Strength training is essential: are we accepting weakness as inevitable?
Getting weaker as we age is often treated as inevitable. It isn't.
Sarcopenia—the loss of muscle mass, strength and physical function—is a major contributor to falls, frailty and loss of independence. But much of what we call “normal ageing” is influenced by inactivity, poor nutrition, illness and underuse.
And muscle remains remarkably adaptable throughout life.
People in their 70s, 80s and 90s can still get stronger.
So perhaps the question isn't “Why do older people become weak?”
It's “Why do we accept weakness as inevitable?”
Use it or lose it
When we challenge our muscles, they adapt. When we stop using them, they weaken.
That matters far beyond lifting weights. Muscle helps us control blood glucose, maintain physical function and cope with illness. Strength allows us to get out of a chair, climb stairs, carry shopping and recover our balance when we stumble.
Small changes in strength can make a huge difference to independence.
Prevention shouldn't start after the first fall
We often become interested in muscle only when someone has already become frail or fallen.
A lifestyle medicine approach means moving the conversation upstream.
We should be helping people maintain muscle throughout adult life, not trying to rebuild it after it has been lost.
The essentials are surprisingly simple:
Resistance training – the most important stimulus for maintaining strength
Adequate protein – particularly important as we age
Regular movement – avoid long periods of sitting
Balance and power training – strength alone isn't enough to prevent falls
Address barriers – pain, poor sleep, loneliness, illness and fear of falling can all reduce activity
Are we eating enough protein?
We may be underestimating how little protein some older people consume.
In a study of 256 Yorkshire adults aged 65–89, fewer than half met the UK recommendation of 0.75 g/kg/day, and fewer than 15% reached the age-specific recommendation of 1.2 g/kg/day. Only one participant achieved 25 g of protein at each of three meals.
How often do we actually ask our patients what—and how much—they eat?
And when we advise someone to lose weight, are we thinking about preserving muscle as well as losing fat?
What are you personally doing to protect your own muscle and bone health?
If we aren't looking after our own strength, are we really likely to have meaningful conversations with our patients about theirs?
I've recently changed my own exercise programme, adding another strength session alongside cardio. I'm also experimenting with ways to increase the protein in my breakfast.
And I'm talking to family members about what they're doing to protect their strength and bone health.
Because knowing the evidence isn't quite the same as putting it into practice.
A challenge for healthcare professionals
Don't wait for frailty.
Don't wait for the first fall.
Talk about strength now.
Ask about resistance exercise.
Ask about protein.
Ask about sitting and daily movement.
Ask what your patients want to remain capable of doing.
And ask yourself the same questions.
Sarcopenia isn't an inevitable consequence of ageing. Strength is not just about muscles.
It's about independence, resilience and living well for longer.
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