spinal tracts may also be involved. When the corticospinal track was tested via muscle monitoring, there were signifi-cant differences between sarcopenic and non-sarcopenic older adults. 12 This in-dicated that the nerve supply was de-creased in sarcopenic adults. Sarcopenia, therefore, is a complex condition of ag-ing that involves every system of the body, including physical inactivity, en-docrine factors, neuromuscular compro-mise to mitochondrial dysfunction are, all interdependent. 13 Malnutrition and poor physical perfor-mance are both conditions that increase in prevalence with age. Digestive en-zymes also decrease with age, leading to maldigestion and malnutrition. 14 Some studies have indicated that muscle power is more impacted by nutritional status than muscle strength. This would imply that the type II muscle fibre, which is affected by certain nutrients, is in-volved. 15 Physical training has a synergis-MAKING EFFECTIVE CHANGES effects. A recent study showed that there were positive effects of whole-body vi-bration – intervention on improving the skeletal muscle mass index, physical fitness, and quality of life of sarcopenic older people living in institutions. 19 Another study found that frail, elderly people improved their levels of physical functionality 20 and regained muscle strength, reducing the risk and inci-dence of falls, frailty, and fracture risks. 21 There’s also a new training method called blood flow restriction training (BFR), which uses light weights with restriction cuffs on the arms and thighs. Because blood flow is being restricted, the lighter weights achieve similar results compared to using heavier weights. This would be very effective for people with sarcopenia just beginning an exercise program. BFR training is a novel train-ing method that has a significant impact on muscle strength 22 and could be in-cluded in a program for older adults with profound muscle weakness and mobility limitations. 23 However, certain REFERENCES 1. Joanisse S, et al. Skeletal Muscle Regeneration, Repair and Remodelling in Aging: The Importance of Muscle Stem Cells and Vascularization. Gerontology. 2017;63(1):91-100. 2. Wilkinson J, et al. The Age-Related Loss of Skeletal Muscle Mass and Function: Measurement and Physiology of Muscle Fibre Atrophy and Muscle Fibre Loss in Humans. Ageing Res Rev. 2018 Nov: 47: 123-132. 3. Yeung S, et al. Sarcopenia and Its Association With Falls and Fractures in Older Adults: A Systematic Review and Meta-Analysis. J Cachexia Sarcopenia Muscle. 2019 Jun;10(3):485-500. 4. Nilwik R, et al. The decline in skeletal muscle mass with aging is mainly attributed to a reduction in type II muscle fiber size. Exp Gerontol. 2013 May; 48(5): 492-8. 5. Buckinx F, et al. Relevance to assess and preserve muscle strength in aging field. Prog Neuropsychopharmacol Biol Psychiatry. 2019 Aug 30; 94: 109663. 6. Domingues-Faria C, et al. Skeletal Muscle Regeneration and Impact of Aging and Nutrition. Ageing Res Rev. 2016 Mar: 26: 22-36. 7. Rong S, et al. The Mechanisms and Treatments for Sarcopenia: Could Exosomes Be a Perspective Research Strategy in the Future? J Cachexia Sarcopenia Muscle. 2020 Apr; 11(2): 348-365. 8. Bonewald L. Use It or Lose It to Age: A Review of Bone and Muscle Communication. Bone 2019 Mar: 120: 212-218. 9. Tagliaferri C, et al. Muscle and bone, two interconnected tissues. Ageing Res Rev. 2015 May; 21: 55-70. 10. Morat T, et al. Neuromuscular function in different stages of sarcopenia. Exp Gerontol. 2016 Aug; 81: 28-36. 11. Clark B. Neuromuscular Changes With Aging and Sarcopenia. Clin Interv Aging. 2017 Jun 13; 12: 955-961. 12. Gennaro F, et al. Corticospinal Control of Human Locomotion as a New Determinant of Age-Related Sarcopenia: An Exploratory Study. J Clin Med . 2020 Mar 6; 9(3): 720. 13. Tournadre A, et al. Sarcopenia. Joint Bone Spine. 2019 May: 86 (3): 309-314. 