Many of us have heard of OSTEOpenia. This is the decrease in bone mineral density and is usually associated with aging. The word is derived from the words “osteo” meaning bone and “penia” which means lack of or deficiency. Less people have probably heard of SARCOpenia which is defined as a progressive loss of skeletal muscle mass and strength. Of course the word “sarco” means muscle. Both sarcopenia and osteopenia come with the risk of adverse outcomes such as physical disability, poor quality of life, and high mortality 1.
Even less people have heard of the combination of these two conditions which is called OSTEOSARCOpenia. This is when an individual suffers from both low bone mineral density and decreased skeletal muscle mass.
When looking at osteopenia and sarcopenia on their own we see some scary statistics. 13% of men and 43% of women after the age of 70 have osteoporosis 2. It is estimated that 6.4% of men and 9.3% of women have sarcopenia and up to 50% of muscle mass is lost by the age of 80. That is an astounding amount of muscle loss! People with both conditions together are likely to experience a higher prevalence of disabilities, falls, and fractures.
So what is the reason for this decrease in bone and muscle as we age?
Well firstly, there are diseases and disorders that can accelerate this loss. Some include kidney disease, menopause, low vitamin D, calcium, and testosterone (especially in men). These causes should be investigated by an individual’s primary health care provider by performing blood work. If deficiencies are noted then certain medications or supplements can be used to slow this progression.
However, a more common and much more preventable reason is likely the main culprit of this condition. That is physical inactivity and poor nutrition. The reason is that bone, muscle, and other tissues like tendons and ligaments need weight bearing activity to avoid atrophy and gain volume and strength. Additionally, adequate amounts of protein and calories are needed not only to gain muscle and bone but also avoid a decrease as we age.
Individuals with higher bone and muscle mass have been shown to stay independent and active longer than individuals that have less than average bone and muscle mass. A study done AT UCLA in 2014 concluded that the more muscle mass an individual has the less likely they are to die prematurely. Researchers concluded that not only should clinicians be measuring muscle mass of individuals routinely but an emphasis should be on maximizing and maintaining muscle mass 3.
Here are some ways you can avoid this muscle and bone loss as you age.
1. Participate in a healthy lifestyle: Avoid things like smoking and alcohol which have a negative effect on our bones
2. Physical activity: resistance and balance training at least 2 x for 30 minutes. Weight bearing exercise gives us the proper stimulus to maintain and even build stronger muscles and bones
3. Increase protein intake: our muscles are made of amino acids which are found in protein. Many older adults find it difficult to consume protein but it is vital to maintain muscle. In addition to dietary protein, high quality protein supplementation up to 2g kg/day* combined with exercise improves muscle and strength
4. Talk to your Doctor about supplementation: Your doctor might notice you are deficient in some common vitamins and minerals which help build strong bones. He/She might recommend supplementing with Vitamin D or calcium
5. Have your annual physical: At your physical make sure your doctor is recording your weight, height, and body mass index. If you notice a large drop from year to year further investigation should be required.
Don't let these scary statistics make you feel that we are all doomed as we age! Unlike a lot of other conditions osteosarcopenia can be prevented and treated with simple lifestyle changes. The best thing you can do whether you are old or young is to get moving. Young people, especially those in early adulthood can began building strong bones and muscles which will give you a large reserve and make working out in future years much easier.
1. Hirschfeld H, Kinsella R, Duque G. Osteosarcopenia: where bone, muscle, and fat collide. Osteoporosis International: A Journal Established As Result Of Cooperation Between The European Foundation For Osteoporosis And The National Osteoporosis Foundation Of The USA [serial on the Internet]. (2017, Oct), [cited February 8, 2018]; 28(10): 2781-2790. Available from: MEDLINE with Full Text.
2. Hassan E, Duque G. Osteosarcopenia: A new geriatric syndrome. Australian Family Physician [serial on the Internet]. (2017, Nov), [cited February 8, 2018]; 46(11): 849-853. Available from: CINAHL Plus with Full Text
3. Preethi Srikanthan, Arun S. Karlamangla. Muscle Mass Index as a Predictor of Longevity in Older-Adults. The American Journal of Medicine, 2014; DOI: 10.1016/j.amjmed.2014.02.007