SLOWING DOWN AGE-RELATED MUSCLE LOSS AND SARCOPENIA
P. NOIREZ 12 AND G. BUTLER-BROWNE 1
5. PREVENT AND/OR TREATMENT
Skeletal muscles are the organs that enable us to maintain posture and movement.
As individuals age they frequently become less active and this will progressively lead to muscle atrophy and frailty. The mechanisms that would allow us to explain how muscles age, why we lose both mass and force are still not well understood.
From the current results it is not possible to ascertain the exact role of intrinsic factors in the aging process. On the other hand, changes in certain extrinsic factors, such as the secretion of certain hormones and neuromuscular inactivity, appear to be involved in this process.
It has been suggested by several authors (Le Page et al.,2002) that age related muscle loss can be reversed by exercise. However we do not know if the oxidative stress liberated by exercise could be damaging to the muscle especially in elderly individuals in the lack of a certain adaptation to regular exercise. It should be noted that during aging there is a gradual increase in the proinflammatory state which could increase the incidence of muscle injury following exercise (Fulle et al.,2004).
However, as stated earlier regular exercise will increase the anti-oxidant response in the skeletal muscles (Meijer et al.,2002) and this is accompanied by an increase in muscle produced interleukin-6 which is thought to counterbalance this pro- inflammatory state (Petersen and Pedersen,2005). How much exercise is required to maintain muscle force and mass? It is not always easy to formulate an adequate standard exercise protocol for each individual. It is not necessarily the role of the doctor to determine how much exercise a healthy individual should undertake in order to stay healthy. This falls into the domain of preventive medecine to maintain a good quality of life for our aging population. One could imagine however, that the doctor could prescribe a series of regular exercises which are adapted to the health status of the patient, then this would be followed by a specialist in physical education. Nevertheless we could ask the question is this really his role and could not these roles be inverted.
As stated previously the loss of muscle strength and mass occurs rather early, between 30 and 40 years of age, therefore it is important that the idea that regular exercise should become an integral part of the general life style just as brushing ones teeth. It is surprising in our modern day culture that the majority of the population prefers to participate in sport by proxy from their arm chair rather than carrying out some sort of physical exercise themselves.
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6. CONCLUSION
At the present time, hormone treatment still remains premature: however, maintaining regular neuromuscular activity could delay the effects of muscular aging; it is nevertheless important to take into account the personal capacities of each individual as well any eventual pathological states before establishing exercise and physical activity programmes.
In elderly people, physical training improves skeletal muscle performance (Le Page et al.,2002), oxydant defense capacity (Meijer et al., 2002), arterial compliance (Tanaka et al., 2000; Monahan et al., 2001), cardiac function during acute exercise (Stratton et al.,1994), maximal oxygen consumption (Beere et al., 1999) and prevents vascular endothelial dysfunction, probably by limiting oxidative stress (Taddei et al.,2000). In addition, exercise training in cardiovascular disease limits the incidence of coronary events (Abete et al., 2001), improves functional capacity to exercise and reduces coronary stenosis in patients with coronary heart disease (Hakim et al.,1999;Gielen et al.,2001).
Moreover, level of physical activity has a direct impact on the level of cognitive activity. Recent studies have shown that improving physical fitness leads to better performances in tasks assessing a diversity of cognitive domains (Renaud and Bherer,2005).
It thus seems that physical training could improve not only the health of the elderly individual but also serve to enhance and maintain cognitive vitality in older adults. However the current way of life is making us increasingly less active. In order to preserve independence during aging, it would be advisable to encourage our contemporaries to indulge in regular exercise and physical activity.
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