Sarcopenia and Muscle Loss With Age

What sarcopenia means

Sarcopenia (from Greek words for "flesh" and "loss") is defined as a decline in muscle mass, strength and function. It is often associated with older adults, but some forms can affect middle-aged people. [1] A major review describes it as a progressive, generalized skeletal muscle disorder linked to falls, functional decline, frailty and death, influenced by genetic and lifestyle factors across the life course. [2]

Sarcopenia is more likely in people with chronic diseases and may contribute to a risk of falls and fractures. [1] It is related to, but not the same as, frailty.

Common features

NIA connects sarcopenia with weakness, fatigue, lower energy and difficulty standing, walking and climbing stairs. [1] These features have many other possible causes, so this page cannot tell you whether you have it.

How it is evaluated

The European consensus on sarcopenia (EWGSOP2) is a widely used definition and diagnostic approach, published in 2019 by an expert working group. [3] EWGSOP2 focuses on low muscle strength as a key characteristic, uses low muscle quantity and quality to confirm the diagnosis, and treats poor physical performance as a sign of severe sarcopenia. [3] A clinician does this evaluation. For falls, a GP may also check for muscle weakness and review medicines. [4]

What helps: the evidence

Evidence labels: established recommendation, promising but limited, mixed, insufficient evidence.

1. Progressive resistance training

   Established

   Cochrane review, 121 trials, 6,700 participants: large positive effect on muscle strength (SMD 0.84) and improvements in gait speed and getting out of a chair. [5]

2. Protein from food

   Expert position paper

   A PROT-AGE position paper concluded older adults need more dietary protein than younger adults to maintain lean body mass and function. [6]

3. Protein supplements added to resistance training

   Mixed for older adults

   A meta-analysis of 49 trials in healthy adults found small gains in strength and fat-free mass; the benefit was smaller with increasing age. [7]

4. Creatine plus resistance training

   Promising but limited

   A 2014 meta-analysis (357 older adults) found greater fat-free mass and some strength gains than training alone, but said more work was needed. [8]

5. Collagen peptides plus resistance training

   Promising but limited (single small trial)

   One 12-week trial in 53 men with sarcopenia (mean age about 72) reported more fat-free mass and strength gain than placebo. [9]

The collagen trial included authors affiliated with a collagen research company, so read it cautiously. [9] Creatine and collagen are covered in supplements for healthy aging.

Medicines and drugs for muscle loss

The Lancet review notes that research is focused on nutritional interventions and on drugs to augment the effects of resistance exercise, and that this is an area of active study. [2] Proper evidence not found here for an approved supplement that treats sarcopenia on its own; the checked sources describe supplements as add-ons to exercise.