Sarcopenia has little to do with aging

It has to do with the duration of time spent being sedentary.

They say a picture is worth a thousand words, but luckily enough today you get both.

Sarcopenia: “poverty of flesh,” or the age-induced loss of skeletal muscle mass, strength, and function = reduced quality of life.  Sorry old-timers, but I hereby officially revise the definition from “aging-induced” to “sedentary-induced.”  Herein, I present evidence that sarcopenia is not a phenomenon of aging per se, but rather of disuse atrophy.  Dear Webster’s & Britannica, please revise accordingly.

Skeletal muscles: use ‘em or lose ‘em #TPMC

Thanks to Julianne Taylor & Skyler Tanner for directing me to these images.

divide and conquer

Exhibit A. Chronic exercise preserves lean muscle mass in masters athletes (Wroblewski et al., 2011)

This study evaluated “high-level recreational athletes.”  “Masters” just means they were over 40.  And “high-level” doesn’t mean “elite,” it just means they exercised 4-5 times per week.  These weren’t super-obsessed gym rats… it’s probably who I’ll be in 7 years [sigh].

They took a lot of measurements which showed these people were pretty fit, but the money shot was this pic:


It wasn’t a randomized double-blind placebo-controlled intervention trial, but that pic made up for all of that.  Even if they cherry-picked the scans, I find them compelling.  Call it confirmation bias if you like.


Exhibit B.  Knee extensor strength, activation, and size in VERY elderly people following strength training (Harridge et al., 1999)

12 weeks of leg exercises performed in 11 adults 85-97 years of age.  They were recruited from a geriatric hospital, and despite still kicking well beyond their expiration date, they maintained the ability to get strong:strong

Some of these gains were likely attributable to the novice effect, or the neuromuscular adaptations that occur in untrained individuals during the onset of a new training program, but nonetheless, these data show there are no intrinsic defects caused by being old that hinder the ability to improve muscle strength [and function].

There was no non-exercising control group with which to compare the following figure, but I assure you, non-exercising 90-year old geriatrics aren’t putting on muscle like this guy did:


I’m not recommending retirees to train for a 480-pound deadlift.  Progress can probably be made carrying a gallon of water around the yard, or up and down a flight of stairs; don’t use handicap parking if your only handicap is being old.   Sarcopenia is a major reducer of quality of life.  You don’t have to join a gym but you have to get off your ass!

calories proper

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  • Dave Bridges

    My concern is the middle ground, elderly people who are in reasonable shape, compared with somewhat sedentary (but not extreme) cases. Is this a linear continuum or a sharp improvement with exceptionally fit cases?

    • William Lagakos

      Hi Dave,
      My guess is that it’s more of a “linear continuum” than an effect restricted to “exceptionally fit cases” because those in the Harridge study only exercised ~40 min/d, 3x/wk for 12 weeks. They did 2 exercises (leg ext & leg curl) for 3 sets of 8 reps at 80% 1RM. In other words, it was a pretty easy intervention.

      The “sharp improvement” probably happens in the beginning and then plateaus off after a few months-to-years, depending on the individual, intervention, etc.

  • Tess Howell

    my 90-year-old mother is a good example of what Bill is saying — a little bit of effort can make a big difference. replacing her knees some years ago had her somewhat weakened, but she began doing water exercises and then working on stair-climbing…. now she thinks she can manage to visit us again, where being able to handle the steps is a “must.” :-)

  • Sidereal

    Great blog Bill which for some reason I’m only discovering now. Thanks!

    • William Lagakos

      Hi Sid,

  • rand18m

    The fact that the elderly can increase muscle mass through training is nothing new, as you know. The idea that there isn’t a mechanism that we call “sarcopenia”, despite the actual description, is incorrect. The best trained elderly is not as strong as that same individual was in youth or even mid life. As you know there has been mountains of research done on this subject, but if anything conclusive and therapeutic other than exercise and an increased need for dietary protein has come forth I’m not aware.

    • William Lagakos

      I understand what you’re saying – fitness likely starts to decline with age after a certain point, even if diet & exercise stay on track. I was ranting more than anything else :)

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  • William Lagakos

    Murine models of atrophy, cachexia, and sarcopenia in skeletal muscle.

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  • William Lagakos

    Sarcopenia: ‘Adhering to the RDA for protein would be like white water rafting without a paddle’
    –> “If you put healthy people in their 70s in bed for 10 days, they can lose 10% of their total lean leg mass.”