Muscle Weakness with Age: What’s Normal and What Can Be Done About It

By Erica Harrison for Seniors Matter.

It always happens when you least expect it—that slight teeter, the little wobble or upright sway that indicates a general state of unsteadiness in your loved one. Or, perhaps it happened in a big way, and your loved one had a fall.

Regardless, generalized muscle weakness, unsteady gait, and falling or instability all point to one thing: sarcopenia.

The progressive loss of muscle mass and decrease of muscle strength, sarcopenia can result in a decline in functional capacity and possibly the loss of the ability to complete activities of daily living.  

As you might imagine, the primary signs and symptoms of sarcopenia are loss of strength and stamina, but others include: 

• Self-reported muscle loss
• Difficulty performing normal daily activities
• Unintentional weight loss
• Falling or instability
• Slow walking speed

If you notice these signs and symptoms in your loved one, it’s time to speak to their health care team about sarcopenia.

Why Sarcopenia Prevention is Important for Older Adults

Falls and fractures are the most prominent implications of sarcopenia for older adults, making timely diagnosis and treatment critical. Muscle weakness, the hallmark characteristic of sarcopenia, is the leading cause of falls in older adults.

In addition, sarcopenia and osteoporosis are closely linked from the molecular point of view (i.e., fat infiltration and alterations in stem cell differentiation), which leads to an increased risk of fractures.

And new research shows that sarcopenia can also lead to dysphagia and gastric cancer, as well as negative outcomes from surgery, such as a prolonged absence of bowel movements (postoperative ileus) and postoperative pneumonia.

Risk Factors for Sarcopenia

You can’t do anything about some of the risk factors for age-related sarcopenia – such as  age and gender – but others can be influenced to alter (and possibly reverse) the course of the disease.

Aging is the primary risk factor for sarcopenia. Muscle mass starts decreasing in our 50s at an annual rate of 1-2%. If unabated, it accelerates from there, increasing to 15% per decade beyond the age of 70.

Men are more at risk for sarcopenia than women, with research showing a 13-fold increased risk in males. 

Although there’s not much to be done about age and sex, regular exercise can postpone, slow and even reverse the damage caused by sarcopenia. 

Exercise to Prevent Muscle Loss in Aging

Aerobic Activity and Sarcopenia

Aerobic activity is any activity that gets the heart and lungs pumping, like walking, running, using an elliptical trainer and cycling, etc. Aerobic exercise – even just moderate-intensity activity – has been found to prevent or delay the onset of sarcopenia by blocking the destructive cellular processes within the muscles.

According to SeniorsMatter subject matter expert Emily Johnson, founder and director of StrongerU Senior Fitness, your loved one should work toward completing 150 minutes of moderate to vigorous aerobic activity per week in bouts of 10 minutes or more. 

Walking is the best way to achieve this guideline, Johnson said, who recommends walking at a moderate to vigorous pace. Your loved one should feel like they’re working at a five to seven on a scale from one to 10.

One study showed that only three months of Nordic walking training (i.e., walking with poles) strengthened the knees of older adults, improving their functional performance and their mobility, and had a positive impact on levels of sarcopenia.

Resistance Training for Sarcopenia

Regardless of age, progressive resistance training increases muscle mass and improves muscle physiology, and countless studies have concluded it’s an effective intervention for sarcopenia. 

However, recent research finds that eccentric resistance exercise (when the tissues are actively engaged and lengthening at the same time) requires less demand on the heart and lungs of older adults, and might be more appropriate than progressive resistance training—although both are beneficial. Eccentric exercises result in stronger muscle tissue in older adults and stimulate connective tissue cells to generate more collagen, strengthening the joints and minimizing injuries. 

You and your loved one can do simple eccentric exercises at home through online tutorials like this class with YogaMedicine or this eccentric posture routine with Miranda Esmonde-White.

For more individualized guidance, seek the guidance of a certified senior fitness trainer, physical therapist or other body therapeutic professional. 

Neuromotor Exercise Training for Sarcopenia

Sarcopenia reduces muscle mass and strength in the lower extremities, which is a large contributor to falls. However, it also reduces “neuromotor fitness,” or the quality of gait, balancing, posture and movement. As a result, the posture of older adults declines over time, and they walk more slowly and increasingly unsteady on their feet. This makes them more at risk for falls and fractures.

Older adults benefit greatly from neuromotor exercises like tai chi and yoga because these exercise modalities improve balance, coordination, gait, agility and proprioception (i.e., the ability to sense one’s position in space). They also combine neuromotor exercise, resistance exercise and, at times, also aerobic exertion.

Yoga and Tai Chi Resources

• This 25 minute video combines tai chi and qi gong with a variety of adaptations (including chair exercises) to help make the routine safe and comfortable for your loved one. This 36-minute tai chi class from LivingBetter can be done seated or standing, or start with this 6-minute beginner’s tai chi video. 
• Yoga with Adriene offers this 28-minute Yoga for Seniors practice. Enjoy this 10-minute evening yoga class from the University of Wisconsin or learn more about chair yoga from Yoga Medicine.
• Learn how yoga can improve soft-tissue mobility, balance and coordination, and breathing in this Age Well with Yoga podcast.

Just remember that ongoing activity throughout your loved ones’ entire lifetime is key to preventing muscle loss due to aging. A little movement is better than none. And even five to 10 minutes of activity for sedentary people is beneficial. So, find ways to get your loved one moving to directly influence their health, well-being and longevity.