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Threats to Independence – Keystone Elder Law – Mechanicsburg, PA

A naturally occurring physical change which occurs with aging is the deterioration of muscle mass and strength. The medical term for this condition is sarcopenia, from the Greek words “sarcos” (flesh) and “penia” (lack of).  This decline begins when individuals are in their 30’s, and by about age 70-80, most have only about 60-80% of their peak muscle mass remaining (a loss of about 8% every 10 years).  After about age 80, the rate of decline in muscle mass jumps to about 15% every 10 years.  The loss of muscle strength occurs even more quickly, as a 2006 study reported declines of 3-4% per year for men, and 2.5-3% per year for women.

These figures should be alarming for older adults who have a goal of remaining independent, since this decrease in muscle mass and strength makes individuals more susceptible to debilitating changes in their mobility and the ability to perform self-care tasks, as well as to the development of heart and metabolic diseases. All of these factors pose threats to independence and contribute to higher mortality rates.

It is important to note that the normal losses which are occurring can be compounded by certain personal habits, such as diet. Protein is the primary nutrient which is essential for muscle mass and strength, so individuals with low protein diets are at risk for increased loss of muscle mass and strength.   In a 2015 article a dietician from the Mayo Clinic reported that about 12% of men and 24% of women over age 70 consume significantly less than the current recommended daily allowance of protein.  In addition, current research studies are indicating that older adults may need even more protein than the current recommended daily allowance.  Foods which are good sources of protein include lean meat, poultry, fish, soy products, beans, legumes, and low-fat milk. If protein intake is less than optimal due to a smaller appetite, an individual may try consuming protein rich foods at the beginning of a meal, or eating smaller amounts of food more frequently throughout the day (including high protein foods).

In addition to diet, an individual’s level of activity will affect the rate of muscle and strength loss. The Centers for Disease Control report that a significant number of older adults are inactive, and they have made it a national public health priority to promote increased physical activity in this population. In addition to slowing the rate of muscle and strength loss, physical activity in older adults has been shown to reduce functional decline, decrease arthritis pain, improve sleep, decrease falls, reduce symptoms of depression, and prevent some chronic diseases. These benefits result in lower medical costs and maintenance of independence with one’s activities of daily living.

Three different types of exercises exist which will contribute to better health. Aerobic exercises such as walking, biking, and swimming use large muscles and increase heart rate to help improve endurance. Muscle strengthening exercises cause muscles to do more work than with usual activity through repetitive movements which have resistance. Examples include climbing stairs, lifting weights, and using resistance bands. Balance exercises such as backward walking, heel walking, or toe walking will help reduce the risk of falls.

Older adults who find physical activity difficult should keep in mind that any amount of activity is better than no activity at all. Your physician and a physical therapist can help recommend activities which are manageable and safe for your ability and health. Frequent, shorter periods of activity throughout the day are easier and provide greater benefits for some people than attempting a longer, more extensive workout. Incorporating activity into your daily routines can promote consistent participation (such as doing simple exercises during TV commercials).

Diet and activity level are lifestyle choices over which all individuals can exert at least some level of control. If the outcome you desire as you age is less dependence and greater independence, a little effort in these two areas may go a long way in helping you reach your goals.

Karen Kaslow, RN, BSN