Fit For Life Keeping old muscles gold
Muscle loss affects the mobility and independence of the elderly, however it’s not often that doctors screen for it.
KUALA LUMPUR: All it takes are three simple tests.
When it comes to the muscle health of the elderly, consultant geriatrician Prof Dr Tan Maw Pin urges family doctors to include screening for any problems during their patients’ visits.
“We know that older people regularly visit doctors, because they are just more susceptible to illness, or they already have high blood pressure or diabetes that requires them to go for regular checking,” she said.
This, the Universiti Malaya lecturer added, would be a good opportunity to keep an eye on the condition of their muscles.
Upkeeping one’s muscles is crucial in ensuring mobility and independence.
This is especially so among older adults who are likely to ignore these important tissues, which play essential roles in our movement, posture, circulation, breathing, digestion, excretion and sight, among others.
Poor muscle health and strength increases the risk for falls, which is the second leading cause of accidental or unintentional injury deaths worldwide (after road traffic injuries), according to the World Health Organization (WHO).
And it is adults aged 65 and above who are the ones suffering the highest number of deaths and injuries from falls, WHO reported.
Prof Tan said that poor muscle health, especially in the elderly, becomes even more apparent when they fall ill.
“Because they have low muscle strength to begin with, as soon as they fall ill, their muscles start shrinking away,” she said.
This reduces their mobility and ability to take care of themselves, leading to a need for someone to take care of them, which incurs further financial and social cost to them and their families.
The three tests for muscle health, which can even be done at home, are monitoring the patient’s weight, measuring their muscle strength and testing their walking balance.
Prof Tan explained that having a serial record of the patient’s weight is important as it is an indication of the amount of muscle they have.
“When you are old, when you lose weight, you lose muscle,” she said.
“So, we actually need people to be aware that even if you are overweight, when you’re ill, you still need to take (muscle health) supplements to actually maintain your body weight – you must not lose weight when you’re old.”
Even if an elderly person has no discernible problems, once they have lost more than 5% of their body weight, healthcare intervention is needed, said Prof Tan.
A more specific test is using a grip-strength dynamometer to directly measure muscle strength.
Prof Tan noted that doctors can get a reasonably priced dynamometer for about RM300-RM400, which can probably last for their entire career.
“So patients can do their grip strength when they come in, and if doctors keep the records, they should see if it deteriorates, if the patient is becoming weaker.”
The final test is for walking balance.
“We actually validated this test in Malaysia – it’s called the Timed Up and Go (Tug) test.
“It’s a very good test because it tests muscle strength, walking speed and balance,” explained Prof Tan.
“So, what we ask an older person to do is to stand up from a chair, walk three metres, turn around, walk back and sit back down again.
“And what we found is that, if they can do that within 13.5 seconds, the risk of falls is much lower.”
She said that they have also developed a more specific centile chart for this test, which shows the Tug time according to age.
This is as the average normal time for the test increases with age.
The chart will show if a person is average, above average or below average for their age.
“So, if you identify yourself as below average, you had better do something before it gets worse.
“So, do more exercise, check that you’re eating the right things, and you might need some rehabilitation,” she said.
While it is more difficult to objectively detect muscle loss through sight alone, Prof Tan shares that some of the indications of early muscle loss include:
● The body looking “baggier”.
● False teeth (without adhesives) starting to fall out, as the mouth muscles can no longer help to hold them.
● Guttering of muscles at the temples of the head.
● Clothes becoming loose and looking baggy.