Sarcopenia is the gradual and progressive loss of muscle mass, strength, and function. It most commonly affects older adults and is a natural part of the aging process. Over time, this condition can make daily movements such as walking, climbing stairs, or lifting objects more difficult and increase the risk of falls or fractures.

Studies estimate that 5–13% of people aged 60 or older and 11–50% of people aged 80 or older experience sarcopenia. Although no specific medication is currently approved for its treatment, lifestyle changes such as exercise and proper nutrition can help maintain muscle mass and improve strength.

Sarcopenia Symptoms

The main signs of sarcopenia include low muscle mass, decreased strength, and reduced physical function. As muscle tissue diminishes, fat often accumulates inside the remaining muscles, further decreasing strength and endurance.

Other common symptoms include:

  • Impaired motor function

  • Slow walking speed

  • Difficulty walking, climbing stairs, or carrying heavy objects

  • Increased frequency of falls

  • General weakness and fatigue

These symptoms can lead to loss of independence and affect overall quality of life if not properly managed.

What Causes Sarcopenia

Sarcopenia primarily occurs as a result of aging, typically beginning around age 30 and progressing more noticeably after 60. Roughly 10% of adults worldwide over 60 years old are affected.

Several biological mechanisms contribute to muscle loss with age:

  • Insulin resistance: Changes in body composition can lead to higher fat levels and lower muscle mass, which impair insulin function and metabolism.

  • Hormonal decline: Reduced levels of testosterone, growth hormone, and insulin-like growth factor (IGF-1) limit muscle repair and growth.

  • Chronic inflammation: Elevated levels of inflammatory markers such as IL-6 and TNF-alpha can damage muscle tissue.

  • Nerve degeneration: The loss of motor neurons and neuromuscular junctions weakens communication between the brain and muscles, leading to muscle atrophy.

Risk Factors

In addition to aging, inactivity and low protein intake are major risk factors for sarcopenia. Obesity can further worsen muscle weakness.

Younger individuals can also develop sarcopenia due to conditions that promote inflammation, malnutrition, or severe muscle wasting (cachexia).

Health conditions linked to sarcopenia include:

  • Chronic obstructive pulmonary disease (COPD)

  • Chronic kidney disease

  • Heart failure

  • Human immunodeficiency virus (HIV)

  • Diabetes mellitus

  • Cancer

How Is Sarcopenia Diagnosed

There is no single test that can confirm sarcopenia. Instead, diagnosis involves a combination of screening tools and physical assessments to evaluate muscle strength, mass, and performance.

Screening Tools

One widely used method is the SARC-F questionnaire, which asks about five areas: strength, assistance with walking, rising from a chair, climbing stairs, and history of falls. Scores range from 0–10, and a total of 4 or higher suggests possible sarcopenia, prompting further evaluation.

Muscle Strength Tests

Two common tests include:

  • Handgrip test: Measures upper body strength and gives insight into overall muscle capacity.

  • Chair stand test: Determines lower-body strength by measuring how many times a person can stand up and sit down in 30 seconds without arm assistance.

Muscle Quality Tests

Several imaging techniques can measure muscle mass and quality:

  • Magnetic resonance imaging (MRI): Provides detailed images of total muscle volume.

  • Computed tomography (CT): Uses X-rays to evaluate lean tissue and fat distribution.

  • Dual-energy X-ray absorptiometry (DXA): Assesses bone density and estimates muscle mass.

  • Bioimpedance analysis (BIA): Uses electrical signals to estimate muscle and fat composition.

Physical Performance Tests

These tests assess mobility, speed, and endurance to gauge sarcopenia severity:

  • Gait speed test: Measures the time to walk 4 meters; speeds below 0.8 m/s suggest sarcopenia.

  • Timed up-and-go test (TUG): Measures how long it takes to rise from a chair, walk 3 meters, and return; over 20 seconds indicates poor performance.

  • Short physical performance battery (SPPB): Combines standing balance, walking speed, and chair stand assessments; scores below 8 reflect severe sarcopenia.

  • 400-meter walk test: Involves multiple laps with rest breaks; taking longer than six minutes indicates severe muscle weakness.

Treatments For Sarcopenia

There are no FDA-approved drugs for sarcopenia, but several lifestyle strategies can help slow progression and restore function.

Physical Activity

Strength and resistance training are the most effective ways to improve muscle mass and strength in older adults. Exercises such as weight lifting, bodyweight training, and resistance band workouts performed two to three times weekly can significantly boost muscle function. Always consult a healthcare provider before beginning any new exercise program.

Dietary Patterns

Proper nutrition plays a critical role in managing sarcopenia. Experts recommend consuming 20–35 grams of protein per meal to stimulate muscle repair and synthesis.

Beneficial supplements may include:

  • Vitamin D

  • B-complex vitamins

  • Vitamin C

  • Calcium and magnesium

  • Selenium

These nutrients help support muscle metabolism and prevent deficiencies that contribute to muscle decline.

How To Prevent Sarcopenia

While completely preventing sarcopenia may not be possible, adopting healthy habits can slow its progression and maintain independence.

Prevention strategies include:

  • Eating a balanced diet with high-quality protein

  • Consuming 1.6–1.8 grams of protein per kilogram of body weight per day

  • Engaging in resistance training at least twice per week

  • Reducing sedentary time and staying physically active

Related Conditions

Sarcopenia increases the risk of several chronic health problems, including:

  • Cardiovascular disease: Muscle loss and physical inactivity contribute to heart disease risk.

  • Type 2 diabetes: Reduced muscle mass impairs glucose metabolism.

  • Osteoporosis: Weak muscles can accelerate bone loss, increasing fracture risk.

  • Cognitive impairment: Low muscle activity affects brain-regulating molecules called myokines.

  • Depression: Loss of strength and mobility can lower quality of life and increase depression risk.

Living With Sarcopenia

Sarcopenia can significantly affect independence and overall well-being. It increases the risk of falls, fractures, and hospitalization, especially in older adults. The condition can also worsen outcomes after surgery or when combined with other illnesses like heart failure or kidney disease.

Recognizing symptoms early allows for better management. Regular exercise, proper nutrition, and medical checkups can help maintain strength, prevent complications, and enhance quality of life.

If you notice changes in your mobility or strength, consult your healthcare provider for assessment and guidance.