肌少症：不只是老化！ Sarcopenia: More Than Just Aging!

認識偷走你力氣的「肌肉流失症」 Understanding the “Muscle Loss Disease” That Steals Your Strength

第一章：肌少症有多可怕？從跌倒、骨折到死亡風險增加 Chapter 1: How Dangerous is Sarcopenia? From Falls and Fractures to Increased Mortality Risk

肌少症的危害遠超乎你的想像，它會引發一系列連鎖反應： The dangers of sarcopenia are far greater than you might imagine, triggering a chain reaction of health problems:

• 增加跌倒與骨折風險：肌力不足，平衡感變差，一不小心就容易跌倒。如果同時有骨質疏鬆，後果不堪設想。 Increased risk of falls and fractures: Insufficient muscle strength and poor balance make falls more likely. If you also have osteoporosis, the consequences can be dire.
• 失能與失去獨立性：走路變慢、從椅子上站不起來、提不動重物，漸漸地，連洗澡、穿衣都需要人幫忙。 Disability and loss of independence: Slow walking speed, inability to stand up from a chair, and difficulty lifting heavy objects gradually lead to needing assistance with daily tasks like bathing and dressing.
• 引發代謝疾病：肌肉是消耗血糖的主要器官，肌肉量不足會增加罹患第二型糖尿病的風險。 Triggers metabolic diseases: Muscle is a primary organ for glucose consumption. Insufficient muscle mass increases the risk of developing type 2 diabetes.
• 死亡風險顯著增加：研究證實，肌少症患者的死亡風險比一般人高出2到3倍！ Significantly increased mortality risk: Studies show that people with sarcopenia have a 2 to 3 times higher risk of death than the general population!

當肌少症、骨質疏鬆症、衰弱症這「危險三重奏」同時出現時，對健康的威脅將會加乘放大。 When the “dangerous trio” of sarcopenia, osteoporosis, and frailty appear together, the threat to health is magnified.

第二章：我有肌少症嗎？三步驟自我檢測與醫師診斷 Chapter 2: Do I Have Sarcopenia? A Three-Step Self-Assessment and Medical Diagnosis

根據「亞洲肌少症工作小組」的最新指引，我們可以透過簡單的三個步驟來評估肌少症。 According to the latest guidelines from the Asian Working Group for Sarcopenia, you can assess for sarcopenia in three simple steps.

第一步：簡易篩檢 (在家就能做！) Step 1: Simple Screening (You can do this at home!)

• 小腿圍測量：坐姿，測量小腿最粗處的周長。若男性 < 34公分，女性 < 33公分，就要警惕！ Calf circumference measurement: While sitting, measure the circumference of your calf at its largest point. If it’s < 34 cm for men or < 33 cm for women, be alert!
• 手指環圈測試：用雙手的拇指和食指，圈住非慣用腳的小腿肚最粗的地方。如果圈起來還有空隙，就代表肌肉量可能不足。 Finger circle test: Use the thumb and index finger of both hands to make a circle around the thickest part of your non-dominant calf. If there’s a gap, it may indicate insufficient muscle mass.
• SARC-F 問卷：問自己五個問題（提重物、行走、起身、爬樓梯、跌倒史），總分若 ≥ 4分，就建議尋求專業評估。 SARC-F questionnaire: Ask yourself five questions (lifting, walking, rising from a chair, climbing stairs, fall history). If your total score is ≥ 4, it is recommended to seek a professional assessment.

第二步：評估肌力與體能 Step 2: Assessing Muscle Strength and Physical Performance

如果初步篩檢發現異常，醫師會進一步做客觀的功能性測量： If the initial screening reveals abnormalities, a doctor will perform further objective functional measurements:

• 手部握力：男性 < 28公斤；女性 < 18公斤，代表肌力不足。 Handgrip strength: < 28 kg for men; < 18 kg for women indicates insufficient muscle strength.
• 五次起立坐下測試：從椅子上連續起立坐下五次，若時間 ≥ 12秒，代表體能表現不佳。 Five-times sit-to-stand test: If it takes ≥ 12 seconds to stand up and sit down five times from a chair, it indicates poor physical performance.
• 步行速度：走路速度若 < 1.0公尺/秒，代表體能表現不佳。 Walking speed: A walking speed of < 1.0 m/s indicates poor physical performance.

只要以上任一項不達標，就會被診斷為「可能肌少症」，這時就應該開始積極介入了！ If any of the above criteria are not met, you will be diagnosed with “probable sarcopenia”, and active intervention should begin!

第三步：測量肌肉質量 (確診) Step 3: Measuring Muscle Mass (for definitive diagnosis)

要最終「確診」，需要透過儀器測量肌肉量。 To get a final, “definitive diagnosis,” muscle mass must be measured using a machine.

• 雙能量X光吸收儀 (DXA)：這是測量肌肉量的黃金標準，快速且輻射劑量極低。 Dual-energy X-ray absorptiometry (DXA): This is the gold standard for measuring muscle mass, and it’s fast with a very low radiation dose.
• 生物電阻抗分析法 (BIA)：常見於健身房和健檢中心，方便快速，但準確度較易受身體含水狀態影響。 Bioelectrical impedance analysis (BIA): Commonly found in gyms and health checkup centers, it’s quick and convenient, but its accuracy is easily affected by the body’s hydration status.

若測出肌肉量不足，再加上第二步的任一項異常，即可「確診肌少症」。如果三項指標（肌肉量、肌力、體能表現）都不足，則為「嚴重肌少症」。 If insufficient muscle mass is measured and combined with any abnormality from Step 2, you will receive a “definitive diagnosis of sarcopenia”. If all three indicators (muscle mass, strength, and physical performance) are insufficient, it is classified as “severe sarcopenia”.

第三章：逆轉肌少症！最重要的兩大支柱：營養與運動 Chapter 3: Reversing Sarcopenia! The Two Most Important Pillars: Nutrition and Exercise

營養策略：吃足「原料」 Nutrition Strategy: Eat Enough “Raw Materials”

• 足量優質蛋白質：這是肌肉的「磚塊」。中老年人的目標是每日攝取每公斤體重1.2至1.5公克的蛋白質。簡單來說，就是確保三餐都要吃到一個手掌大小的優質蛋白質（如豆製品、魚、肉、蛋、奶）。 Sufficient high-quality protein: This is the “building block” of muscle. The goal for middle-aged and older adults is a daily intake of 1.2 to 1.5 grams of protein per kilogram of body weight. In simple terms, this means making sure you eat a palm-sized portion of high-quality protein (like soy products, fish, meat, eggs, or dairy) with each meal.
• 維生素D：不只對骨骼好，也直接影響肌肉功能。建議每日補充800-1000國際單位(IU)，並多曬太陽。 Vitamin D: Not only is it good for your bones, but it also directly affects muscle function. A daily supplement of 800-1000 International Units (IU) is recommended, along with getting more sun exposure.

運動處方：給予「成長信號」 Exercise Prescription: Providing “Growth Signals”

理想的運動計畫應包含三大元素： An ideal exercise program should include three main components:

第四章：結論：投資肌肉，就是投資一個獨立自主的未來 Chapter 4: Conclusion: Investing in Muscle is Investing in an Independent Future

肌少症不是無法避免的老化宿命，而是一個可以明確診斷、積極干預的臨床疾病。 Sarcopenia is not an unavoidable fate of aging but a clinical disease that can be clearly diagnosed and actively intervened.