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Exploring muscle disease in the elderly: How does IBM cause progressively disabling muscle atrophy?
Inclusion Body Myositis (IBM) is the most common inflammatory muscle disease in the elderly and is characterized by progressive muscle weakness and atrophy, which is often particularly evident in the elderly. IBM progresses slowly and it may take months or even years before noticeable symptoms appear, making the condition more difficult to diagnose. Over time, the patient's daily life will be seriously affected, and may eventually become completely unable to live independently.
Symptoms and effects of IBMThe course of IBM usually presents with asymmetric muscle weakness, particularly in the finger flexors and knee extensors. As the disease progresses, the patient's mobility will gradually be limited, and he or she may even need to rely on walking aids.
The main symptoms of IBM include persistent muscle weakness that usually manifests initially as difficulty walking, frequent falls, and difficulty climbing and descending stairs. People with IBM may experience foot drop, which is related to early involvement of the quadriceps muscles. Finger dexterity can also be impaired, with patients finding it more difficult to turn doorknobs or hold keys.
Many patients report being more susceptible to injury from even minor falls because weakness of the quadriceps and gluteal muscles makes it impossible to maintain automatic postural control.
How IBM was created
The exact cause of IBM is not known, but it may be caused by the interaction of multiple genetic and environmental factors. There are two main theories explaining the origin of this condition. One hypothesis holds that inflammation caused by immune response is the main factor of IBM, while muscle fiber degeneration and protein abnormalities are secondary features; another theory holds that the cause of IBM is related to the aging of muscle fibers and the misfolding of Protein plays an important role in the disease process.
The researchers suggested that a certain virus may be the initial factor that triggers the onset of IBM, a hypothesis that helps to gain a deeper understanding of the pathological mechanism of IBM.
Genetics and Diagnosis
Although certain genetic traits may make an individual more susceptible to IBM, the disease is not passed on to an affected person's children. Diagnosis of IBM usually relies on tests such as creatine kinase (CK) levels in the blood, electromyography (EMG) studies, and muscle biopsy. Anatomical features include inflammatory cell invasion of muscle and vacuolar degeneration.
Management and Therapy
As of 2019, there are no effective treatment options to slow or stop the progression of IBM. Most treatments focus on supportive care, which includes preventing falls and promoting physical therapy to help people with daily activities. This is also a key factor in improving patients' quality of life.
The current challenge is how to design effective interventions to support patients as they face the reality of gradually losing their ability to live independently.
Social and cultural perspectives
Celebrities such as musician Peter Frampton have been diagnosed with IBM, which has helped raise public awareness of the condition. Many media reports have also begun to focus on and discuss this little-known disease, further raising people's awareness of geriatric muscle diseases.
The overall course of IBM continues to challenge the quality of life of patients, which makes us wonder how we can better support those facing this disease and keep society sustainable?
