Dominic Stone
As people age, their muscles undergo progressive changes, including the loss of muscle mass and strength. This age-related loss of muscle function is known as Sarcopenia, derived from the Greek words for flesh (sarcos) and loss (penia). It is characterised by a decrease in lean body mass, muscle strength and physical function. Sarcopenia affects activities of daily living, contributing to reduced gait speed, falls, fractures, and frailty. The condition varies in degree according to physical activity levels, gender, and race. While ageing is a significant factor in muscle deterioration, a sedentary lifestyle can also accelerate muscle loss. However, exercise, particularly stretching, weight training, and moderate physical activity, can help slow or prevent muscle atrophy and improve overall physical fitness.
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What You'll Learn
Loss of muscle mass
As people age, their muscles shrink and lose mass, a process known as sarcopenia. This is a natural process, but a sedentary lifestyle can accelerate it. The number and size of muscle fibres decrease, and the remaining fibres are replaced more slowly and with tough fibrous tissue. This results in reduced muscle power and strength, which can make it difficult to perform routine activities. The loss of muscle mass and strength is clinically significant as it reduces exercise capacity, which is needed to perform activities of daily living.
The rate of muscle mass decline varies between individuals, but it generally occurs at a rate of 3-8% per decade after the age of 30, and this rate of decline is even higher after the age of 60. Men tend to lose more absolute and relative muscle mass than women, with the loss becoming most noticeable in the seventh decade and beyond. Men over 70 lose an average of 4.7% of their peak muscle mass per decade, while women lose 3.7%.
The loss of muscle mass is accompanied by a progressive increase in fat mass and changes in body composition, such as a decrease in bone density and stature. These changes can increase the risk of several conditions, including type 2 diabetes, obesity, heart disease, and osteoporosis. The development of osteoporosis, in particular, can lead to crush fractures of the vertebrae and almost all hip fractures in older individuals.
The causes of sarcopenia are multifactorial and not yet fully understood. It is believed to be influenced by age-related changes in endocrine and nutritional factors, as well as inactivity. Genetic factors also play a role, as the speed and amount of muscle changes seem to be caused by genes. Additionally, the reduction in muscle mass may be linked to a decrease in mitochondrial biogenesis and ATP production, which could be the basis of reduced muscle protein turnover.
While the loss of muscle mass is a natural part of ageing, it can be slowed or prevented through regular exercise and a well-balanced diet. Moderate exercise, including aerobic and resistance training, can help maintain strength, balance, and flexibility, while also enhancing muscle protein synthesis and mitochondrial biogenesis. A diet rich in calcium and vitamin D is particularly important for older adults to maintain bone health and reduce the risk of osteoporosis.
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Loss of muscle strength
As people age, their muscles shrink and lose mass, which is a natural process. This loss of muscle strength and power is known as Sarcopenia, derived from the Greek words for flesh (sarcos) and loss (penia). The condition is characterised by a loss of muscle strength and power, as well as reduced function. It occurs with increasing age and is a major component in the development of frailty. The loss of muscle mass reduces strength and exercise capacity, which are needed to perform daily activities. Elderly individuals often fall due to poor muscle strength and reduced balancing ability related to muscle ageing.
The speed and amount of muscle changes seem to be caused by genes. Muscle changes often begin in the 20s in men and 40s in women. The total number of muscle fibres decreases with age, beginning at about 25 years and progressing at an accelerated rate thereafter. The individual fast-twitch type II fibres decrease in cross-sectional area, suggesting that their relative contribution to force generation is less in older adults. The number and size of muscle fibres also decrease, so it takes muscles longer to respond in our 50s than they did in our 20s.
The loss of muscle mass is clinically important as it reduces strength and exercise capacity, which are needed to perform daily activities. Handgrip strength decreases, making it more difficult to accomplish routine activities such as opening a jar or turning a key. The heart muscle becomes less able to propel large quantities of blood quickly around the body.
There are several potential causes of Sarcopenia. One of the most striking effects of age is the involuntary loss of muscle mass, strength and function. Muscle mass decreases by approximately 3-8% per decade after the age of 30, and this rate of decline is even higher after 60. This involuntary loss of muscle mass is a fundamental cause of disability in older people. A decrease in muscle mass is also accompanied by a progressive increase in fat mass and, consequently, changes in body composition.
A sedentary lifestyle can accelerate the loss of muscle mass. Exercise is one of the best ways to slow or prevent problems with muscles. Even moderate amounts of physical activity can reduce the risk of developing high blood pressure, heart disease, and some forms of cancer. Long-term regular exercise may slow the loss of muscle mass and prevent age-associated increases in body fat. It also helps maintain the body's response time and its ability to deliver and use oxygen efficiently.
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Changes in body composition
As people age, their muscles undergo progressive changes, primarily involving the loss of muscle mass and strength. This loss of muscle mass and strength, known as sarcopenia, is derived from the Greek words "sarcos" (flesh) and "penia" (loss). It is a significant component in the development of frailty and disability, affecting the quality of life of many elderly individuals. The rate of muscle mass decline varies, with men losing more absolute and relative muscle mass than women. This loss of muscle mass and function has a marked effect on daily activities, contributing to reduced gait speed, balance, and an increased risk of falls and fractures.
