By Geetanjali Kale, MD
I have a lot of patients bring up concerns in terms of fatigue, weakness, loss of balance, slowing of movement, loss of muscle mass, increased risk of falls.
Fragility is a nonspecific condition mainly characterized by decreased functional reserves, and increased vulnerability. Sarcopenia is characterized by loss of skeletal muscle mass characterized by progressive and generalized loss of muscle function, mass, or quantity and poor physical performance.
Prevalence: can be 5-13% in 60-70 years old and increases up to 50% in people when patients are 80 or older.
Sarcopenic obesity is when lean body mass is lost while fat mass may be preserved or increased.
Causes of sarcopenia involve chronic undernutrition, chronic medical conditions, chronic inflammatory conditions, sedentary lifestyle, immobility, poor lifestyle choices, neurodegenerative diseases. When patients suffer from obesity and metabolic syndrome, along with sarcopenia, they often get prescribed GLP-1 agonist agents to help their metabolic syndrome and overall weight.
It is important to remember to address underlying sarcopenia in those circumstances. Sarcopenia can be diagnosed with Body densitometry or IBA testing, however it is not routinely performed clinically, since recent commercial machines can be unreliable. So, testing depends on clinical exam, Chair test, hand grip test, gait testing etc.
Treatment of sarcopenia in general and along with co-existing obesity, hinges on adequate protein intake. Average sedentary adult should have 0.8 mg/kg protein a day but in sarcopenia your doctor may want you to increase your protein intake, based on underlying conditions. It is important to have replete vitamin D, to help with muscle mass. Antioxidants such as colorful fruits and vegetables also help with muscle maintenance. It is very important to hydrate and focus on exercising muscles safely and as tolerated by individual ability.
It is important to consider that sarcopenia and obesity can co-exist and while overall weight is reflected on the scale and helped by multitudes of recently available medications including, GLP-1 agonists, we also need to take care of our overall muscle mass.