Some context for my question: A 97 year old male with a variety of health issues (including at least mild heart problems, COPD and CKD), described by all medical professionals who see him as in excellent health for his age, who is frail and needs a walker and who can get up from a chair using his arms. The relevant medical professionals include internal medicine / geriatrics, cardiology, RNs, a nurse practitioner, registered dietitians and various PTs. None of them seem very interested in research generally, except the cardiologist who frequently notes that there’s essentially no good research on people in their 90s.
I agree that “counter” is not an appropriate attitude and I regretted using that word as soon as I hit post. I try not to be at all argumentative with his healthcare professionals.
I’ve found various research papers, but fear that if I send people many research papers they will ignore them. A limited number of papers that are likely to be helpful with this audience would be appreciated.
Regarding sarcopenia generally, the research I’ve seen, including what I’ve read from Austin’s video, has shown an association between sarcopenia and adverse outcomes, rather than causation. For example, the Kraschnewski study mentioned is titled “Is strength training associated with mortality benefits” (emphasis added). The mindset of the various caregivers has been that it’s associated because underlying issues cause both muscle loss and bad outcomes, rather than muscle loss causing problems, and that muscle loss is to be expected in the elderly. His doctors and nurses just refer to PTs, none of whom have been interested in pursing strength training. Perhaps the APTA Choosing Wisely guidelines would help, although PTs are among those who stress association over causation and guideline 2 uses the work “associated”. Choosing Wisely: An Initiative of the ABIM Foundation
The EWGSOP guidelines Sarcopenia: European consensus on definition and diagnosisA. J. Cruz-Gentoft et al. | Age and Ageing | Oxford Academic (which I had not been familiar with) also seem helpful, although I’m not sure that they are enough to overcome the association, not causation, mindset, combined with a general reluctance to purse strength training (even of the get up from a chair exercise Austin recommends). Perhaps this is due to unfamiliarity and unwillingness to do things outside their normal practice.
On diet, the universal view of his caregivers is that maintaining weight is enough, despite decreased caloric intake and obvious muscle loss. In addition, his diet comports with the RDA guidelines and he has mild CKD (plus one episode of acute kidney failure from dehydration). In the video, Austin recommends balancing the risks of sarcopenia against the risks of too much protein for those who have CKS, which I find to be a good argument but which obviously is not published research.
Apologies if I’ve missed something in the materials or misread the research. I’d be more than happy to be corrected.