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Common Causes (and Solutions) to Age-Related Muscle Weakness 

A senior woman with sarcopenia, or age-related muscle weakness being assisted by a nurse as she walks

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Table of Contents

As the years pass, you might find your muscles aren’t as strong or noticeable as they once were. This phenomenon is known as sarcopenia.  The term is derived from the Greek word for “loss of flesh,” but in this case refers to muscle loss leading to muscle weakness.

Sarcopenia is a common issue that plagues many seniors, gradually decreasing muscle mass, strength, and function as we age. Such a decline can interfere with everyday activities, escalate the risk of mishaps like falls, and result in various related health challenges.

But sarcopenia isn’t an inescapable condition. Its development and intensity are shaped by multiple elements, including nutrition, lifestyle, hormonal fluctuations, and underlying medical issues, to name a few.

Fortunately, numerous strategies are available to counteract and manage sarcopenia, from exercises and resistance training to medications and nutritional supplements.

In this article, we’ll shed light on the common causes of sarcopenia, its impact on your autonomy and movement, and the actionable steps you can adopt to fend off and control it. You’ll gain deeper insight into the significance of preserving muscle vitality as you age and the assorted tools at your disposal to stay strong and injury-free.

Causes and Risk Factors for Muscle Weakness

Image of a frail senior man with cane being assisted by his daughter.
Many age-related factors can contribute to muscle weakness and mobility issues.

Age-related muscle loss isn’t attributed to a singular cause but instead emerges from a medley of factors, including age-induced body changes, hormonal imbalances, medical ailments, dietary choices, and lifestyle habits. Let’s delve into each of these contributors:

As we mature, muscle cells shrink, eventually succumbing to natural death. Coupled with the body’s dwindling protein production, this leads to a drop in both muscle mass and potency.

While this muscle attrition rate can differ among individuals, it’s commonly observed to commence around the 30-year mark and often intensifies over the age of 60.

Hormonal fluctuations

Hormones are instrumental in governing muscle growth and its metabolism. Aging can cause a dip in pivotal hormones like growth hormone, testosterone, estrogen, and insulin-like growth factor, impacting muscle health.

Certain medications like corticosteroids might also suppress hormone levels, triggering muscle deterioration.

Medical conditions

A slew of ailments, including diabetes, cancer, chronic kidney disease, COPD, heart failure, rheumatoid arthritis, osteoporosis, and neurological disorders (like Parkinson’s and Alzheimer’s disease), can induce or amplify muscle wastage. They can influence muscle function, metabolic rate, appetite, and activity levels.

Dietary factors

Proper nutrition is the linchpin of muscle health. Age can usher in changes in appetite, flavor preferences, digestion efficiency, and nutrient absorption.

Obstacles like difficulty chewing or swallowing can lead to malnutrition, a precursor to muscle loss. It’s essential to ensure a well-balanced intake of calories, proteins, carbs, fats, vitamins, minerals, and hydration.

Lifestyle choices

Our daily decisions can make or break muscle health. Leading a sedentary lifestyle is a primary villain behind muscle deterioration.

Conversely, physical activity can be the hero, fostering muscle growth and halting atrophy. Smoking, excessive alcohol, stress, and sleep quality are other lifestyle determinants affecting muscle well-being.

Muscle Weakness Effects on Mobility & Independence

Image of a weak older woman being assisted to stand by a nurse due to sarcopenic muscle issues
Sarcopenia often results in a more limited sense of independence and mobility for seniors.

Muscle weakness can throw a wrench in routine tasks— ascending stairs, rising from a chair, grocery hauling, or even dressing. The danger of falls and consequent injuries can lead to severe complications like fractures, the need for hospitalization, or even a loss of independence.

Data from the CDC reveals a concerning trend: one in every four seniors in the U.S. experiences a fall annually, with these mishaps being the top culprits behind fatal and non-fatal injuries in this age bracket. 

While muscle weakness significantly contributes to falls, factors like imbalanced coordination, diminished vision, or environmental risks can’t be sidelined. These falls can spiral into grave outcomes, ranging from hip fractures and traumatic brain injuries to fatality.

