Protein Metabolism in the Elderly

Hidden Threat During Quarantine and Transition Phase in Elderly: The Need for Special Precautions

“…Although primary aging contributes to muscle mass; nutrient intake, hormonal balance, physical activity, and the presence of trauma/injury has also been shown to influence the rate of muscle mass loss. 17 Kehler et al 18 showed that not all elderly suffer frailty, some are strong and healthy, and surprisingly frailty can also be found in young people.…”

“…19 Induced by stress, the release of pro-inflammatory cytokines and cortisol trigger catabolism state. 17 Second, the limitation of activity in quarantine will increase the sedentary time. Study shows that reduction in short-term physical activity (14 days) from 10.000 to 1.500 steps/day can significantly affect lower limb lean mass and increase visceral fat, with highlights also impairs insulin sensitivity and dyslipidemia.20 Insulin resistance impairs muscle synthesis as insulin is an anabolic hormone involved in the primary protein synthesis pathway, the mammalian target of rapamycin (mTOR) pathway, through the insulin / PI3K / Akt signaling.…”

“…Study shows that reduction in short-term physical activity (14 days) from 10.000 to 1.500 steps/day can significantly affect lower limb lean mass and increase visceral fat, with highlights also impairs insulin sensitivity and dyslipidemia.20 Insulin resistance impairs muscle synthesis as insulin is an anabolic hormone involved in the primary protein synthesis pathway, the mammalian target of rapamycin (mTOR) pathway, through the insulin / PI3K / Akt signaling. 17 In addition to body composition, step reduction also increases pro-inflammatory cytokines: TNF-α and C-reactive protein, by approximately 12% and 25% respectively, and reduced myofibrillar protein synthesis by approximately 26%, which would enhance protein degradation. 21 Third, physiologically, anabolic resistance and cellular dysfunction occur due to the build-up of reactive oxygen species in the elderly.…”

“…The rate of muscle protein synthesis that cannot keep up with the rate of protein degradation will result in loss of muscle mass and strength. 17 Muscle loss is approximately 8% per decade from 40 to 70 years, and increases to 15% per decade after this. 22 Moreover, nutrient intake in elderly is usually inadequate due to decreased appetite, decreased sensory function, tooth disorders, and cognitive impairment.…”

“…25 Lastly, the pressures of other health problems or comorbidities also influence the metabolism that leads to the catabolic state or induces anorexia. 17 Hence, additional health measures should be done as precautions to slow the progression of frailty in elderly. Boreskie et al 26 summarized some of the efforts that can be made as "SAVE" (Socialization, Adequate nutrition, Vitamin D, and Exercise).…”