Benefits of being physically active

REFERRING to the report “Malaysia expected to become a ‘super-aged nation’ by 2056” (The Star, Jan 28; online at https://bit.ly/3EBdWdT), one common yet often overlooked aspect affecting older adults is sarcopenia, a condition characterised by loss of muscle mass, strength and function in older adults.

As early as 30 years old, we start to lose muscle mass and strength at a gradual pace. But there are some who do this at a faster rate. This is a condition called sarcopenia.

Literally meaning “lack of flesh”, sarcopenia affects the skeletal muscles, making them weaker over time and can cause problems like weakness, frailty, memory loss and even death. Sarcopenia is now recognised as a disease.

As we age, we often feel weak, but does this mean we are suffering from sarcopenia? The answer is no. A sarcopenia diagnosis is confirmed by the presence of low muscle mass, muscle strength and/ or physical performance.

Older adults with sarcopenia might notice that they have muscle weakness, slow walking speed, muscle shrinkage, difficulty performing their normal daily activities and are prone to falling.

So, how common is sarcopenia in Malaysia? A recent study showed that one in 20 or 5% of adults aged 60 years and above in Malaysia have sarcopenia, and 3.6% suffer from severe sarcopenia.

More worrying is that older adults with sarcopenia are 80% more likely to suffer from cognitive impairment than those without it.

Furthermore, those with severe sarcopenia are at a higher risk of cognitive impairment. This means having weak muscles makes it more likely that one will have trouble thinking and remembering, thus highlighting the importance of maintaining muscle mass and strength.

While advancing age is a risk factor for sarcopenia, studies have shown that other factors may contribute to the condition. These factors are reduced protein intake, prolonged immobility, chronic inflammatory conditions (rheumatoid arthritis, inflammatory bowel disease and chronic obstructive bowel disease), other conditions like obesity, diabetes and chronic kidney and liver disease, and smoking.

To date, there is no medicine approved by the Federal Drug Administration of the United States to treat or prevent sarcopenia. But there are other remedies to keep it at bay.

Being physically active is on top of the list. The World Health Organisation (WHO) recommends 150 minutes per week of moderate exercise such as brisk walking or 75 minutes per week of vigorous exercise such as jogging. Resistance exercises such as weightlifting and doing squats and push-ups can help to increase muscle bulk.

Adequate intake of protein is vital to stimulate muscle growth. A protein intake of at least one gramme per kg of body weight is recommended. Vitamin D was also found to be protective against sarcopenia by increasing muscle strength.

As Malaysia’s population continues to age, it is becoming increasingly important to address the issue of sarcopenia and its impact on older adults. With exercise and good nutrition, we can work towards preventing sarcopenia and continue to enjoy a high quality of life as we age.

DR KARTHIKEYANATHAN RAMOO

and PROF DR NORAN NAQIAH HAIRI

Public Health Department

Universiti Malaya