14. Löhr J-M, et al. The ageing pancreas: a systematic review of the evidence and analysis of the consequences. J Intern Med. 2018 May;283(5):446-460. 15. Ramsey K, et al. Malnutrition is associated with dynamic physical performance. Aging Clin Exp Res. 2019 Aug 19: 35-41. 16. Turżańska K, et al. Protein and physical activity in prevention and treatment of sarcopenia. Wiad Lek. 2019; 72(9 cz 1):1660-1666. 17. Strasser B, et al. Role of Dietary Protein and Muscular Fitness on Longevity and Aging. Aging Dis. 2018 Feb 1; 9(1): 119-132. 18. Dupont J, et al. The Role of omega-3 in the Prevention and Treatment of Sarcopenia. Aging Clin Exp Res. Jun 2019 :31 (6): 825-836. 19. Chang S, et al. The preliminary effect of whole-body vibration intervention on improving the skeletal muscle mass index, physical fitness, and quality of life among older people with sarcopenia. BMC Geriatr. 2018 Jan 17;18(1):17. 20. Wadsworth D, et al. Effects of Whole-Body Vibration Training on the Physical Function of the Frail Elderly: An Open, Randomized Controlled Trial. Arch Phys Med Rehabil . 2020 Mar 4; S0003-9993(20): 30144-1. 21. Bemben D, et al. Relevance of Whole-Body Vibration Exercises on Muscle Strength/Power and Bone of Elderly Individuals. Dose Response. 2018 Dec 6; 16(4): 1559325818813066. 22. Beckwée D, et al. Exercise Interventions for the Prevention and Treatment of Sarcopenia. A Systematic Umbrella Review. J Nutr Health Aging. 2019; 23(6): 494-502. 23. Cook S, et al. Blood Flow Restricted Resistance Training in Older Adults at Risk of Mobility Limitations. Exp Gerontol, 2017 Dec. :99: 138-145. 24. Kirwan R, et al. Sarcopenia during COVID-19 lockdown restrictions: long-term health effects of short-term muscle loss. GeroScience. 2020 Dec; 42(6): 1547–1578. Sarcopenia is the age-related loss of skeletal muscle mass and strength. tic influence with diet protein. Physical training improves muscle performance, muscle strength and prevents muscle wasting. Physical training combined with an increased amount of protein in the diet results in increased muscle mass. 16 The best physical training ap-proach would be a combined exercise program consisting of both resist-ance-type and endurance-type exercises for skeletal muscle mass and function and to improve physical performance and quality of life. 17 To treat the age-re-lated chronic low-grade inflammation which is assumed to contribute to the development of sarcopenia, Omega-3 polyunsaturated fatty acids (PUFAs) would be an additional therapeutic agent for sarcopenia 18 and should be included. There are other strategies that can help – and in the case of the more severe sarcopenic individuals one strategy first helps by raising their muscles to func-tioning levels? Whole-body vibration is safe and can be used at very low fre-quencies and still have therapeutic www.Cndoctor.ca patients with heart conditions may re-quire careful monitoring. Because we are living with COVID-19, I encourage everyone to read the follow-ing referenced paper. The authors out-line how measures such as quarantine, isolation, and social distancing leading to an extended time at home contribute to impaired sleep, increased stress, anx-iety, cognitive decline and depression. 24 All of these affect eating patterns and physical activities/exercise, which pro-mote increased body fat, CVD, inflam-mation, diabetes and sarcopenia. CVD, diabetes, and elevated body fat are as-sociated with a greater risk of COVID-19. To mitigate these risk fac-tors, and to prevent more chronic symp-toms from developing for the sarcopenic person, the authors offer several home-based strategies including resistance exercise, higher protein intakes, and good diets and supplementation. These home-based strategies will also improve sleep, stress, anxiety, cognitive decline and depression. May/June 2021 Chiropractic and Naturopathic Doctor 15
Chiropractic + Naturopathic Doctor May/June 2021: Page 15
