenia or might have sarcopenia . I think it ’ s now up to us having greater awareness amongst the clinicians and allied healthcare professionals that muscle should be part of routine screening . At the age of 50 or 60 , we should be undertaking some muscle assessment to see where someone sits in terms of their muscle functional capacity .
And then clearly , we know that exercise works , and we know that nutrition with exercise is important to help prevent muscle loss . We just need to be able to implement this into the real world . We need everyone to come on board , all the healthcare professionals and clinicians , to have a collective approach where we are recommending this as standard care for older people in particular . ■
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