Furthermore, muscle decline can also have psychological ramifications, potentially denting self-esteem, triggering social withdrawal, and elevating the risks of mood disorders and cognitive degeneration.

Prevention and Treatment of Sarcopenia 

Many measures exist to pre-empt and manage it, depending on its root causes and symptom severity.   The golden ticket, however, is exercise—particularly resistance training. Additional options might encompass medications, dietary boosters, and hormonal treatments.

Exercise: Your Ally Against Sarcopenia 

Exercise is sarcopenia’s nemesis and a formidable tool against muscle decline. It invigorates muscle growth, amplifies strength and endurance, optimizes circulation, curtails inflammation, and recalibrates hormonal levels.

Regular exercise fortifies the muscles and offers numerous benefits for seniors, including enhanced heart health, bone density, cognitive function, mood, sleep quality, and overall vitality.

While the modality and intensity of exercises can be tailored to individual preferences and health status, some universal guidelines for seniors include:

  • Strive for a minimum of 150 minutes of moderate-intensity aerobic workouts weekly. These can span brisk walks, cycling, swimming, or even dance sessions. Remember, you can break these 150 minutes weekly into smaller chunks to fit your schedule.
  • Incorporate a weekly regimen of resistance training sessions focusing on major muscle groups. Equipment like free weights, machines, resistance bands, or even bodyweight can be utilized to build strength.
  • Infuse balance and agility exercises into your regimen. Tai chi, yoga, or pilates can be beneficial. These enhance posture, movement range, and stability.
  • Always start at a gentle pace, escalating intensity and duration carefully. It’s crucial to remain attentive to your body’s signals and avoid over-exercising. If in doubt, consult your physical therapist for proper guidance.

Why to Focus on Resistance Training

Resistance training means offering unique and challenging forms of resistance to which your body can learn to adapt.  This resistance can be created in a number of ways—free weights, machines, elastic bands, body weight, or water.

Resistance exercises are essential for seniors, especially those grappling with age-related muscle weakness. They bolster muscle mass and strength, improve muscle contraction power and metabolic health, and fortify bone strength against conditions like osteoporosis.

Working on the lower body muscles—like the glutes, quads, hamstrings, and calves—can improve walking, stair-climbing, and balance. Strengthening the upper body muscles—chest, back, shoulders, and arms—is instrumental for daily tasks like lifting and reaching.

To integrate resistance training into your routine, you might consider exercises such as:

Squats

How to perform Squats:

  • Begin by standing upright with your feet hip-width apart. Place your arms by your side or extend them in front of you for balance.
  • Engage your core muscles to ensure stability throughout the movement.
  • Slowly bend your knees while pushing your hips back like sitting in an invisible chair. Ensure your chest is up and your back is straight.
  • Aim to lower yourself until your thighs are parallel to the ground, or go as deep as you comfortably can.
  • Press through your heels, keeping your chest up, and stand up to return to the starting position.
  • Perform 10-15 squats per set.

Heel Raises

How to perform Heel Raises:

  • Stand upright with your feet about hip-width apart. Hold onto a stable object like a chair or wall for balance if necessary.
  • Engage your core muscles for stability.
  • Slowly lift your heels off the floor, shifting your weight onto the balls of your feet.
  • Raise your heels as high as possible, ensuring you’re balanced.
  • Gently lower your heels back down.
  • Complete 10-15 heel raises per set.

Triceps Press

How to perform Triceps Press:

  • Stand with feet shoulder-width apart. Grasp one end of a resistance band with your right hand and raise this arm overhead. Bend the right elbow so the band is behind your head. The other end of the band should be held by your left hand, positioned behind your back.
  • Extend your right arm, pulling the band upwards. Feel the triceps (the back of your upper arm) contract.
  • Slowly bend the right elbow and return to the starting position.
  • Do 10-15 presses on one side, then switch to the other.

This alternative variation may prove easier if you have certain injuries or shoulder restrictions.

  • Grasp one end of your band at about eye level
  • With the other hand, grab the other end of the band
  • Keeping the top arm in a neutral position, straighten the bottom arm until you feel engagement in the triceps engaging
  • Do 10-15 presses on one side, then switch to the other.

