Ageing expert helps physios target loss of muscle mass in older people

Glasgow Caledonian University Professor in Ageing and Health Dawn Skelton has published a new research paper which provides guidance for prescribing and delivering resistance exercise to older people living with sarcopenia.

Sarcopenia is the loss of skeletal muscle mass and function over and above ageing loss and it affects 25% of people under the age of 70 years and 40% of those over the age of 80 years.

Professor Skelton, from the Research Centre for Health (ReaCH) Ageing Well research group, was part of a wider team working in collaboration with AGILE (Chartered Society of Physiotherapy) and the British Geriatric Society Sarcopenia and Frailty Special Interest Group.

Resistance exercise is a first-line treatment for sarcopenia and until now the optimal exercise prescription remained unknown. The new paper is a ‘how to’ guide for physiotherapists.

Professor Skelton said: “I have been involved with the same group doing an audit of frailty and sarcopenia services across the UK to see what they offer in terms of rehabilitation.

“We were shocked at how small a number were actually doing any form of exercise rehab, even though that’s the best evidence for sarcopenia.

“Exercise has a huge evidence base for frailer older people, but they are really hard to engage in exercise as they tire easily and have often feel poorly and unmotivated. You have to build up a relationship and understanding with them about why they need to work the muscles and why it’s a good thing and will help them live independently and get out and about more easily.

“This piece of research isn’t a normal systematic review of the evidence. The resistance exercise prescription outlined in the paper will help physiotherapists understand how best to work with these patients and how it will make a big difference to their patients’ lives if they aim for the best prescription.”

Published in Age and Ageing, a leading international journal of clinical ageing research, the paper ‘Resistance exercise as a treatment for sarcopenia: prescription and delivery’ was viewed over 1800 times in the first week of publication.

Last year Professor Skelton was one of the experts who predicted that the number of falls among older adults would increase due to a decline in balance and muscle strength caused by inactivity during the first lockdown.

The report ‘Wider Impacts of COVID-19 on Physical Activity, Deconditioning and Falls in Older Adults’ was published by Public Health England last August.

Professor Skelton is a member of the National Falls Prevention Coordination Group (NFPCG) and was on the advisory group for the report, giving her guidance and advice throughout.

The report predicted that 110,000 more older people (an increase of 3.9%) were likely to have at least one fall per year as a result of reduced strength and balance activity during the pandemic, with a cost of £211 million to the health and social care system.

She said: “We predicted an increased number of falls just from first three months of lockdown - and now we have had nearly two years of social restrictions, meaning lunch clubs and other community venues have not been open for older people so their incidental activity is still well below pre-pandemic levels.

“I’ve just read the AGE UK third wave survey where there is feedback about access to frailty and fall services and most of them are still not up and running, and people are falling left, right and centre.

“Some who needed hips replaced two years ago are chair bound and not moving at all now. It’s grim reading. It’s really scary to think what is going to happen with the older population in the future. They have been badly hit by COVID-19 virus and social restrictions, and they are still baring the brunt of it.”