Sarcopenia and Frailty

By Marcia Holsinger, Physical Therapy Assistant

Stay Active, Stay Healthy

You have heard it said: "I have no energy, the older I get the more tired I become, I can't do what I used to do", and "I get so tired doing the simplest things".

Our vigor diminishes as we age from fun, to functional, to frailty, to failure.

Frailty is common among older people and is associated with an increased risk of falling, increased hospitalization, disability, and death. As one ages, the risk of becoming frail is greater.

Sarcopenia is a major contributor to frailty. It is the loss of muscle mass and strength and it is caused by being inactive. When you feel tired or exhausted, you are more likely to just sit around which causes you to lose muscle strength. When the quality and quantity of muscle decreases (sarcopenia), your cardiovascular system is affected too, and your energy reserve decreases. Hence, you feel tired three or more days a week, have a slower walking speed, have muscle weakness, and have low levels of physical activity.

Loss of leg strength begins at age 30 at the rate of 1-3% each year (-10% per decade) and the loss accelerates after the age of 50. The major predictors of nursing home placement is leg strength and gait speed.

The cause of sarcopenia is simply physical inactivity and it seems to be the most important and the easiest to modify. Physical activity will slow this decline of muscle loss and, lack of activity will increase the rate.

The best treatment for sarcopenia and frailty is to prevent them from happening. Not all older people are frail. Physical therapists can evaluate frailty risk factors in older people who are living in the community and provide a program for strengthening, balance and fall risk assessments.

Your physical therapist can work closely with your health care team to design a treatment program that will enable you to reach your goals for improved mobility and to continue the activities that are meaningful to you. Your physical therapist will show you how to start slow and make small changes to strengthen your legs and trunk. Having an exercise partner will increase your chances for success and you will increase your confidence as well.

Start slowly and keep moving.