Hand Weight Lateral Raises

How to perform Lateral Raise:

  • Stand with feet shoulder-width apart, holding a dumbbell in each hand by your sides.
  • With a slight bend in the elbows, raise both arms to the sides until they reach shoulder level.
  • Slowly lower the dumbbells back to the starting position.
  • Complete 10-15 repetitions.

Bicep Curls

How to perform Bicep Curl:

  • Stand with feet shoulder-width apart, holding a dumbbell in each hand. Arms should be extended by your sides.
  • Keeping the elbows close to your torso, curl the dumbbells upwards while rotating the palms to face your shoulders.
  • Slowly lower the dumbbells to the initial position.
  • Execute 10-15 curls.

Band Pull-Apart

How to perform Band Pull Apart:

  • Stand with feet shoulder-width apart. Grasp a resistance band in front of you with both hands extended and palms facing each other.
  • Stretch the band apart by moving your arms to the sides, engaging and squeezing the shoulder blades.
  • Gently bring the arms back to the starting position, releasing the tension in the band.
  • Complete 10-15 pull-aparts.  Repeat as needed.

Always maintain good posture and technique throughout each exercise to avoid injury for the maximum benefit.

Remember, it’s always a good idea to consult a healthcare provider or fitness professional before plunging into a new exercise regimen. They can provide guidance tailored to your needs, ensuring you reap the maximum benefits while staying safe.

Role of Medication in Managing Muscle Atrophy

Image of an older African American woman holding prescription pills and a glass of water.
Many medications are often prescribed for sarcopenia and other age-related muscle issues.

Medications are valuable tools in combating muscle atrophy. They can help to address underlying causes, diminish inflammation, enhance muscle function, and promote muscle growth. But medication isn’t the sole remedy. A blend of nutritious diet, routine exercise, and regular consultations with professionals like physical therapists is often the best approach for managing sarcopenia.

Medications to counteract muscle atrophy largely depend on its root cause and severity.  This table outlines some of the most commonly prescribed medications and what they are used for:

Medication TypeEffectExamples
Anti-inflammatory drugsAlleviate inflammation and muscle painIbuprofen, Naproxen
CorticosteroidsCounteract immune response and inflammation in autoimmune conditionsPrednisone, Dexamethasone
AntispasmodicsDiminish muscle spasms and rigidityBaclofen, Tizanidine
Neuromuscular blockersObstruct nerve signals to muscles, curbing spasms or contractionsBotulinum toxin, Vecuronium
Anabolic steroidsEnhance muscle bulk and vigorTestosterone, Oxandrolone
Growth hormoneFacilitate muscle growth and recuperationSomatropin, Mecasermin
Myostatin inhibitorsPrevent proteins that impede muscle growthBimagrumab, Follistatin

The Importance of Regular Physical Activity

Consistent physical activity is the bedrock for elderly individuals aiming to preserve muscle mass and strength, thereby keeping sarcopenia at bay. 

Physical activity:

  • Boosts muscle protein synthesis while preventing muscle degradation.
  • Elevates blood flow and oxygen supply to muscles.
  • Improves mitochondria function and count, which is essential for muscle energy.
  • Minimizes inflammation and oxidative stress, potential muscle cell adversaries.
  • Activates growth catalysts and hormones necessary for muscle regeneration.

The prescribed 150 minutes of exercise encompasses dancing, bicycling, swimming, running, or hiking. Muscle strengthening and balance-focused exercises are also pivotal.

Hormonal fluctuations profoundly influence muscle mass and potency. Testosterone, GH, and IGF-1 foster strength and muscle growth. In contrast, hormones like cortisol and epinephrine provide the necessary energy for muscle functions.

Typically, aging introduces a decline in testosterone and GH, potentially leading to sarcopenia. On the other hand, specific hormonal therapies could inadvertently induce muscle reduction.

