The Aging Male

The life expectancy for males in the United States is 76 years. However, this can be extended by a program of self-care to establish health and longevity. Common issues as men age include Sarcopenia (loss of muscle mass) and frailty, Diabetes, Dementia and Depression, Hypertension and Hypercholesterolemia, Prostate problems, Osteoporosis and loss of Libido/Erectile Dysfunction. Most of these issues and the problems that ensue are preventable.

 

Sarcopenia is the age related loss of muscle mass, muscle function and muscle quality. Men lose muscle mass at a rate of 1% per year starting at age 30, and occurs in 53% of men over the age of eighty. The loss of muscle mass is related to the loss of testosterone that occurs with andropause. Other hormonal losses, such as decreased DHEA levels, decreased estrogen, decreased Vitamin D and decreased growth hormone also contribute to sarcopenia. Nutritional deficiencies, decreased protein intake, decreased physical activity and peripheral vascular disease can contribute to loss of muscle mass.

 

Sarcopenia is a precursor to developing disability. Studies confirm that in patients with sarcopenia there is a fourfold increase in the risk of disability in at least some of the activities of daily living, and a threefold increase in the risk of having a balance disorder. There is also a twofold greater likelihood of having to use a cain or walker. Similar studies show that low muscle strength was a predictor of mortality in older adults. If adults exercise they will have an increase in muscle strength and an improvement in balance. So the treatment of sarcopenia involves resistance exercise training, hormone replacement and nutritional support. Progressive resistance training 2-3 times per week has been shown to improve physical function and disability, muscle weakness, balance and activities of daily living.

 

Hormone replacement including Vitamin D, Testosterone, DHEA and Growth Hormone should be considered in the adult male with severe sarcopenia and frailty. Vitamin D can improve muscle strength, reduce falls and prevent fractures. Testosterone will increase lean body mass and decrease fat. However some trials show little if any improvement in muscle strength. DHEA replacement shows conflicting results as to whether it helps muscle mass and strength and studies have shown that Growth Hormone replacement increases muscle mass.

 

Nutritional support and supplementation with high protein meals and amino acid therapy can help with sarcopenia but additional studies are needed. The point here is to start to care for your body before these changes take over your body. Sarcopenia can be preventable with good nutrition, supplementation and a steady exercise program. Your well-being depends upon this.

 

A second issue in the aging male is diabetes, typically nutritional or type 2 diabetes mellitus. Men who are older with diabetes are more prone to falling and more fractures. High blood sugar levels also increase pain perception as glucose blocks the ability of endorphins to reduce pain. Patients with diabetes also see their general health decline more rapidly than older people without the disease due to peripheral neuropathy, decreased vision, depression and dementia. dementia is worsened by elevated blood sugar.

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