Loss of strength as we age, and training muscular strength and power is something I deal with on a daily basis. I want to discuss solving this problem of muscular strength in older adults. It is growing, especially in the midst of a worldwide pandemic. Loss of muscular strength or what is medically described as Sarcopenia is a problem and should be a priority of all health and fitness professionals.
Functional longevity is important to all of us and is driven by many things. A holistic approach to living a long and functional life should include emotional, social, mental, and spiritual aspects in addition to the physical. I’m specifically addressing the physical aspect of aging because that is what I know.
WHAT GROUP ARE YOU IN?
Professionals who work with older adults often describe them as belonging to one of two categories based on the individual’s functional level. The health and fitness professional will choose an approach and develop a plan based on these categories.
The first category, are those considered actively aging. They are typically pretty functional with their daily activities and lifestyle. They may have fair to excellent strength, mobility, and level of function. They exercise, play sports, can travel with little difficulty, and can manage most physical limitations or medical issues they may have. Older adults in this active aging group can be as old as 90 years of age and even above.
The second category of older adults is frail individuals. They have poor strength and mobility. They may need a cane or walker to ambulate or frequently use a wheelchair. They may have significant limitations with daily function, are high-risk fallers, and often times live with a caregiver or in a skilled nursing home. Loss of muscular strength, power, and mobility contribute to older adults becoming frail.
Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, and it is strictly correlated with a physical disability, poor quality of life, and death. It is an age-associated muscle degeneration that becomes more common in people over the age of 50. However, its severity is variable and can be prevented!
CHANGES AS WE AGE
It is reported that strength declines in sedentary adults at a rate of about 1% per year beginning in their 50’s and then accelerates to approximately 3% per year once they reach their 70’s.
It’s important to note that declines in muscular performance have been primarily attributed to the loss of muscle mass, as a result of the aging process or lack of use. The average individual will lose approximately 40% of their muscle mass between the ages of 20 and 70 with a slightly greater loss in the lower extremities compared to the upper extremities.
It is estimated that anywhere from 22-53% of the older adult population will develop sarcopenia. This loss of muscle mass is a risk factor for the development of disability, however, other factors associated with aging also contribute to decreased function and disability.
One of these factors is the ability to coordinate muscular activity into functional movements. This also declines as we age. Significant declines in functional tasks such as putting on a shirt, managing large and small buttons, zipping a garment, or participating in sports. This decline in coordinated muscular activity may contribute to poor balance and an increased risk of falling.
Muscular power, the ability to produce force over a short period of time, and muscular endurance, the ability to maintain muscular performance over a longer period of time, also decline as we age. So, addressing power and endurance is an important part of your strength training program.
Bone density declines at a rate of approximately 1% per year from age 40-50 for both men and women. In women, bone loss increases to 2-3% per year during and 5-10 years following menopause. Women often lose up to 1/3 of their bone mineral density (BMD) during this time. Strength training is shown to slow the loss of bone density in some cases.
Maximal aerobic capacity, as measured by maximum oxygen consumption (VO- 2max), decreases with advancing age at a rate of about 30-40% per decade. This decrease is due to several factors including reductions in heart and lung function, as well as circulation.
When considering these physiological declines, it is important to recognize and appreciate the variability that exists among individuals. With a proper functional exercise plan, these changes can be slowed or prevented.
IT’S NOT TOO LATE TO MAKE CHANGES
The most basic key to achieving functional longevity is human movement. We were created to move and we should be moving naturally every day. Natural or functional movements are those things we do in order to accomplish a task or to provide enjoyment. Lifting, bending, stooping, walking, running, carrying, pushing, pulling, jumping, skipping, hopping, squatting, throwing, catching, crawling, climbing, rolling, somersaulting…these are natural movements that we have been doing since we were a little kid.
So, most of us have to purposefully build physical activity into our day. This can easily be accomplished if it is important to us. The best advice is to quit sitting so much and start moving more.
Here is a summary of some things we can do to help slow our loss of function as we age:
- Walk the dog
- Wash your car by hand
- Do your own yard work
- Play with kids (they keep you young)
- Garden
- Take lots of short walks
- Take the stairs whenever you can
- Park at the back of parking lots
- Ride a bike
- Play a sport
- Take a hike
- Make ice cream (with a hand crank)
- Dance
- Play a musical instrument
- Yoga
- Strength Training
- Muscular Power Training
- Muscular Endurance Training
Since the focus of this article is on the loss of muscle mass and how it contributes to decreased function and disability I want to finish with suggestions regarding strength, endurance, and power training. All of these suggestions will be dependent upon your current level of fitness and function, therefore working with a fitness professional with experience in training older adults can be very helpful.
As described, strength in older adults is very important for maintaining a certain level of muscle mass. Strength training should be part of your overall exercise program 2-3 times a week. If capable, your exercise choices should be functional in nature and include power and endurance.
When I mean functional, I’m referring to strength training while standing using dumbbells, cables, tubing, or body weight. This is much better than sitting on a non-functional weight machine. It engages your nervous system, stabilization system, and skeletal system in addition to training your muscles.
When strength training, make sure to use load/resistance, perform 3-4 sets of 10 repetitions, and try to progress by increasing the resistance on a regular basis. To build strength, and prevent sarcopenia your muscles need to be challenged.
For developing power, you need to add the component of speed to the exercise. For example, to work on leg power you can stand up from a chair or perform a step up, but do it faster. Make sure to stay under control but try it faster than normal and even hold a little weight.
Endurance training is simply to perform an exercise with lower resistance and complete a number of sets at high repetitions such as 4 sets of 20 reps.
Maintaining strength and muscle mass as we age is very important. It is a major factor in disability in our later years. I see a lot of individuals who focus only on cardiovascular training and skip strength training. Please change. I hope this article gives you a better understanding of how to have a more well-rounded fitness program.