Sarcopenia is a loss of muscle mass. This is a natural process as we age that can be delayed and even reverses in certain people.

Here is an excerpt from a journal article in Physiology Review:

Loss of muscle mass with aging, which is largely due to the progressive loss of motoneurons, is associated with reduced muscle fiber number and size. Muscle function progressively declines because motoneuron loss is not adequately compensated by reinnervation of muscle fibers by the remaining motoneurons. 

At the intracellular level, key factors are qualitative changes in posttranslational modifications of muscle proteins and the loss of coordinated control between contractile, mitochondrial, and sarcoplasmic reticulum protein expression.”

I’m going to break that all down in this article, but first, it’s important to know that even if you’re 90 years old, you can still gain muscle mass from working out and lifting weights. 

That’s some good news, my friend!

What specifically causes sarcopenia?

We don’t know. As in, the scientists and healthcare professionals don’t know the exact cellular changes that take place to cause the slow progress of sarcopenia (muscle loss). 

What we do know is that sarcopenia and the loss of peak power output occurs in elite athletes (sprinters) after the age of 30. This can be measured in a lab with peak force output vs. younger individuals and against their own results when they were in their 20’s. These changes as described in the paper are neurophysiological, or related to nerves and our physiology. 

Here’s the definition of physiology: “the branch of biology that deals with the normal functions of living organisms and their parts.” Basically, the HOW, not the WHAT, which would be anatomy.

As we age, type II(b) muscle fibers or fast twitch muscle fibers slowly convert to type II(a) or intermediate muscle fibers. In addition to this, the neuron that controls (innervates) all of the different muscle fibers within a muscle stops innervating as many fibers.

This leads to slower contraction speeds and a progressive decrease in the size of the muscle fibers themselves. 

This excerpt sums of the changes that take place quite succinctly.

“aging-related changes in microvasculature, oxidative stress, and protein modifications with negative effects on motoneuron transport mechanisms, structure, function and survival have been forwarded as significant etiological factors. The aging-related denervation/reinnervation process has a strong impact on quantitative changes in muscle, such as muscle fiber loss and atrophy, resulting in overall muscle wasting and loss of muscle function in old age. 

However, qualitative changes in skeletal muscle affecting protein function, repair processes, the loss in the coordinated expression of contractile, SR, and mitochondrial proteins, and the overall decreased resilience to stress in old age most probably have an even more important role for the impaired muscle function associated with old age. 

Thus, the impact of aging on skeletal muscle structure and function represents an extremely complex biological process that is not easily targeted by a singular intervention strategy; there are currently a number of intervention strategies which have the potential to improve muscle function and significantly improve quality of life among the growing population of elderly citizens, such as interventions targeting the low-grade inflammation and interventions improving the proliferative capacity of satellite cells and the elimination senescent cells. 

All these interventions together with less sedentary life style and optimal nutrition have the potential to improve muscle function with significant positive effects on mobility, reducing the risk of fall-related accidents, and improving quality of life, albeit having little effect on overall life span. 

In this context, drugs targeting senescent cells secreting proinflammatory cytokines, chemokines, proteases, and inducers of stem cell dysfunction, termed the SASP, represent a new and highly promising intervention strategy in experimental models and being close to the introduction in clinical trials.”

In Layman’s terms, sarcopenia occurs due to blood flow changes, neurological changes, muscle tissue changes, protein synthesis changes, and more. 

The why behind this is baked into our very physiology.

Sometimes asking the why question only uncovers more questions. Eventually, you get the point of asking a why question that get’s to, “okay, so why does protein synthesis efficiency decrease? Okay, so it’s through that pathway, but why does that happen?” 

I think at the end of the day we are always trying to figure out why we are eventually going to decline and die. 

Interestingly enough there are some scientists working on life extension and anti-aging treatments to help humans live 200 years. That’s pretty crazy, right?!

Why is Sarcopenia a concern?

Sarcopenia is a concern due to the functional deficits that occur as a result. 

Difficulty getting up from the floor, in and out of the car, up and down off of the toilet, walking up and down hill, catching yourself after tripping to prevent a fall; all of these are much more difficult if you let sarcopenia run wild without any intervention. 

Falling is one of the leading causes of death in the senior population. 

Interestingly enough, prior to modern medicine, this wasn’t a problem as most of us would die before we were old enough to experience significant sarcopenia, from infection or some other disease. 

But now, it’s common to live into our late 70’s and 80’s which means we need to pay closer attention to the weakness that is associated with sarcopenia. Thankfully there is a lot that can be done. 

Is there anything that can be done to slow down sarcopenia?

Yep. Strength training. 

The best thing we have to date to slow down and even reverse sarcopenia is lifting weights. 

Many seniors, and you might be one of them, are afraid to lift weights, or, aren’t sure where to start. 

Thankfully you have google, youtube, your local gym, and so many other resources to help you get started safely and effectively. 

All you need to be is a little curious, try out some new things, start light, and just use this as another learning opportunity to develop a new skill.

All of my clients who are seniors who have not lifted weights before, I encourage them and now you, to embrace a beginner mindset. 

This beginner mentality and eagerness to learn can actually translate into more neuronal connections in your brain to reduce your risk of dementia and Alzheimers, too. 

If you’re still not sure where to start, i’ll link to a few resources below:

For an in-depth overview of strength training for seniors check out this CDC recommendation.

Silver sneakers training recommendations.

Is there a best type of exercise to slow down and reverse sarcopenia?

Strength training is the number one most effective way to slow down and reverse muscle loss related to aging. 

Regardless of if you are 70, 80, or even 90, you can still gain muscle mass. This has been demonstrated conclusively in the research.

Is it inevitable to become old and weak?

No! It’s only inevitable if you allow it to happen. 

It’s interesting. 

I have one client who is in his 80’s and goes fishing, elk hunting, and golfs routinely. He lifts weights and wants to be completely independent and fit as long as possible. He’s loving life. 

I have another client who is 77, doesn’t work out, sits at home most of the day, has terrible balance, can’t really travel much anymore, but is very content with his life. He’s okay if he dies now. 

It’s so interesting to see the different preferences between people. 

It’s hard for me to understand person #2’s life choice and perspective, however, I have learned to accept that for him and people like him, no amount of persuading to work out will do much. 

All I can do is present information and then you must make your own decision of how you want your life to go.

Good luck and stay strong!!