Diet and exercise to stay away from sarcopenia and prepare for old age

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(Hong Kong News) Old age comes quietly, muscles are gradually lost, the sense of movement is difficult, and you fall again and again… Do you suffer from a lot of diseases, do you feel depressed, and even feel that life is hopeless?

Old is a compulsory subject. If you are not well prepared, you are prone to suffer from “Unprepared Aging Syndrome”, “Caregiver Empty Nest Syndrome”, “Physical and Physical Crisis Symptoms in Early Aging”; you need your own will, experience, awakening, and positivity to cope with it slowly , enjoy the rest of your golden years.

A psychiatrist referred a patient. The patient is an elderly person. In addition to insomnia and mental stress, he may have suffered from “sarcopenia”. He hoped that the geriatric specialist would evaluate and follow up.

sarcopenic depression

The Ms. Zheng in front of me, if I look at the symptoms of sarcopenia initially, it does not belong to the serious level. First of all, although Ms. Cheng is elderly, she is only 66 years old (one year younger than me), which is considered young and belongs to young old.

I believe that the old body still has the strength to cope with this geriatric disease. Secondly, preliminary assessments, including hand grip strength and walking speed, all showed that the condition was mild.

Of course, to confirm the condition of the disease, Ms. Zheng needs to do computerized tomography examination and bone quality measurement. But before I confirmed the condition to Ms. Zheng, she had already responded negatively: “Oh, doctor, I don’t think I can get a doctor! I’m full of diseases, waiting to die!”

Why is the patient’s mentality so depressed? I hurriedly explained that although there is currently no specific cure for sarcopenia, clinical treatments such as disease assessment, effective drugs combined with physical therapy, a balanced diet, supplements of nutrition, calcium, and vitamin D, and adequate sunlight intake can help maintain ideal conditions. Weight loss, exercise habits, etc., are effective in delaying deterioration.

Feet can’t stop climbing

I shared the situation of another patient, the fifth sister-in-law, with her. The fifth sister-in-law found that her feet were weak two years ago, and she had no choice but to stop her favorite mountain climbing. The doctor diagnosed that the weakness of her feet might be related to sarcopenia. In order to cope with this problem, the fifth sister-in-law began to pay great attention to diet and exercise.

Resistance training is the key to building muscle. She takes fitness classes twice a week, mainly doing resistance training, such as pulling resistance bands, lifting dumbbells, etc.; usually supplemented by a lot of aerobic exercise, such as cycling, walking, squats Stretching etc. As for diet, Mrs. Wu pays more attention to a balanced diet, especially supplementing protein, because protein is the raw material for muscle synthesis.

In less than a year, the fifth sister-in-law happily announced: “The strength of both feet has been fully recovered!” Therefore, sarcopenia is not as terrible as imagined.

Retire early to take care of mother

“Doctor, you don’t know. My situation is different and I can’t handle it!” Ms. Zheng said that her problem was not economic.

Although she is single, but as a retired civil servant, she enjoys a monthly pension and owns her own residence, so living expenses are not a problem. She has been retired for more than 10 years. Because she suffered from severe eye disease at the time, and surgery failed to correct it, she felt that it was difficult to cope with work, so she resolutely retired early.

She admitted that she was not mentally prepared before retiring, but at that time her mother had dementia, so she thought that she would just focus on taking care of her, only to realize that the job of a caregiver turned out to be so exhausting.

She said that as soon as she became a caregiver, she denied her six relatives and took care of her mother around the clock throughout the year. However, her mother’s condition did not improve at all, and it became worse and worse. The mother’s temperament changed drastically, and she often blamed and doubted her, spat at her, and even tried to attack her.

However, the most uncomfortable thing was the reaction of the two younger sisters. Not only did they fail to understand the difficulty of taking care of their mother alone, but they also contradicted each other, even saying, “All the so-called sacrifices are your own fault!”

Mom died and didn’t know how to cry

After taking care of her mother alone for 7 years, Ms. Zheng finally agreed to send her to a nursing home. However, this does not mean that the responsibility of being a caregiver can be thrown away. She still does not change the weather. She visits her mother in the nursing home every day and feeds her two meals a day. She still places her spiritual sustenance on taking care of her mother.

But a century of epidemics has changed everything. Family members are not allowed to visit the home, and mother cannot be seen through the glass.

“I really didn’t know what to do at the time?” Ms. Zheng said, “I gritted my teeth and kept an eye on the epidemic every day. When I knew there was an outbreak in the nursing home, I knew it was ‘deadly (deadly)'”!

Ms Cheng’s mother turned out to be the victim of the fifth wave of the epidemic in Hong Kong. “I really don’t understand the reaction. Everything came very quickly. I was informed by the hospital: your mother has been ‘sickened (coronavirus)’, has been sent to the North Lantau Hospital, and your mother has passed away. I seem to be watching TV news. It doesn’t feel like it’s about me.”

