3. Age-relAted muscle
loss
muscle shrinks in size And
strength
similAr to osteoporosis’s effects on
bone
contributes to A number of chronic diseAses
And conditions …

4. 30
25
30 years
20
45 years
15
75 years
10
5
0
% Muscle Loss

5. Average men & women
over age 30 begin losing
muscle at a rate of 15%
per year
Sedentary adults risk losing up to 30%
of muscle by age 75

6. Muscle of Muscle After
Average Healthy Sarcopenia
Adult Occurs

7. DECREASE OF LEAN MASS IS ASSOCIATED WITH AN INCREASE
IN THE TOTAL AMOUNT OF LIPID STORES
Body composition in man as a function of age.
black bar, Muscle; light grey, other tissues; dark
grey, fat. (Adapted from Cohn et al. 1980.)

8. reduced Aerobic cApAcity
decreAsed muscle strength
frAilty
gAit problems
WeAk bones (osteoporosis)
fAlls & frActures
loss of physicAl function & independence
decreAsed bAsAl metAbolic rAte
(middle-Age Weight gAin)

12. Fast twitch(FT) neurons tend to
die off first.
Adjacent motor neuron(slow twitch (ST) motor neuron),
may reinnervate the muscle fibers:
MOTOR UNIT REMODELLING .
Less Efficient Motor Units.:
MOTOR UNIT RESTRUCTURING
Less precise Less force Less Loss of
control of production coordinated balance and
movements and quick speed
movements

14. Loss of satellite cell
function
LOSS OF ABILITY TO DECREASE IN
MUSCLE CELLS TO MUSCLE PROTEIN
REGENRATE SYNTHESIS
Loss of
muscle mass

15. Decreased concentrations of :
GROWTH HARMONE TESTESTERONE
INSULIN LIKE
GROWTH FACTOR

16. Reduced levels of growth hormone associated with aging contribute
to age-related decreases in muscle mass, strength, and lipolysis.

17. grAph shoWing decline in testesterone
With Aging in men

22. Strengt #1 way to prevent
or reverse muscle
h loss
Trainin
g
Aerobic Walking, cycling,
golfing, swimming
Activity
Proper
Diet Protein,
Carbohydrates, Fiber

23. In 3 - 4 months, adults
can increase strength by
2-3 times their current
strength ability.

24. enefits of Weight trAining for older Adults
Weight training is especially important to
slow the process of sarcopenia
Regular weight training has shown to:
•reduce blood pressure
•improve blood cholesterol levels
•improve insulin sensitivity
•increase bone mineral density
•improve cardiovascular function
•relieve depression
•reduce body fat
•improve functional abilities

25. In a New England Journal of Medicine
study, 100 nursing home residents in
their 80s and 90s were put on a weight-
training program for 10 weeks.
At the end of the 10 weeks, some of the
results were so positive that a number of
residents were able to
switch from a walker to a cane!
The results appear next…

26. % Increase
28%
Strength
12% Walking Speed
113% Stair-Climbing
Power

28. SARCOPENIA IN ELDERLY MEN AND WOMEN: THE RANCHO BERNARDO STUDY.
Castillo EM, Goodman-Gruen D, Kritz-Silverstein D, Morton DJ, Wingard DL, Barrett-Connor E.
American Journal of Preventive Medicine, 2003 Oct;25(3):226-31.
METHODS: Height, weight, muscle strength, fat-free mass (FFM), fat mass by bioelectric
impedance analysis and grip strength(men) were measured for community-dwelling men (694) and
women (1006) aged 55-98 years (mean=73)were selected; alcohol and medication use, smoking,
and physical activity were ascertained.
RESULTS:
•Mean FFM was 43.5 kg for women and 61.7 kg for men. Sarcopenia, defined as FFM of > or =2.0
standard deviations below the gender-specific mean of a young reference population, was present
in 6.0% overall. Prevalence increased dramatically from 4% of men and 3% of women aged 70-75
to 16% of men and 13% of women aged 85 and older.
•Both men and women with sarcopenia had a significantly lower fat mass and body mass index
than those without sarcopenia.
•Grip strength, but not quadriceps strength, was lower in men and women with sarcopenia.
• Physically active women were about half as likely to have sarcopenia, but no association was
found in men.
• Few men and women were current smokers, but they were more likely to have sarcopenia.
• Co morbidities (heart disease, diabetes, pulmonary disease, arthritis, cancer) and medications
(thyroid hormones, corticosteroids, and hormone replacement therapy) were not associated with
sarcopenia.
CONCLUSIONS:This study also identified lack of physical activity and current smoking as
reversible risk factors for sarcopenia.

