Sarcopenia: Name the disease and let the pill popping begin!
Sarcopenia: a mysterious disorder that causes people’s muscles to shrink away. 25%, 30%, even greater loss of strength… until the victim is struggling to make it up to the second floor bedroom. Would you undergo a treatment for this disorder if it was safe and effective? And do you think your insurance company should pay for such a treatment, if it were to become available?
What if I told you that sarcopenia is another word for “the way people’s muscles get smaller as they age”? That’s what sarcopenia is. Even if they stay active, 70 year olds and 80 year olds have smaller muscles than 30,40,50 year olds. Our muscles naturally atrophy as we age.
The question now is if this natural atrophy (dare I call it “natrophy”?) is a disease–whether it is a process that should be reversed by medications and other treatments if we can find a way to do so.
This is a profound and difficult question that I’m not going to answer today. Instead I’m going to comment on a related issue. It is this: if industry has any hope of making money treating sarcopenia, it’s very important they get the world to accept the word “sarcopenia.” If you want something to feel like a disease, give it a Latin sounding name.
If someone announced they were going to try to help older people stop losing muscle strength as they age, they probably wouldn’t get many members of the general public thinking that government research dollars should go to help them. They probably wouldn’t get people clamoring for their insurance company to cover any treatments for this problem. The public would say there are more important social issues for us to tackle, and better ways to spend scarce government resources.
But perceptions can change over time. Yesterday’s normal can become tomorrow’s disease. And it often starts with a name.
Sarcopenia. With all those Latin roots, the word convinces us that even if muscle loss is normal, it isnevertheless a sickness.
As a physician, I recognize that muscle weakness in aged populations leads to lots of problems. Older people fall. They become less mobile, which can lead to social isolation and misery. I would like older people to maintain more muscle strength if they could.
I also know, however, that much of this weakness could be avoided by regular exercise. Healthy older people, if they “use it” regularly– if they lift weights, do knee bends, take walks, etc– don’t “lose it” so much that they become immobile. My worry is that the word sarcopenia is going to lead to the medicalization of this normal aging process. The next step will be some wonder drug that causes yet more of our retirement dollars, and more of our society’s wealth, to get sucked up by the medical industrial complex. I worry that we’ll start popping pills instead of working out.
I would elaborate on my concerns, but I need to get to the gym!
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