“So, when my mother passed away, I didn’t cry. I don’t know how to cry!” At this moment, Ms. Zheng had two lines of tears on her face.

Wake up and enjoy the rest of your life

She said that for more than a year, she felt that her body was deteriorating rapidly, she couldn’t get excited about anything, she couldn’t sleep at night, she was listless during the day, and her appetite was low. She said that she was “losing life”.

“Insomnia alone has killed more than half of my death, and now you say I have sarcopenia, why don’t you let me die early!” Ms. Zheng demanded.

Ms. Zheng’s current problem does not lie in sarcopenia. What she has to face is actually “not well prepared for aging syndrome”, “burnt out caregiver empty nest syndrome”, “mental and physical crisis symptoms of early aging”, “sequelae of COVID-19 epidemic prevention and isolation”; however, regardless of any of the above, I believe that medicine cannot be simply dealt with, but requires the patient’s own will, experience, abandonment, awakening, improvement, positivity, and devotion to slowly cope with it, and even enjoy the rest of the golden years.

“Aging” is not an easy subject, but it is a compulsory subject, so the sooner you practice it, the better. However, it doesn’t matter if it’s late, because as long as you make up your mind and prepare well, getting old is normal, joyful, and grateful.

I wish you all: Happy New Year of Guimao, peace and joy!

Lose muscle by 8% every 10 years after the age of 40 and 15% after the age of 70

Sarcopenia refers to the symptoms caused by the gradual loss of muscle mass due to the aging of the body. It sounds like a new disease because this medical term was only used more than 10 years ago.

But if you look closely at the symptoms of sarcopenia, it is not new at all: slow movement, slow walking, difficulty in lifting heavy objects, towels that cannot be twisted dry, stopping after climbing 10 stairs, using force to get up from a chair, and falling once And again… isn’t this exactly a symptom of “age decline”? Sarcopenia is just a more “in” name.

Patients have a shorter life expectancy

Muscle loss has always been a subject of continuous discussion in biology. Muscle loss has been defined by medical research more than 20 years ago. When a person reaches the age of 40, muscle mass will decrease by 8% every 10 years. By the age of 70, the rate of loss is faster, decreasing by 15% every 10 years.

What’s more, once muscle cells are lost, they cannot grow back. In other words, as we age, muscle cells will only decrease and fail to replenish. After aging, the muscles gradually atrophy, and it is rare to buy. Don’t you see, after entering the second half, our solid muscles are gone!

For many people, sarcopenia seems to come on suddenly. Because in the initial stage of muscle loss, there is no significant change in body function, so most patients are not aware of it; however, the hidden fact is that their health has been threatened.

Because when the skeletal muscle decreases, the basal metabolic rate also slows down; cholesterol and triglycerides are easy to accumulate, and the risk of cardiovascular disease naturally increases. At the same time, metabolic rate affects protein storage and glucose metabolism.

As a result, sarcopenia increases the risk of diabetes, metabolic syndrome, disability, and even death. Many scientific studies have shown that patients with sarcopenia tend to have a shorter life expectancy.

Physiological and pathological factors

Therefore, the effects of muscle loss should never be ignored. The causes of sarcopenia can be divided into two factors: physiological or pathological. When it comes to physiology, it can be counted more or less on the head of aging.

Aging causes changes in the nervous system, weakened hormones, decreased estrogen, insulin resistance, etc., coupled with reduced activity after aging, sedentary inactivity, and bedridden, are the main reasons for continued muscle loss. As a result, my feet became floating, I fell for no reason, my muscles were weak, I was sore, I shrank and became shorter, and it was difficult to walk. . . .

Therefore, when sarcopenia is mentioned, everyone immediately thinks of the “old man”.

As for pathological factors, most of them are caused by physical changes, including malnutrition, diabetes, thyroid disease and various cancers. If you find that your weight has dropped suddenly within a few months and your muscles have been severely lost, you must do a detailed examination to find out the cause and prescribe the right medicine as soon as possible.

Text Liang Wanfu (geriatric specialist)

Lack of exercise, loss of appetite, and infection exacerbate muscle loss

Most studies have pointed out that muscle loss is prone to or exacerbated after infection with COVID-19.

Especially the lack of exercise of the elderly during the epidemic, loss of appetite when infected, and excessive inflammation due to illness will accelerate muscle loss.

Some elders often say, “Weakness when sitting down and getting up, and weak feet when walking”, which may be a sign of lack of muscle and muscle strength.

Increased risk of falls and fractures

Numerous studies have linked lack of muscle to chronic pain, obesity, type 2 diabetes, functional decline, and more. Some elderly suffer from low back pain or knee headache, which may be due to weak hip muscles, unstable posture and tilting when walking.

