As we age, we tend to lose muscle mass and muscle strength. This progressive muscle loss, known as sarcopenia, can begin as early as our forties, depending on several factors, including diet and physical activity.
Sarcopenia has been linked to an increased risk of physical disability, depression, debilitating falls, and death. With the aging of the population, the incidence of sarcopenia is expected to dramatically rise in the coming decades: more than 200 million cases are projected by 2050. As such, sarcopenia is a major global public health challenge.
“Sarcopenia can be considered for muscle what osteoporosis is to bone,” Dr. John E. Morley, geriatrician at Saint Louis University School of Medicine, wrote in the journal Family Practice. He pointed out that up to 13 percent of people in their 60s and as many as half of those in their 80s have sarcopenia.
As Dr. Jeremy D. Walston, geriatrician at Johns Hopkins University School of Medicine, put it, “Sarcopenia is one of the most important causes of functional decline and loss of independence in older adults.”
Yet few practicing physicians alert their older patients to this condition and tell them how to slow or reverse what is otherwise an inevitable decline that can seriously impair their physical and emotional well-being and ability to carry out the tasks of daily life. Sarcopenia is also associated with a number of chronic diseases, increasingly worse insulin resistance, fatigue, falls and, alas, death.
A decline in physical activity, common among older people, is only one reason sarcopenia happens. Other contributing factors include hormonal changes, chronic illness, body-wide inflammation and poor nutrition.
But — and this is a critically important “but” — no matter how old or out of shape you are, you can restore much of the strength you already lost. Dr. Moffat noted that research documenting the ability to reverse the losses of sarcopenia — even among nursing home residents in their 90s — has been in the medical literature for 30 years, and the time is long overdue to act on it.
In 1988, Walter R. Frontera and colleagues at the Department of Agriculture Human Nutrition Research Center on Aging at Tufts University demonstrated that 12 previously sedentary men aged 60 to 72 significantly increased their leg strength and muscle mass with a 12-week strength-training program three times a week.
Two years later in JAMA, Dr. Maria A. Fiatarone and colleagues at the Tufts research center reported that eight weeks of “high-intensity resistance training” significantly enhanced the physical abilities of nine frail nursing home residents aged 90 and older. Strength gains averaged 174 percent, mid-thigh muscle mass increased 9 percent and walking speed improved 48 percent.
So, what are you waiting for? If you’re currently sedentary or have a serious chronic illness, check first with your doctor. But as soon as you get the go-ahead, start a strength-training program using free weights, resistance bands or machines, preferably after taking a few lessons from a physical therapist or certified trainer.
Proper technique is critical to getting the desired results without incurring an injury. It’s very important to start at the appropriate level of resistance. Whether using free weights, machines, bands or tubes, Dr. Moffat offers these guidelines:
“Start with two repetitions and, using correct form through the full range of motion, lift slowly and lower slowly. Stop and ask yourself how hard you think you are working: ‘fairly light,’ ‘somewhat hard’ or ‘hard.’ If you respond ‘fairly light,’ increase the weight slightly, repeat the two reps and ask yourself the same question. If you respond ‘hard,’ lower the weight slightly and do two reps again, asking the question again.
“If you respond truthfully ‘somewhat hard,’ you are at the correct weight or machine setting to be exercising at a level that most people can do safely and effectively to strengthen muscles. Continue exercising with that weight or machine setting and you should fatigue after eight to 12 reps.”
Of course, as the weight levels you’re working at become easier, you should increase them gradually or increase the number of repetitions until you fatigue. Strength-training will not only make you stronger, it may also enhance bone density.
The fact that you may regularly run, walk, play tennis or ride a bike is not adequate to prevent an incremental loss of muscle mass and strength even in the muscles you’re using as well as those not adequately stressed by your usual activity. Strengthening all your skeletal muscles, not just the neglected ones, just may keep you from landing in the emergency room or nursing home after a fall.