Mitigating Sarcopenia In The Elderly: Resistance Training Is A Powerful Potion

While researching afib-detection apps recently, the skeptical cardiologist stumbled across an article with the title “Resistance training – an underutilized drug available in everybody’s medicine cabinet”
This brief post from the British Journal of Sports Medicine blog nicely presents the rationale for using strength training to improve the overall health of the elderly. I have reblogged it below.
Americans spend billions on useless supplements and vitamins in their search for better health but exercise is a superior drug, being free  and without drug-related side effects
I’ve spent a lot of time on this blog emphasizing the importance of aerobic exercise for cardiovascular health but I also am a believer in strength and flexibility training for overall health and longevity.
As we age we suffer more and more from sarcopenia-a gradual decrease in muscle mass.
Scientific reviews note that loss of muscle mass and muscle strengh is quite common in individuals over age 65 and is associated with increased dependence, frailty and mortality
Specific information on progressive resistance training for the elderly is sparse but I found this amusing and helpful video on a Canadian site that provides some guidance for beginners.

And below is the referenced blog post:

Resistance training – an underutilised drug available in everybody’s medicine cabinet

By Dr Yorgi Mavros @dryorgimavros
As we get older we begin to lose muscle mass, approximately 1% every year. But more importantly, the decline in muscle strength declines at a rate 3-times greater [1]. The consequences of this decline in strength are significant, with lower muscle strength being associated with an increased risk dementia[2], needing care, and mortality[3]. But should we accept this as our fate, or is there anything we can do prevent, reverse or at least slow this age-related decline?
In 1990, a type of exercise called progressive resistance training, commonly known as strength training, was introduced to 9 nonagenerians living in a nursing home, specifically to treat the loss of muscle mass and strength, and the functional consequences of disability [4]. After just 8 weeks, these older adults saw average strength gains of 174%, with 2 individuals no longer needing a cane to walk. In addition, one out of the three individuals who could not stand from a chair, was now able to stand up independently. Just take a moment to think about the results of that study. If I told you there was a medicine that you or a loved one could take, and it could make either of you strong enough to now get out of a chair, would you take it?

What if you or a loved one had a hip fracture, and I told you that same medicine could help reduce the risk of mortality by 81%, and the risk of going in to a nursing home by 84%, as was shown in this study [5]. Currently, the only way to take this medicine is by lifting weights, or pushing against resistance.
A recent study from Britain, [6] showed an association between adults who participated in 2 days per week of strength training and a 20% reduction in mortality from any cause, and a 43% reduction in cancer mortality. Data from the Women’s Health Study in the US published at a similar time were very similar, with women reporting up to 145 minutes per week of strength training having a 19-27% reduced risk of mortality  from any cause [7].
So where does the benefit of strength training come from? First and foremost, it is anabolic in nature (meaning that it can stimulate muscle growth) making it the only type of exercise that can address the age-associated decline in muscle mass and strength. Within our laboratory at the University of Sydney, we have shown that we can use this type of exercise to improve cognitive function in adults who have subjective complaints about their memory [8]. What’s important though, is that there was a direct relationship between strength gains and improvements in cognition, and so maximizing strength gains should be a key focus if you want to maximize your benefit [9]. This type of exercise has even been taken into hospitals and used in adults with kidney failure undergoing haemodialysis, where it was shown to reduce inflammation, and improve muscle strength and body composition [10].
Other laboratories around the world have also used strength training to increase bone strength in postmenopausal women [11], help manage blood sugar levels in adults with type 2 diabetes [12], as well as to counteract the catabolic side effects of androgen-deprivation therapy for men with prostate cancer [13]. Not to mention its benefits to sleep [14], depression  [15] and recovery from a heart attack  [16].
So it is no surprise to see that the  Australian [17] and UK [18] public health guidelines for physical activity recommend we take part in activities such as strength training 2-to-3 days per week. Unfortunately however, these recommendations lack detail and guidance on intensity and frequency.
A key theme in all the randomized controlled studies discussed above, is that not only were exercises performed at least 2 days per week, but they were fully supervised, used machine and/or free weights, and were done at a high intensity, which is commonly set to 80% of an individual’s peak strength. It is for this reason I like to focus on the guidelines put forward by The American College of Sports Medicine (ACSM) [19]. The ACSM advises that everyone, including older adults do at least 2 days of progressive resistance training, which is to be performed at a moderate (5 – 6) to high/hard (7 – 8) intensity on a scale of 0 to 10, involving the major muscle groups of the body. So if you are looking to maximise the benefit from your time in the gym, or looking to make a positive change to your lifestyle, remember that there is medicine you can take; Try lifting some weights or doing other forms of strength training, 3 days a week, and importantly, make sure it feels moderate to hard. Not only will it add years to your life, but life to your years.

Since college I have regularly done weight training 3 times per week As I get  dangerously close to age 65 and joining the ranks of the “elderly” I have ramped up the intensity of my workouts, working hard to forestall the sarcopenia that will ultimately be my fate.
Antisarcopenically Yours,
Video credit: Produced for the University of British Columbia’s (UBC) Department of Physical Therapy, the Aging, Mobility, and Cognitive Neuroscience Laboratory, the Centre for Hip Health and Mobility and the Brain Research Centre at Vancouver Coastal Health and UBC



8 thoughts on “Mitigating Sarcopenia In The Elderly: Resistance Training Is A Powerful Potion”

  1. Hey, Doc,
    A good book on this subject of strength training for us older folks (I’m 80)
    is LIVING LONGER STRONGER BY Ellington Darden, Ph.D. He believes, and practices, that training harder and smarter (less frequent) will lead to a healthy old age. He and I are about the same age and both used to be in competitive bodybuilding. He became converted to Arthur Jones’ methods (remember Nautilus equipment?).
    I also get a lot of cardio benefits by training with minimal rest between exercises.
    Thank you for all you do for America.

  2. The known benefits of all forms of exercise keep increasing every day. Some forms are great in one way, whilst others are for other things. That’s why variety is key.
    Exercise beats drugs any day. Do the free option (exercise), or you’ll be forced to do the paid option (drugs) later.

  3. Dr. P. Thank you for a great blog entry. One of the citations in the piece you referenced, i.e. footnote 19 titled: “Chodzko-Zajko, W.J., Exercise and physical activity for older adults”, caught my eye, so I chased the citation to ground.
    It points to a truly well written and well researched dissertation on the subject you brought to light regarding aging and exercise. Here’s the link:

  4. Awesome! Thanks for this. In my case you are preaching to the choir, but it amazes me how many people do not use resistance training as a part of their lives for a measly three hours per week! As I like to say, “use it or lose it”!
    Another helpful book in this area is Younger Next Year by Chris Crowley and Henry Lodge M.D. The idea is once you hit your 50’s the slide begins. Follow their rules and the slide becomes a flat line horizontally until about age 80. So decline or maintain? Pretty simple choice!

  5. I hope Chi Kung and Tai Chi work too? Our stamina has improved. But our dog died and it’s VERY hard to get myself motivated to walk every day – let alone get to, or afford a gym! Nice post – thanks, made me think.

  6. To address my own low bone density at age 64, I have been following a weight training program from the book “The Barbell Prescription – Strength Training for Life After 40” by Jonathan Sullivan. This book is a companion book to the book “Starting Strength – Basic Barbell Training” by Mark Rippetoe. Both books are highly recommended and thoroughly cover the how, why, and when of strength training, as well as safety considerations. I have a workout log I keep for my weight training, and at the top of the log in large letters I have written “Take Your Medicine”, i.e. do the workout.


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