Long-term poor posture can put bones in non-ideal positions, accelerate bone wear and lead to degeneration and pain. Loss of muscle mass not only affects daily life, but also increases the risk of falls and fractures, which is a major problem for the elderly and caregivers.

Simple 3-style muscle exercises at home

Doing exercise must be done correctly, not just walking and moving casually. Because the muscle must be stimulated enough to allow it to repair itself after a small amount of damage, so that the muscle can grow bigger.

Elderly people must do resistance exercise to train their muscles, and achieve the effect of exercise through the way of muscles against external resistance. When doing it, we must pay attention to eccentric contraction, that is, we must return to the original position after exerting force, and try to prolong the muscle contraction time to stimulate the muscles.

The following 3 simple muscle strength exercises at home are recommended to be done at least 2 times a week (non-consecutive 2 days), each movement is 10 times as a group, and 3 groups are done.

lower body training

Designed to increase the strength of the hip and thigh muscles used from sitting to standing and reduce the risk of lower back pain, knee pain or falls due to muscle weakness

action:

1/Sit in a sturdy chair and fold your arms across your chest. Lean your body forward slightly, keeping your knees slightly outward (Figure A)

2/Use your hips and lower body to stand up straight (Figure B)

3/Sit back in your chair while counting to 3 seconds, slowly

Note: If you still feel relaxed after doing 3 sets, you can hold a water bottle or a bag with objects in both hands to increase the load and stimulate muscle hyperplasia.On the contrary, if the movement is too difficult, you can stand up with a stable object

back training

Aim to strengthen the back muscles of the middle and lower back, reduce round shoulders (cold back) caused by muscle weakness, and frozen shoulders that may be caused by unstable shoulder blades

action:

1/Sit in a sturdy chair and lean forward.Raise your hands high into a Y shape (picture C), relax your shoulders and avoid shrugging your shoulders, push your arms back, clamp your back and hold for 3 seconds, then return to the original position

2/Hands down in a Y shape to elbows and shoulders (Figure D), shoulders relaxed to avoid shrugging.Push your arms backwards, clamp your back and fixate for 3 seconds, return to the original position

Note: If you still feel relaxed after doing 3 sets, you can hold water bottles with both hands to increase the load and stimulate muscle hyperplasia

hip abductor muscle training

Designed to strengthen the hip abductor muscles, reducing the risk of falls due to weakness of this muscle, as well as low back pain or lower body pain due to poor posture

action:

Stand with both hands on a stable chair, keep your body centered and straight, lift one lower limb to the side, hold it for 3 seconds (Figure E), slowly put it back to its original position, and do it again on the other side

Note: If you still feel relaxed after doing 3 sets, you can extend the fixation time to 5 to 10 seconds, and you can also slowly draw circles in the air with your lower limbs, or use resistance bands on your ankles to increase muscle stimulation

The exercises described above are in no way a substitute for an expertly evaluated treatment plan, and if in doubt, you should first consult your doctor or physical therapist.

Text, Demonstration Chen Jiahao (Physiotherapist)

What if the elders forget to take medicine?

The principle for the elders to make up for taking medicine depends on whether it is a chronic disease medicine or a symptomatic medicine; whether a chronic disease medicine needs to be supplemented depends on when you remember to forget to take the medicine.

Usually, it is based on the midpoint of the two doses: if you remember that you forgot to take the medicine, it is before the midpoint of the two doses (for example, take the medicine in the morning and evening, and remember to forget to take the morning medicine when it is close to noon), then It should be taken immediately.

Simplify the course of treatment and reduce eating mistakes

However, if the midpoint of the two doses has passed when you think about it (for example, you take the medicine in the morning and evening, and you forget to take the medicine in the morning when you remember it in the afternoon), you don’t need to take it again. You only need to use the original dose when you take the medicine next time Yes (you must not use 2 times the dose the next time you take the medicine because you forgot to take it once).

However, it is recommended to additionally record the date and time of the occurrence, and provide medical staff to evaluate the efficacy of the current drug during follow-up follow-up.

For elders with multiple diseases and multiple medications, the occurrence of eating mistakes or forgetting to take can be reduced by simplifying the course of treatment;

Therefore, when more and more medications are used and become more and more complicated, it is suggested that the integrated care clinics of various medical institutions should be used for evaluation, so as to reduce unnecessary medications, avoid repeated medications and interactions, and other medication problems.

In addition to the assistance of family members or caregivers, make good use of small tools such as pill boxes or medicine strippers to avoid taking medicines by mistake and ensure the safety of medicines for yourself and your family. If you have any questions about dispensing medicines, you can consult with community pharmacies and pharmacists.

Wen Li Ji

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