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Myopathy refers to diseases that affect the muscles, leading to weakness, pain, or difficulty in movement. In older adults, myopathy is an important concern because it reduces independence, increases fall risk, and complicates daily care. Unlike arthritis or neurological disorders, myopathy directly involves the muscles, making mobility and strength the primary challenges.
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Prevalence of myopathy
Muscle weakness becomes more common with age. Studies show that up to 20–40% of older adults experience some form of muscle dysfunction, whether from chronic diseases, medications, or age-related muscle decline (sarcopenia). Myopathy is often underdiagnosed because its symptoms can mimic arthritis, stroke, or simple ageing.
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Types of myopathy
Inflammatory myopathies
Caused by immune system attacks on muscle tissue (e.g. polymyositis, dermatomyositis).Metabolic and endocrine-related myopathies
Linked to thyroid disorders, diabetes, or mitochondrial dysfunction.Drug-induced myopathy
Common in older adults taking multiple medications. Statins, glucocorticoids, alcohol, antimalarials, and antivirals can damage muscles, sometimes causing severe complications like rhabdomyolysis.Genetic myopathies
Less common in late life, but may persist from earlier onset conditions.Critical illness or disuse myopathy
Prolonged immobility, hospitalisation, or malnutrition weakens muscle structure.
Complications of myopathy
Myopathy in the elderly goes beyond muscle weakness. It can set off a chain of complications that affect independence, safety, and overall health. If left unrecognised, the consequences can be severe.
Falls and fractures
Weak muscles reduce balance and coordination, increasing fall risk.Loss of independence
Everyday tasks like climbing stairs, bathing, or even standing up become difficult.Increased frailty
Weaker muscles accelerate the decline into frailty, making recovery from illness or injury harder.Respiratory complications
Severe myopathy can affect breathing muscles, leading to breathing difficulties or infections.Medication risks
Continuing drugs that cause myopathy, such as statins, may worsen muscle damage if not addressed.
Signs and symptoms
Recognising myopathy early helps prevent complications. Symptoms vary but often include:
Gradual or sudden muscle weakness, especially in the shoulders, hips, and thighs
Muscle pain, cramps, or stiffness
Difficulty climbing stairs, rising from a chair, or lifting objects
Fatigue and reduced endurance
In severe cases, dark urine from muscle breakdown (myoglobinuria)
Treatments available
Treatment aims to reduce muscle damage, relieve symptoms, and restore function. Options depend on the type of myopathy:
Medication review
Stopping or adjusting drugs that trigger muscle damageMedications
Immunosuppressants or steroids for inflammatory myopathiesPhysical therapy
Strength training, balance exercises, and mobility aids to improve functionNutrition
Adequate protein and vitamin D to support muscle repairAcute care
Hospitalisation for rhabdomyolysis with intravenous fluids to protect the kidneys
How to prevent or delay onset of myopathy
Prevention is especially important in older adults, as even small declines in muscle strength can reduce independence. Strategies include:
Regular exercise
Engage in strength training at least twice a week and add walking, cycling, or swimming for endurance. Balance and flexibility exercises reduce fall risk.Adequate nutrition
Ensure daily protein intake (1.0–1.2 g per kg body weight) and include foods rich in vitamin D, calcium, and antioxidants. Supplements may be needed if dietary intake is insufficient.Medication monitoring
Request periodic medication reviews with doctors or pharmacists to identify drugs that can damage muscles, such as statins or long-term steroids.Chronic disease control
Manage conditions like diabetes, thyroid disease, and kidney problems, which can accelerate muscle loss.Avoid immobility
Prolonged bed rest or sedentary lifestyles accelerate muscle weakness. Encourage daily movement, even in small amounts, such as chair exercises or short walks.Fall prevention
Home modifications, vision checks, and proper footwear reduce the risk of injury if weakness develops.Regular health screening
Blood tests and functional assessments help detect early muscle changes before they become disabling.
Conclusion
Myopathy in older adults is not an inevitable part of ageing. It signals a problem that deserves attention and action. By recognising the warning signs early, adjusting medications, promoting daily movement, and supporting proper nutrition, we can delay progression and preserve independence. Protecting muscle health means protecting dignity, safety, and quality of life for older adults.
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