The total number of muscle fibres decreases with age, resulting in reduced muscle power. Specifically, Type II fast-twitch glycolytic fibres, which are responsible for generating force, undergo a decline in cross-sectional area. This decline in the number of functional motor units and fibre area contributes to the overall decrease in whole muscle cross-sectional area. Additionally, the individual fast-twitch Type II fibres decrease in cross-sectional area, further reducing the force generation capacity of the muscles.
Age-related changes in body composition can lead to various metabolic disorders. The decrease in muscle mass is accompanied by an increase in fat mass, altering body composition and contributing to conditions such as insulin resistance, type 2 diabetes, hypertension, and hyperlipidemia. These metabolic changes can result in an increased incidence of cardiovascular death. Furthermore, bone density decreases, joint stiffness increases, and there is a reduction in stature. The bones lose calcium and other minerals, becoming more brittle and prone to fractures.
The process of sarcopenia is influenced by various factors, including nutrition, hormones, medical comorbidities, physical activity levels, and genetics. Exercise, particularly aerobic and resistance training, has been shown to enhance muscle protein synthesis, mitochondrial biogenesis, and muscle growth. It can help delay the onset and slow the progression of age-related muscle changes, improving strength, balance, and flexibility. Additionally, a well-balanced diet, adequate calcium and vitamin D intake, and a positive attitude can also play a role in counteracting the effects of aging on muscle composition.
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Increased risk of metabolic disorders
Aging is an ongoing and irreversible physiological process that leads to the gradual deterioration of tissue and cellular functions, increasing the susceptibility to age-related diseases, including metabolic disorders. The study of aging has long been linked with the study of metabolism, as early theories pointed to the rate of metabolism and by-products of metabolism as drivers of aging processes.
The total number of muscle fibers decreases with age, beginning at around 25 years and progressing at an accelerated rate thereafter. This results in reduced muscle power and strength, and increased susceptibility to metabolic disorders. The loss of muscle mass and strength is clinically known as Sarcopenia, derived from the Greek words "sarcos" (flesh) and "penia" (loss). Sarcopenia occurs with increasing age and is a major component in the development of frailty. It affects both men and women, with men losing more absolute and relative muscle mass.
The speed and amount of muscle changes seem to be caused by genes, with muscle changes often beginning in the 20s in men and 40s in women. The loss of muscle mass during the aging process reduces strength and exercise capacity, both of which are needed to perform daily activities. This can lead to a decrease in mobility, balance, and gait speed, increasing the risk of falls and fractures.
The development of metabolic disorders is also influenced by environmental and behavioral factors. For example, a sedentary lifestyle, an obesogenic environment, and a diet with plentiful food can contribute to the onset of metabolic disorders. Excess visceral fat causes an excess release of free fatty acids (FFAs), which have been linked to insulin resistance and other metabolic abnormalities.
To mitigate the risk of metabolic disorders and the negative effects of aging on muscle health, maintaining physical activity and a well-balanced diet is crucial. Moderate exercise programs can help preserve muscle strength, balance, and flexibility, while adequate calcium and vitamin D intake are essential for bone health, especially in older women and men.
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Reduced physical performance
As people age, their muscles shrink and lose mass, leading to reduced physical performance. This is a natural process, but a sedentary lifestyle can accelerate it. The speed and amount of muscle changes seem to be caused by genes. The total number of muscle fibres decreases, and so does their size, resulting in reduced muscle power. This is most noticeable in the hands, which may look thin and bony. The loss of muscle mass and strength is clinically referred to as Sarcopenia, derived from the Greek words for flesh ("sarcos") and loss ("penia"). It is a significant contributor to frailty in older people.
The changes in muscle fibres are more prominent in type II fast-twitch glycolytic fibres, which are responsible for force generation. The decrease in the number of type IIB fibres is achieved through selective denervation, followed by re-innervation by axonal sprouting from juxtaposed innervation units. This remodelling of the motor unit results in a reduced response rate.
The loss of muscle mass and strength leads to a decrease in physical performance, including reduced walking capacity, speed, mobility, sit-to-stand performance, upper extremity function, and balance. Elderly individuals are more prone to falls and fractures due to poor muscle strength and reduced balancing abilities.
The effects of ageing on physical performance are not limited to muscles but also extend to bones, joints, and tendons. Bones lose calcium and other minerals, becoming thinner and more brittle with age. The spinal column becomes curved and compressed, leading to a slight loss of height. The foot arches become less pronounced, contributing to a reduced stature. The long bones of the arms and legs are more prone to fractures due to mineral loss.
The water content of tendons, which attach muscles to bones, decreases with age, making them stiffer and less able to tolerate stress. The heart muscle's ability to pump large quantities of blood quickly also diminishes. However, exercise and a well-balanced diet can help delay and slow these age-related changes in physical performance.
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Frequently asked questions
Aging causes structural and functional changes in skeletal muscle. The total number and size of muscle fibres decrease, resulting in reduced muscle power and strength. This is accompanied by a decrease in bone density and joint stiffness, leading to a reduced range of motion and frailty.
The age-related decrease in lean muscle mass is called Sarcopenia. It is a multifactorial condition that impairs physical function and predisposes individuals to disability. Sarcopenia is likely caused by a combination of factors, including nutrition, hormones, medical comorbidities, and activity levels.
Exercise is one of the most effective ways to prevent or slow the loss of muscle mass. Regular physical activity, including aerobic exercise and resistance training, can enhance muscle protein synthesis, improve muscle growth, and maintain strength and flexibility. Additionally, a healthy diet and a positive attitude can help delay the onset and slow the progression of age-related muscle loss.
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