Interventions to alleviate these effects might include:

  • Dietary supplements, Such as creatine or Vitamin D (under a physician’s oversight.)
  • Lifestyle shifts: Incorporating a balanced diet, avoiding smoking, getting adequate sleep, and maintaining physical activity.
  • Hormone replacement therapy (HRT): A double-edged sword with potential benefits and risks, demanding strict medical monitoring.

Key Takeaways

  • Sarcopenia results from the reduction of muscle cells as we age.
  • Hormonal changes, especially in testosterone and growth hormone, exacerbate this condition.
  • Various medical conditions and certain medications contribute to its acceleration.
  • A sedentary lifestyle and inadequate nutrition are significant contributors.
  • Muscle deterioration increases the risk of falls, injuries, and can impact mental well-being.
  • Resistance training is essential for fighting the effects and strengthening muscles.
  • A combination of aerobic exercises, muscle strengthening, and balance exercises can mitigate its effects.
  • Dietary supplements and lifestyle adjustments can play a role in combatting this muscle loss.

FAQs

What distinguishes sarcopenia from regular muscle loss due to aging? 

Sarcopenia is a specific type of muscle loss associated with aging and is more pronounced than the typical muscle wear and tear. It involves a decrease in muscle mass and a decline in muscle function, which can significantly impact daily activities.

Are there any genetic factors that can predispose an individual to sarcopenia? 

Yes, genetics can play a role. While lifestyle and nutritional choices are crucial, some individuals may have a genetic predisposition that makes them more susceptible to sarcopenia.

Is there a specific age at which I should be more concerned about muscle weakness? 

Though muscle loss can begin as early as in the 30s, significant concerns around sarcopenia usually arise after the age of 60 when the rate of muscle deterioration accelerates.

Can sarcopenia influence other health conditions, or vice versa? 

Yes, other health conditions like diabetes, heart disease, and osteoporosis can either be exacerbated by sarcopenia or make one more susceptible. Similarly, sarcopenia can enhance the risks associated with these conditions.

Are there any early signs of sarcopenia to watch out for? 

Early signs might include a noticeable decrease in strength, difficulty performing routine tasks that were once easy, fatigue after minimal activity, or reduced stamina.

Does sarcopenia only affect the limbs? 

While limb muscles might be more visibly affected, sarcopenia can also impact core muscles and other body areas, influencing posture, balance, and overall mobility.

Can sarcopenia-related muscle loss be entirely reversed?

While complete reversal might not always be feasible, with the right interventions, including exercise, diet, and sometimes medication, the progression of sarcopenia can be halted or slowed, and some muscle function can be regained.

References

  1. Larson ST, Wilbur J. Muscle Weakness in Adults: Evaluation and Differential Diagnosis. Am Fam Physician. 2020 Jan 15;101(2):95-108. PMID: 31939642. https://www.aafp.org/pubs/afp/issues/2020/0115/p95.html
  1. Volpi E, Nazemi R, Fujita S. Muscle tissue changes with aging. Curr Opin Clin Nutr Metab Care. 2004 Jul;7(4):405-10. doi: 10.1097/01.mco.0000134362.76653.b2. PMID: 15192443; PMCID: PMC2804956. https://pubmed.ncbi.nlm.nih.gov/15192443/
  1. Manini, Todd M.a; Hong, S. Leeb; Clark, Brian C.b. Aging and muscle: a neuron’s perspective. Current Opinion in Clinical Nutrition and Metabolic Care 16(1):p 21-26, January 2013. | DOI: 10.1097/MCO.0b013e32835b5880 https://pubmed.ncbi.nlm.nih.gov/23222705/
  1. Omura, T., & Araki, A. (2022). Skeletal muscle as a treatment target for older adults with diabetes mellitus: The importance of a multimodal intervention based on functional category. Geriatrics & Gerontology International, 22(2), 110-120.
  1. Dolan E, Artioli GG, Pereira RMR, Gualano B. Muscular Atrophy and Sarcopenia in the Elderly: Is There a Role for Creatine Supplementation? Biomolecules. 2019 Oct 23;9(11):642. doi: 10.3390/biom9110642. PMID: 31652853; PMCID: PMC6921011. https://www.mdpi.com/2218-273X/9/11/642
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