Sarcopenia guide

What is Sarcopenia?

Sarcopenia is the loss of skeletal muscle mass and strength as a result of ageing. According to the British Dietetic Association (BDA), it is not a condition that is just about muscle loss but significantly impacts strength and activity levels,. This leads to mobility issues and increased risk of osteoporosis and falls and fractures, which often significantly diminishes independence in older adults.

It can also be a complication of chronic diseases which lead to fraility, disability and a higher likelihood of hospitalisation. There are, however, key treatments which can significantly reduce the chances of patients suffering from Sarcopenia such as resistant exercise and adequate protein nutrition can effectively combat this condition.

What are the causes of Sarcopenia?

There are four main causes and ensuring we take steps to minimise the condition is essential:

• Age – From the age of 30 to 60 we lose approximately 250g of muscle each year. After the age of 70 this loss accelerates to around 15% of muscle per decade
• Malnutrition – Insufficient proteins and calorie intake impacts on the body’s ability to maintain muscle mass
• Physical inactivity – A sedentary lifestyle is a significant contributor to muscle loss. Insufficient physical activity directly contributes to Sarcopenia by hindering muscle maintenance and promoting muscle breakdown
• Chronic Diseases – Long term inflammatory diseases such as Chronic Obstructive Pulmonary Disease (COPD) impact the balance of muscle protein synthesis and breakdown, leading to the loss of muscle mass and strength and leading directly to Sarcopenia.

How do we identify Sarcopenia?

To effectively screen for Sarcopenia, we utilise tools like the SARC-F questionnaire and perform a functional assessment, including gait speed, hand-grip strength and the sit to stand test.

A score of four or higher in the SARC-F questionnaire, which screens patients for self-reported signs suggestive of Sarcopenia and includes deficiencies in strength, walking, rising from a chair, climbing stairs, and experiencing falls.  or a low gait speed, clearly indicates a risk of the condition.

Additional diagnostic methods such as the Dual-energy X-ray absorptiometry (DXA), which is a common, low-radiation imaging test used to assess skeletal muscle mass, fat mass, and bone density for Sarcopenia diagnosis, further aid our understanding of the condition. For malnutrition, we use the Malnutrition Universal Screening Tool (MUST) to ensure effective intervention.

Dietary Recommendations for Sarcopenia

• Protein – Aim for 25-30g of high quality protein with each meal to robustly support muscle maintenance. Excellent sources of protein include lean meats like chicken and beef, fish, eggs, dairy, nuts and Tofu
• Fruiit and vegetables – These nutrient powerhouses provide essential vitamins, minerals and fibre while helping reduce inflammation. Focus on leafy greens, berries and vegetables
• Wholegrains – Incorporating wholegrains such as oats, quinoa and brown rice provides complex carbohydrates and fibre to fuel your body efficiently
• Healthy Fats – Embrace sources of healthy fats like Olive Oil, avocados, nuts and seeds to enhance overall health and deliver anti-inflammatory benefits
• Vitamin D – Commonly deficient in older adults, Vitamin D is crucial for muscle strength. You should also include sources like fatty fish, fortified dairy and eggs in your diet in addition to breakfast cereals which are fortified in Vitamin D
• Omega 3 Fatty Acids – These nutrients help muscle growth and have strong anti-inflammatory effects and can be found in oily fish like salmon and mackerel and Omega 3 supplements.

Our patients matter

Mersey Care NHS Foundation Trust listens and responds to patients and their carers to help improve the services we deliver.

If you have any comments, compliments or concerns you can speak with a member of staff or contact our Patient Advice and LiaisonService (PALS) and Complaints Team.

Telephone: 0151 471 2377 Freephone: 0800 328 2941 Email: palsandcomplaints@merseycare.nhs.uk