Strength Train as a Senior?

In my previous blog, I wrote about how changes in body composition due to strength training affects metabolism and how this helps in weight loss and weight maintenance. If, on the other hand, your objective is to gain weight, together with increases of fat, you also would want to gain more muscle mass to support the extra weight and to avoid chronic conditions linked to a body composition leaning towards higher body fat percentages. Furthermore, very underweight individuals such as frail elderly, individuals suffering from chronic gastrointestinal conditions, certain cancers or eating disorders may have significantly decreased muscle mass.  Inactive people of all ages, whether underweight, normal weight, or overweight can have unhealthy low levels of muscle tissue.  There are also many naturally tall and lean individuals, ectomorphs, who could benefit from building more muscle mass.

One thing that I noticed in the years working as a nurse in long term care was that seniors requiring nursing home care were not just the ones suffering from dementia and chronic diseases but also from general frailty and mobility issues. General frailty, or as described by Baechle and Westcott 2010 p244 as “severe muscle atrophy and strength loss” caused by “years of inactivity” is something that I observed in many seniors admitted into long term care (both underweight, normal weight and overweight individuals) - as well as sadly the progression of decreased strength, mobility and independence in their activities of daily living during the continued stay in long term care as their mobility further decreased.  I often witnessed inability to get up from a couch or toilet seat, balance issues and increased risk of falls. However, as described in my previous blog, general frailty is not something that is inevitable with increased age! Movement, including strength training, can increase appetite in underweight individuals (Zeratsky 2020) that can help put on weight.  This in turn, can fuel even simple weight bearing activities such as walking as well as more involved strength training and other exercise activities. In addition, lack of appetite can often accompany mental health issues such as depression and anxiety and exercise can improve mood that can then affect dietary intake (leading to potential increased intake in those who are underweight and decrease intake in those who are overweight when eating is affected by mental health issues).  In fact, “lifestyle interventions tend to improve mood and anxiety, and exercise has been considered to be effective enough to play a role in depression care and in many countries is considered a clinical guideline to treat these mental health conditions” (Pagoto 2019, p410).

Although underweight seniors can have decreased muscle mass, frailty and mobility issues, this does not take away from the idea that even normal weight or overweight older adults can be just as weak from the sheer depletion of muscle mass and strength due to changes in body composition due to aging. Increasing muscle mass in the senior population needs to be a focus given the unfortunate fact that there is a 10 pound of muscle loss per decade after age 50!!!  (Nelson et al.1994).   Fortunately, it is never too late to start!! There have been very convincing studies in the past decades showing that seniors can gain significant muscle strength without injuring themselves in the process - too many for me to reference!  Some of these studies included frail individuals up to 100 years of age (Fiatarone and Singh 2002, Fiatarone et al. 1994) and frail nursing home patients averaging 90 years of age (Westcott et al.2000).  One study that I found truly impressive was by Westcott (2009) that showed that lean muscle weight changes after exercise among different age groups between the ages of 21 to 80 years of age had no significant differences!  Which means that you can make similar body composition improvements (gain lean muscle mass) in your sixties and seventies as you did in your twenties and thirties!!

In their outstanding book, “Biomarkers” Evans and Rosenberg (1992) introduce us to the work of Dr. Walter M. Bortz II (1982),  who studied and wrote about the devastating effects that come from bed rest at any age and who noted that ' ‘use it or lose it’ is a pervasive biological law”. He observed that medicine has not been quick enough to highlight the benefits of exercise. It is my hope that the more movement and exercise, such as strength training, is given the spotlight by health and fitness professionals, the more “a physically active life may allow us to approach our true biogenetic potential for longevity”. (Borz II W., 1982)

References:

Baechle, T., and Westcott, W. 2010. Fitness Professional’s Guide to Strength Training Older Adults. (p 244). Champaign, IL: Human Kinetics.

Bortz II W.M., “Disuse and Aging”. Journal of the American Medical Association 248, No. 10 (September 10, 1982): 1203-8.

Evans, W., and Rosenberg, I. 1992. Biomarkers. New York: Simon and Schuster.

Fiatarone, M., O’Niel, E., and Ryan, N. 1994. Exercise training and supplementation for physical frailty in very elderly people.New England Journal of Medicine 330: 1769-1765.

Fiatarone, M.A., and Singh, M. 2002. Exercise comes of age: Rationale and recommendations for geriatric exercise prescription. Journal of Gerontology Series A: Biological Sciences and Medical Sciences 57 (A): M262-28.

Nelson, M., Fiatarone, M., M., Morganti, C., Trice, I., Greenberg, R., and Evans, W. 1994. Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures. Journal of the American Medical Association 272(24): 1909-1914.

Pagoto, S., (2019). Depression and Anxiety. In D.J. Green (Ed). The Professional’s Guide to Health and Wellness Coaching (p 410). San Diego, California: American Council on Exercise (ACE).

Westcott, W., Richards, M., Reinl, G., and Califano, D. 2000. Strength training elderly nursing home patients. Mature Fitness. American Senior Fitness Association. www.seniorfitness.net.

Westcott, W. 2009. ACSM strength training guidelines. ACSM’s Health & Fitness Journal 13 (4):14-22.

Zeratsky, Katherine, R.D., L.D.  (2020, August  27) What’s a good way to gain weight if you’re underweight? Mayo Clinic. Retrieved from http://healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/underweight/faq-20058429