Sarcopenia (muscle loss ) in Patients with Parkinson’s Disease

[Farooqji]

mdpi.com/1660-4601/16/24/4884

[Boscoejean]

Here in lies the problem- the recommendations on sarcopenia are increased protein which of course can be problematic for someone taking Parkinson medication

"To effectively deal with sarcopenia in Parkinson's disease, a combination of resistance exercise training, a high-protein diet, and potentially nutritional supplements is recommended, with the goal of improving muscle strength and mass.

Here's a more detailed explanation:

1. Resistance Exercise Training:

Importance: Progressive resistance-based strength training is crucial for improving muscle strength and potentially reversing muscle loss.

Types: Include both upper and lower body exercises.

Frequency: Aim for 2 sessions per week of progressive resistance exercise.

Benefits: Resistance training is beneficial for osteoporosis, which is increased in Parkinson's disease.

Combine with other exercises: Include aerobic exercise (potentially HIIT), and balance and neuromotor exercises (posture, gait, balance, and agility).

2. Nutrition:

High-Protein Diet: Ensure adequate protein intake, especially leucine-rich protein, as it's important for muscle building and repair.

Nutritional Supplements: Consider supplements like whey protein, leucine, and vitamin D, as they may enhance lean body mass and muscle function.

Hydration: Adequate hydration is also important.

3. Early Assessment and Intervention:

Importance: Early diagnosis and intervention are crucial to prevent functional decline in Parkinson's patients with sarcopenia.

Assessment: Regularly assess body composition, muscle mass, and muscle strength.

Screening tools: Consider using screening tools like SARC-F, but be aware of their applicability in PD patients.

4. Other Considerations:

Sarcopenia and Parkinson's Disease:

Sarcopenia and Parkinson's disease share common pathways, and sarcopenia may affect the prognosis and quality of life of patients with Parkinson's.

No pharmacological treatment:

There are currently no medications approved for the treatment of sarcopenia.

Personalized Approach:

The best approach for managing sarcopenia in Parkinson's disease may vary depending on the individual's needs and circumstances, so it's important to work with a healthcare professional to develop a personalized plan. "

"Egg white protein can be beneficial in combating sarcopenia, the age-related loss of muscle mass and strength, by providing a high-quality protein source that stimulates muscle protein synthesis and supports overall muscle health. "

[pearlette in reply to Boscoejean]

Can be done if you start small

Most of us have reduced physical activity in the period leading up to diagnosis.

Then you are scared to move, fall etc

Then you often start restricting protein without often needing to ( some people need to reduce in certain meals but the majority do not)

You also have muscle fibres which may be stretching and shortening abnormally regardless of dopamine (L- dopa) supplementation.

It means you have to start slow with small increments (as if you were 10 -20 years older and without Parkinsons)

-Worth investing in simple balance exercises (even sitting ones to teach your brain how to cope).

-Increase your calorie intake first with healthy non processed carbs, good fats and small increases in protein anywhere you can adjust. (Examples: a good source of leucine : chick peas will tick all 3 boxes);most calorie restricted diets make you lose some muscle mass too.

-Feel free to add any energy improving strategy that has worked for you (thiamine B1, vitamin D3, anything you believe helps your mitochondria);optional ! but happy to read that red grapes help too.

-Keep moving regularly ( even on days you just cannot exercise; functional stuff like bending to pick up something off the floor, reaching out for a book off a higher shelf when still seated if you cant stand safely) ; carrying your own grocery shopping even if it means more frequent trips. Any exercise stimulates muscle to develop.

The last 4 points helped me preserved some strength , the more targeted attempt at resistance training which I started this February is far more difficult and I have had to slow down the volume and pace much more than I expected.

I now know that what I expected to achieve in 3 months may take 9 months but it increments exponentially ; the more I do , the results show more consistently. But breaks are important too.

[pearlette in reply to Boscoejean]

The reality is that most of us have probably gone down in our level of physical activity as we move towards the point of diagnosis and even accepting that exercise is actually effective at doing something good for the disease .

So it will mean :

slow starts of really small amount of resistance exercise

requiring small increases of protein and more importantly calories; you don't absorb very well

change of mindset

I recently restarted my attempts to improve my muscle mass and strength; last attempt was in Mar 2023 was sabotaged after what seemed like a minor sprain of some little back muscle which remained dystonic almost continuously.

I had noticed the decreased muscle mass (in my limbs) but did not realise how much my strength had deteriorated.

With the right amount of dopamine I progressed reasonably well in the first 3 weeks, one session a week with a trainer. Then I had a total meltdown ; my thigh muscles went into a state of "clonus

[Boscoejean in reply to pearlette]

I have read accounts of taking some dopamine prior to the exercise

[pearlette in reply to Boscoejean]

Yes the accepted evidence is that you have enough dopamine to keep you "on".Many report needing a little more

L - Dopa when they increase their levels of physical activity.

[Boscoejean in reply to pearlette]

makes sense