A Comprehensive Guide to Age Related Muscle Loss and How to Prevent It
A decline in skeletal muscle, also known as sarcopenia, is just a fact of aging—true. But does age related muscle loss automatically mean you’ll also lose vitality, strength, and independence in your later years? Absolutely not. In fact, research strongly demonstrates that no matter what your current age or what kind of physical shape you’re in, you can take steps today to either stave off, slow down or significantly reverse sarcopenia—a loss in muscle mass that begins as early as age 35.
What, Exactly, Is Sarcopenia—and How Does It Show Up?
“Sarcopenia is age related muscle loss and function,” said Dr. Roger Fielding, Senior Scientist of the Nutrition, Exercise Physiology and Sarcopenia (NEPS) Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. “It’s related to both the amount of muscle you have, and how that muscle actually functions to perform the various tasks we rely upon our muscles to help us perform.”
Muscle attrition can manifest in various ways—as in one’s declining ability to carry a suitcase across a room or rise, unassisted, from a couch or toilet seat. “In day-to-day activities, a loss of muscle often corresponds to a loss in mobility,” said Mary Ellen Posthauer, RDN, CD, LD, FAND, a registered dietician who spent her career working in nursing homes and assisted living facilities. “Can you sit down and get up from a chair without stabilizing yourself? Can you stand on one foot for 20 seconds or longer? What’s your grip strength when you open a package? How far can you walk without becoming winded? These are some of the frailty tests doctors use in measuring degree of muscle loss.” Sarcopenia is a significant component of frailty—which is itself a medical syndrome.
“With sarcopenia, there can be a slowing down of one’s habitual walking speed,” said Dr. Fielding. “As the syndrome worsens, it begins to have an impact on a person’s daily life. In extreme cases, someone might need assistance with routine activities such as bathing, cooking, cleaning and housework. That’s the physical trajectory.”
Is There an Emotional Component to Sarcopenia?
Research on a definitive link between sarcopenia, age related muscle loss and emotional decline is still emerging, said Dr. Fielding. “Yet when I talk to older people, many of whom have a number of chronic conditions, and I ask them what they’re most afraid of, it isn’t necessarily getting sick or dying—it’s losing their independence,” he said.
When independence slips away—when, for instance, someone is so frail that he or she has to give up his or her home to live with family or in a nursing home—that major transition can send one reeling into depression. “There might not be a direct causal relationship between sarcopenia and emotional decline,” Fielding said, “but there’s evident of a correlation. As we age, there can be fears surrounding how both our physical and emotional decline could impact our quality of life.”
How Common Is Sarcopenia and Age Related Muscle Loss?
The data on age related muscle loss and sarcopenia’s pervasiveness varies, depending on the definition used to describe the condition. “For individuals over the age 65,” said Dr. Fielding, “sarcopenia has been reported to be present in anywhere from five percent to 20 percent of the population. And regardless of what objective or empirical definition you use, I can tell you this: The prevalence of sarcopenia seems to increase with age. It’s higher, for example, in 70-year-olds than it is in 60-year-olds.”
Starting sometime between our mid-30s and early 40s, we begin losing approximately one-half to one percent of our muscle mass per year—and about one to two percent annually of what Fielding calls our “maximal voluntary muscle strength” (MVMS)—the amount of strength one can exert in a voluntary contraction. In essence, it’s a test of power. Not all of us who experience the loss of muscle mass or MVMS will cross over the threshold into sarcopenia, yet even without an official diagnosis, we can experience a slow but increasing number of symptoms that characterize the condition. “Your habitual walking speed may slow down with each passing year,” Fielding noted as an example. “Or you might develop difficult with climbing a fight of stairs.”
Can Sarcopenia Be Prevented or Reversed to Any Extent?
The short answer: a resounding yes. While some age related muscle loss is inevitable even for a bench presser, “There’s good evidence to suggest that people who are more physically active not only have an overall better health status, but they lose muscle at a slower rate than those in poor health or who are not physically active,” Fielding said. “And even when you lose muscle, there are approached you can take to reverse that muscle loss and function, to some extent.”
Chief among these approaches: strength training. “If you begin a supervised program of resistance exercise training, and you do it at a moderate to high intensity—meaning that you train at or near your maximum strength, which varies between from one individual to the next—the measured gains in strength can be realized within the first two to three weeks of the program,” Fielding said. “And if that program continues to be performed at a high enough intensity and it is progressive, those strength gains will continue. For healthy older people in particular, those gains can be pretty substantial up through 12 to 24 weeks of training. And gaining this kind of strength can really reduce the risk of falls and injuries as we age.”
And yes, amid all this talk of pumping iron, cardio work still has its place. “There are certainly numerous benefits to aerobic exercise, particularly in terms of cardiovascular health,” Fielding said. “It’s not either-or, but both: In addition to cardio, most people really need to also consider performing some type of regular resistance training exercise, because strength and muscle power are important components of overall health.”
Can’t carve out the time for a full-blown exercise program? Good news: You can still experience the kind of strength increase that staves off sarcopenia by focusing on exercises that will give you the greatest return on your time invested. “Aim to do one to two strength training session a week, as well as to walk at least 20 minutes three to four times a week,” Fielding said. “You could focus on the upper extremity muscles by using some dumbbells or free weights,” he continued. “With just some effort, the benefits can be enormous.”
What’s the Link Between Protein Intake and Sarcopenia (Age Related Muscle Loss)?
“There’s really good observational evidence from epidemiological studies that if people consume lower intakes of protein in their diet, even within the normal range, they seem to lose more muscle than people that consume what we might consider a more adequate level of protein,” Fielding said. But if you’re already consuming an adequate amount of the daily recommended amount of protein, per the federal Dietary Reference Intake—about 56 grams of protein a day for me, 46 per day for women—the research is mixed on just how much additional protein one should consume to bolster muscle mass and slow its gradual decline. “If you’re already consuming an adequate level of protein, or maybe a little more,” Fielding said, “there have been some studies that have shown that, yes, adding more is beneficial. But other studies seem to show that there’s a point of diminishing returns.”
So how much protein, according to Fielding, should you actually be eating? “At minimum, you should consume the recommended daily allowance of 0.8 kilograms of protein per kilogram of body weight,” he said. For someone who weighs 150 pounds, that’s 55 grams of protein per day. And Fielding recommends that you spread out that protein from daybreak to dusk. “Many people consume all of their protein at the evening meal,” he said. “But you need adequate protein throughout the day. If you’re just eating your protein at dinner, for instance, you might not be optimizing the window in which you can make more protein or maintain your muscle’s protein.”
Posthaeur concurs—adding that adequate protein intake and an overall good diet go hand-in-hand with moving more and reducing age related muscle loss. She recommends including high-quality animal and plant-based protein in your diet—including wild salmon, chicken, Greek yogurt, nuts, and beans. “When it comes to preventing or managing sarcopenia,” she said, “the combination of a nutritious, balanced diet and strength training go together. You’ll experience the greatest improvements to your well-being when you implement both.”