Cachexia, sarcopenia and muscle loss

Sarcopenia is a gradual decline in muscle strength and mass, often associated with ageing or reduced activity. Cachexia is a complex wasting syndrome linked to an underlying illness and may involve unplanned weight loss, reduced appetite and metabolic changes. A person can have features of both.

Muscle strength, physical performance and changes in body composition help clinicians assess sarcopenia. Cachexia cannot be explained by eating less alone: inflammation and altered metabolism can make it difficult to maintain muscle even when nutritional intake improves.

Either problem may make rising from a chair, carrying groceries, climbing stairs or walking steadily more difficult. Sarcopenia commonly presents with weakness and declining physical function; these features can also occur for many other reasons, including pain, nerve problems, medication effects and prolonged inactivity.

Arrange a medical assessment for unexplained weight loss, persistent weakness or a clear drop in everyday ability. The review may cover appetite, recent illness, medicines, falls and conditions affecting the heart, lungs, nerves or digestion. A clinician may assess walking speed, grip or chair-rise ability and decide whether blood tests or other investigations are appropriate.

Management is tailored to the cause. For sarcopenia, supervised resistance and balance work can help rebuild useful capacity, with nutrition support when intake is inadequate. Cachexia care also focuses on treating the underlying illness and easing symptoms that interfere with eating or activity. Exercise should start at a level that is safe for the person's current health rather than pushing through severe fatigue.

Seek prompt medical advice if muscle loss is accompanied by continuing unplanned weight loss, marked loss of appetite, repeated falls, worsening difficulty walking or inability to manage usual self-care. Sudden weakness on one side, new facial droop, trouble speaking, severe breathlessness, chest pain or collapse needs emergency care.

Ask what may be driving the muscle change, whether your medicines or another health condition could contribute, and how your strength and progress will be measured. You can also ask for an activity plan matched to your fall risk, pain and energy, plus advice from a dietitian if eating enough is difficult.