What is Sarcopenia?
Sarcopenia, the age-related decline in muscle mass and strength, is associated with a reduction in muscle function, physical performance, and quality of life. The term is derived from the Greek phrase “poverty (penia) of flesh (sarco)” and is identified as a common disease in older adults. Muscle mass is reduced by 1-2% every year after the age of 50 leading to a reduction in strength, muscle mass and physical performance. This translates to a reduction in gait speed and increase in falls risk.
Mechanisms of Sarcopenia
- Sedentary lifestyle – physical inactivity is a key determinant for sarcopenia, leading to a faster decline in muscle strength and mass.
- Disease –Diabetes mellitus is a common trait for older adults suffering from Sarcopenia.
- Diet – reduction in energy intake and monotonous diets impair exercise adaptations related to muscle mass enhancement mainly due to the reduction of energy intake and consequently due to reduced intake of essential macro and micro nutrients required for the anabolic process.
Strength Training
Strength training is the recommended first-line treatment for countering the deleterious consequences of sarcopenia in older adults. It’s further advantageous for preventative measures. The modality involves repeated and systemic performance of individual exercise sessions over a period with the aim of improving muscle strength and skill. A foundation of exercise prescription is lower limb exercises due to their role in performing activities of daily living including walking, sit to stands, stairs etc. Similarly, upper limb exercises translate to improvements in dressing, cooking and self-care. The goal is to progressively overload the muscles so that positive adaptations take place i.e., increase muscle size and function. Below is a simple illustration of an easily modifiable program for older adults with (or without) sarcopenia.
- Training frequency
- 1-3 sessions per week
Exercise Selection (examples)
- Squat
- Lat pull down
- Calf raises
- Seated row
- Hamstring curl
- Chest press
- Bicep curls
- Split squat
- Deadbugs
Exercise intensity
- RPE-based: 3-5 and progressing to 6-8 out of 10
- 1RM-based: 40-60% 1RM progressing to 70-865% 1RM
Exercise Volume
- 1-3 sets
- 6-12 repetitions
Rest periods
- 60-120s between sets
- At least 48 hours between session for adaptation to occur.
By Katrina Laczoffy
APA Senior Physiotherapist & Clinical Supervisor - Evado Studios Hawthorn & Clayton
DPT, BExSpSc(Hons)