I've got a relatively probably an unusual YouTube channel when you look at
our statistics over half of our viewers over age 40 and over 25% is over age 65
why is that important for what's going on in this video this video is about a
couple of topics sarcopenia or muscle loss and frailty now these are very much
as you'll see in a few minutes there the overlap is huge on a practical basis
they're probably they're mostly the same issue for for the elderly population it
really begins to take take its toll in the mid 60s and beyond
this is sarcopenia or muscle loss age 25 age 63 about the same thighs size or leg
size but with the 25 year old much more of this as a muscle and with the 63 year
old much more of this as fat there's another way of seeing it it's very
visible now sometimes it's not so visible but again if you're if someone's
large and they don't have a lot of this visible muscle cut in their mid 60's and
beyond you need to start thinking about the inside of them looking like this why
is that a big deal well again we'll talk about that so just every time you see
sarcopenia just think muscle loss aging well it's been declared a global health
priority by the World Health Organization and the rolls of muscle
loss and frailty in late life is receiving increasing attention the by
far the biggest growing demographic a current around the world is the 65 and
above we are aging we're starting to conquer we're starting to have some
success in terms of knocking out the things that kill us younger even in
terms of heart attack stroke some of these other
disablers we're getting older as a population due to that success as we do
trail tea and muscle loss are again bigger and bigger deals and they're
growing each year now what is that what's the difference between frailty
and muscle loss frailty is the decline it's more of a conceptual issue it's the
decline of an individual's homeostatic function strength and physiologic
reserves it leads to an increase in vulnerability while sarcopenia or muscle
loss describes the loss of muscle mass and function with age as you can see you
start thinking about those two definitions frailty is a little bit more
functional and orientation sarcopenia or muscle loss is again right in front of
you very easy to see objective conceptual definitions have been widely
agreed on but there's lack of consensus on how to measure them we review in this
article they review different operational definitions review the
science the literature and and the evidence that no matter what definition
you use the prevalence and clinical impact of these conditions is high and
growing they also talk about the commonality of low physical function to
both conditions both frailty and loss of muscle mass it's a feature which can use
a it can be very pragmatic again you can you can start digging down on a couple
of things okay look at the muscle mass if you've got the resources to do an MRI
you can look at MRI and here's another one
usual walking speed is a simple easy to measure very feasible and it's been
extensively validated against health health outcomes
that's just use of walking speed also sit and stand when the somebody's
ability to get up out of a chair and walk that's for people at the lower end
of of function ability and again as we've
talked about we've got viewers on every end of the on both ends of that spectrum
for example Jon Lorsch eiders doing fairly competitive cycling I do
intervals on the treadmill at one to one-and-a-half percent incline and 5
minute mile pace so again we've got a lot of different variations but the
point here is not to talk about the the different ends of the spectrum the point
is to talk about the importance of muscle mass and muscle function in terms
of aging now we've talked about reasons why is why is muscle mass important wise
function important they bring up a big issue here surgery you know surgery is
basically just another stressor to the body but as you see here frailty appears
to outperform traditional anaesthetic and surgical risk scores in terms of its
association with post-operative complications length of hospital stay
institutionalization and mortality let me put that in simple English people
with frailty that go into their 60s and 70s and lead a sedentary life are far
more likely to end up institutionalized or dead after stressors like surgery
we've talked about other reasons too let me see we've talked about false and we
talked about you know what this gentleman may not have muscle loss well
maybe he does maybe he's like that first MRI where he appears to be nutritionally
okay but look significant loss of muscle and just body fat in there increasing
his his BMI we've also talked about some other issues as well we recovered a
video where we talked about cardio vist cardiovascular risk and cardiovascular
inflammation the risk factors for that increase the loss of muscle mass so
again if you're set up for hypertension diabetes these two especially greatly
increase your loss of muscle mass as you get older the it's not clear why but
there's thoughts about you know what those same things that that same
cardiovascular inflammation that decreases your or that that causes
endothelial damage may also decrease your blood supply to muscle tissue so
we've covered several issues around sarcopenia or a muscle loss I've done
several videos on it this one has to do with the best way to maintain
mitochondrial mass and that is high intensity intervals and why is
mitochondrial mass a big deal for for this issue mitochondria or do appear to
be well they're central to the process of aging and mitochondria are this is
where our vast majority of mitochondria are located in our large skeletal
muscles so again start thinking about what you're doing to maintain your
muscle mass because if you want to age well if you want to avoid disability and
if you want to live a long time you're going to need the muscle to do it thank
you