Aging and exercise: Loss of muscle mass and bone density can be reversed

Dr. Kerry Kuehl, left, helps Selma Moss used elastic straps for strength training at OHSU. (KATU)

Losing muscle and bone mass as we age can lead to numerous health problems, but there is a way to decrease and even reverse the process with strength training.

At 95, Selma Moss is hoping to keep active despite an arthritic knee that has been keeping her down of late.

So for the next two months, she'll be working closely with Dr. Kerry Kuehl at OHSU’s Human Performance Lab to reverse the effects of "sarcopenia."

“Sarcopenia is the term for muscle wasting and that means loss of muscle and bone,” said Kuehl. “We lose about one percent of our muscle and bone mass a year after age 30. So between 30 and 40 we lose about 10 percent of our lean body mass. That triples when we’re 70.”

That loss can lead to an increase in hip fractures, falls and premature death.

The best way to slow the process and reverse it is strength training, Kuehl said.

“For Selma, we’re going to do physical therapy twice a week for four weeks, for a month, to get her able to stand,” he said. “Then we’re going to start some very light strength training. Then she’ll be able to go and do something like tai chi. We can get her back in the swimming pool.”

Kuehl says as with any exercise regime -- but especially seniors -- the key is starting slowly with simple equipment.

“You just can’t say, ‘Go to LA Fitness and start a weight training program,’” Kuehl said. “We can’t do that.”

With resistance strength training, people can increase their muscle mass by 20 percent in a year or two.

“The good news is there’s a direct impact on health care costs, on disability and on quality of life for our seniors,” Kuehl said.

Selma's feeling better already.

"Nice chair," she said before using elastic bands for strength training. “I feel like a movie star.”

From Dr. Kuehl:

Now that we’re well into 2019, some of us may be straining to adhere to those New Year’s resolutions about exercise. As a sports medicine specialist at OHSU, I can tell you that your investment in physical activity will pay big dividends especially as we age.

Consider this: Each year after age 30, we lose an average of 1 percent of lean body mass and maximal oxygen uptake or VO2Max. Between 70 and 80 years of age, we lose three times that rate.

This loss of muscle mass and VO2Max, known as sarcopenia,is a primary cause of disability from falls and hip fractures and premature death as we age. Exercise has been shown to reduce sarcopenia, but not all types of physical activity are the same when it comes to gaining muscle. What is the number one way to increase lean body mass and reduce sarcopenia? Resistance exercise and strength training is the best type of exercise and should be a priority for those of us who find ourselves on the mailing list of the AARP.

There are some important guidelines to discuss before you get started: If you’re 50 or older and currently do not exercise, check in with your doctor as he or she may recommend an exercise stress test prior to starting. This is especially important if you have cardiovascular disease risk factors like high blood pressure, high cholesterol, smoking, obesity, diabetes, pulmonary disease like asthma and rheumatologic disease like arthritis.

In a 2015 article from experts on aging and exercise based in Italy and Australia, the researchers provide some general principles for older adults who want to start a resistance training program.

Types of strength training include lifting weights (machines or free weights), body resistance (push ups, sit ups, pull ups) and straps (suspension trainers, resistance bands).

Warm-up and cool-down periods should be twice as long for seniors. Rather than 5 to 10 minutes for warmup and 5 to 10 minutes for cool down, optimal warm-up activities should last 10 to 20 minutes, and 10 to 20 minutes should be designated to the cool-down period.

It is important to stretch active muscles in both periods, and the warm-up session should include progressive muscle strengthening.

Move the resistance through the entire range of motion and avoid heavy lifting. To learn proper technique, you should have an orientation session with an exercise trainer or join a strength training class.

Older adults need a longer rest period between sets in traditional strengthening (1 to 2 minutes) as well as safe physical environments are necessary.

The average frequency should be three days per week and the individual should wait at least 48 hours between training sessions.

Do not hold your breath during a strenuous movement but breathe regularly throughout the range of motion.

Never work through pain. If you develop pain during a lift or movement, stop the exercise and rest. Consult a doctor if the pain persists.

Strength training is the best way to reverse the effects of aging and sarcopenia. In a book published by the Centers For Disease Control called “Growing Stronger – Strength Training for Older Adults,” it is the most complete easy to read way to get started with resistance exercise. By doing this type of exercise, you will build strength to maintain bone density improve balance, coordination, and mobility which will reduce your risk of falling maintain independence in performing activities of daily life.

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