An unmet clinical need, the treatment of sarcopenia can be supported by doctors of chiropractic
SARCOPENIA IS AN AMAZING AND COMMON CONDITION which puts the elderly at increased risk of falls, fractures, head injuries, mobility disorders, loss of autonomy, reduced quality of life and comorbidities.(1) Uncontrolled sarcopenia increases even the probability of death by nearly 2-1/2 times. (2) Despite this, sarcopenia is one of the most overlooked and undertreated conditions in primary health care practices, (3) treatment of sarcopenia creating a significant unmet clinical need that chiropractors can fill.
Sarcopenia and consequences
Sarcopenia is characterized by the progressive and generalized loss of skeletal muscle mass and strength with the risk of adverse effects such as physical disability, poor quality of life and death.(4)
The consequences of sarcopenia are sobering. Older adults with sarcopenia are up to five times more likely to develop physical disabilities.5 Excessive muscle loss, one of the hallmarks of the disease, not only increases the likelihood of impairment, but increases the risk of bone fractures. the hip by 60%, regardless of the bone. density.(5)
Sarcopenia also increases the occurrence of comorbidities, including coronary artery disease, type 2 diabetes, obesity, kidney disease, arthritis, respiratory disease, thrombophlebitis, depression, and cognitive impairment(1) – which all increase the risk of mortality. Sarcopenia is even financially taxing, increasing medical expenses for those who suffer from it and adding an estimated $18 billion annually to total health care costs in the United States, a figure that even exceeds osteoporosis.(6)
Sarcopenia is a common clinical condition, present in many age groups and settings, including 33% in adults aged 65 and over in community health settings, 50% in people over 80, 50 to 70% in frail people and 76% in people hospitalized in intensive care. older patients.(6,7,8,9)
Unlike osteoporosis, which people easily recognize, sarcopenia is generally not known to the public. Despite this, when told about it, 71% of seniors say they would change their diet and exercise habits to alleviate it.(10)
Meeting an unmet clinical need
Chiropractors are uniquely suited to treating sarcopenia to provide patients with the education and leadership they need to alleviate this destructive condition because:
• Compared to other health professionals, chiropractors are better suited philosophically and educationally to meet the needs of those at risk for or suffering from sarcopenia. Sarcopenia is a musculoskeletal disease rooted in poor lifestyle choices, and who is better prepared to counsel patients on healthier choices and apply treatment for sarcopenia than chiropractors, whose training behaviors and of practice are rooted in this tradition.
• It is estimated that up to 14% of seniors seek chiropractic care.(11) Therefore, if you have seniors in your practice, you already see patients with sarcopenia. By virtue of chiropractors seeing patients more frequently, they are online to educate and mentor patients about sarcopenia.
• Although the visual appearance of sarcopenia may not be apparent until the sixth or seventh decade, the genesis of the condition occurs much earlier, often traceable to the fifth or fourth decade or earlier. Consequently, sarcopenia is as much a middle-aged problem as it is a geriatric condition. Providers like DCs, who treat thousands of middle-aged patients and advocate for nutrition, exercise and a healthy lifestyle, are uniquely positioned to be influencers at a time when it can make a meaningful difference in reducing the risk of this disease.
• This can improve patient outcomes. The combination of passive and active care (passive care consisting of spinal manipulation therapy and active care, nutrition, and exercise) may prove to be an effective way to treat sarcopenia.
Exercise and nutritional interventions are known to be effective with the treatment of sarcopenia. But a recent research study evaluating the effect of spinal manipulation therapy (SMT) on muscle mass may have opened the door to other intriguing possibilities.
In this study (12), it was found that the thickness of the lumbar multifidus muscle increased after a trial of three spinal manipulation therapies. This is important since muscle mass is a fundamental problem in sarcopenia. This is not to say that SMT is a cure for sarcopenia, as further investigation is needed to validate a causal relationship here. But the combination of passive and active care as provided by chiropractors can prove to be a very effective form of treatment for sarcopenia.
With their unique training, skills, philosophy, and commitment to educating their patients, chiropractors are well positioned to address the unmet clinical need that currently exists with sarcopenia. They just have to seize the opportunity.
JOSEPH A. MILLER, DC, MSCN, MA, BA, BS, has 30 years of experience in the chiropractic profession, where he was a highly respected practitioner, teacher, researcher, author, and speaker. As CEO of Prime of Life Nutrition, he maintains a clinical nutrition practice helping seniors with sarcopenia, becoming a thought leader on the subject. He is available for speaking engagements and personal consultations and can be contacted at firstname.lastname@example.org.
1 Miller JCA. Sarcopenia: A review of the validity and utility of five commonly used screening tests for early detection in clinical practice. Journal of Contemporary Chiropractic 2021; Flight. 4: 72-78.
2 Landi F, Liperotti R, Russo A. Sarcopenia as a risk factor for falls in the elderly. Clinical Nutrition 2012; 31(5):652-658.
3 Cruz-jentoft AJ, Bahat G, Bauer JM et al. Sarcopenia: definition and diagnosis of the revised European consensus. Age and aging. 2018; 0:1-16.
4 Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al. Sarcopenia: European consensus on definition and diagnosis. Report of the European Working Group on Sarcopenia in the Elderly. Age and aging 2010; 39(4):412-423.
5 Janssen I. Influence of sarcopenia on the development of physical disability. Cardiovascular Health Study. 2006; 54:56-62.
6 Brown JC, Harhay MN. Sarcopenia: Mortality among a sample based on the community-dwelling older adult population. Sarcopenia & Muscle Cachexia Journal 2016; 7(3): 290-298.
7 Iannuzzi-Sucich M, Prestwood KM, Kenny AM et al. Prevalence of sarcopenia and predictors of skeletal muscle mass in healthy older men and women. J. Geront. 2002; 57(12):M772-M777.
8 Robinson SM, Reginster JY, Rizzoli L et al. Does nutrition play a role in the prevention and management of sarcopenia. Clinical Nutrition 2018; 37(4): 1121-1132.
9 Bianchi L, Abete P, Bellelli G et al. Prevalence and clinical correlates of sarcopenia identified according to the EWGSOP2 definition and diagnostic algorithm in hospitalized elderly people. GLISTEN study. J. Geront. 2017; 72, 11:1575-1581.
10 Van Ancumm JM, Alcazar J, Meskers C. Impact of using the updated EWGSOP2 definition in the diagnosis of sarcopenia. A clinical perspective. Camber. Geront. 2020; 90:1041-1047.
11 Weigel P, Hockenberg JM et al. Longitudinal study of chiropractic use among older adults in the United States Chiroo. Osteopath. 2010; 18:34
12 Koppenhaver SL, Fritz JM, Hebert J. et al. Association between changes in abdominal and lumbar multifidus muscle thickness and clinical improvement after spinal manipulation. J. Ortho. & Spine therapy. 2011; 41(6):389-399.