29. Journal of Applied Physiology 107: 1172-1180, 2009.
Effects of aging on human skeletal muscle after immobilization
and retraining
C. Suetta, L. G. Hvid, L. Justesen, U. Christensen, K. Neergaard, L. Simonsen, N. Ortenblad, S. P. Magnusson,
M. Kjaer, and P. Aagaard .
AIM: To investigate the effects of unilateral lower limb immobilization and subsequent
retraining on muscle mass, muscle architecture, neuromuscular activation, and resting
twitch characteristics in young and aged human individuals.
SUBJECTS: Twenty healthy men, 9 old (OM: 67.3 yr, range 61–74 yr) and 11 young (YM: 24.4
yr, range 21–27 yr), volunteered to participate in the study.
METHOD: All subjects were subjected to unilateral (randomly selected limb) lower limb
casting from the hip to the ankle for 2 wk. All measurements were conducted at baseline
previous to the immobilization procedure (Pre), after 2 wk of immobilization, and again
after 4 wk of heavy resistance training (6 wk).
RESULTS:
After retraining, both young and old regained their initial muscle strength, but old had
smaller gains in quadriceps volume compared with young.
CONCLUSION
The present data shows that aging is accompanied by an attenuated rate of muscle atrophy
in response to immobilization compared with that of young individuals, and importantly
that old subjects demonstrate a diminished capacity to restore muscle size and muscle
architecture during subsequent retraining

30. PREVALENCE OF SARCOPENIA AND PREDICTORS OF SKELETAL MUSCLE MASS IN
HEALTHY, OLDER MEN AND WOMEN
The Journals of Gerontology: Series A, Volume57, Issue12Pp. M772-M777.
Michele Iannuzzi-Sucich a ,. Karen M. Prestwood a and Anne M. Kenny a.
OBJECTIVE The objective of this study was to determine the prevalence of sarcopenia in a
population of older, community-dwelling research volunteers.
METHOD
Appendicular skeletal muscle mass was measured by dual x-ray absorptiometry in 195 women
aged 64 to 93 years and 142 men aged 64 to 92 years. Body mass index (BMI) was calculated and
physical activity and performance were measured with the Physical Activity Scale for the Elderly,
the Short Physical Performance Battery, and the Physical Performance Test. They measured
health-related quality of life by using the SF-36 general health survey. Serum estrone, estradiol, sex
hormone-binding globulin, parathyroid hormone, and 25-hydroxy vitamin D were measured in all
participants and bioavailable testosterone was measured only in men. Leg press strength and leg
press power were determined in men.
RESULTS
The prevalence of sarcopenia in our cohort was 22.6% in women and 26.8% in men. A subgroup
analysis of women and men 80 years or older revealed prevalence rates of 31.0% and 52.9%,
respectively. In women, skeletal muscle mass correlated significantly with BMI and levels of serum
estrone, estradiol, and 25-hydroxy vitamin D; in men, it correlated significantly with BMI, single leg
stance time, leg press strength, leg press power, SF-36 general health score, Physical Performance
Test total score, and bioavailable testosterone levels.

31. LEUCINE: A KEY AMINO ACID IN AGEING-ASSOCIATED SARCOPENIA.
Nutrition Research Reviews(2003), 16: 61-70
Dominique Dardevet, Isabelle Rieu, Pierre Fafournoux, Claire Sornet, Lydie Combaret,
Alain Bruhat, Sylvie Mordier, Laurent Mosoni and Jean Grizard
AIM: To find out whether chronic oral leucine supplementation would be beneficial for
maintaining muscle protein mass in elderly men and women.
SUBJECTS: The effect of meal Leucine supplementation on in vivo protein synthesis in
adult and ageing rats.
FININDINGS :Leucine has been shown to stimulate insulin secretion, and the
restoration of muscle protein synthesis in ageing rats

32. grAph shoWing effect of orAl leucine on
muscle protein synthesis

33. Journal of Applied Physiology 104: 1452-1461, 2008
SKELETAL MUSCLE PROTEIN ANABOLIC RESPONSE TO RESISTANCE
EXERCISE AND ESSENTIAL AMINO ACIDS IS DELAYED WITH AGING
Micah J. Drummond, Hans C. Dreyer, Bart Pennings, Christopher S. Fry, Shaheen
Dhanani,Edgar L. Dillon, Melinda Sheffield-Moore, Elena Volpi, Blake B.
Rasmussen
METHOD
Seven young and six old male subjects (age range: 24–77 yr) were
selected. dual-energy X-ray absorptiometry scan (Hologic QDR 4500W,
Bedford, MA) was performed to measure body composition and lean
mass. Each subject ingested 20 g of EAA 1 h following leg resistance
exercise
OBSERVATION
Muscle protein synthesis MPS increased early in young (1–3 h
postexercise) and later in old (3–6 h postexercise). The acute muscle
protein synthesis (MPS) response( usually delayed with aging) after
resistance exercise and EAA ingestion is similar between young and old
men.

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