For years it has been assumed that muscle wasting was an inevitable part of growing old, but John Stanbrook who at 87 completed last years London Marathon is, together with several other master athletes, forcing us to reconsider this view. While the media is full of how sedentary lifestyles and poor nutrition are making our youth ill, research also seems to suggest that that it may be an important factor influencing how our neuromuscular system ages.
Old age is commonly associated with a progressive loss of muscle mass, strength and performance (sarcopenia). At its worse it can lead to physical disability, poor quality of life and premature death. Current research is suggesting that sarcopenia and loss of muscle function is not a result of “healthy ageing” rather that it is a natural ageing process of sedentary adults, not healthy ones.
We know that a sedentary life style is extremely unhealthy, contributing to a wide variety of illnesses including diabetes and heart disease. The following highlights some of the recent finding from an in-depth review.
In the Muscular System
Several studies have also shown that in the sedentary person, the loss of muscle mass in old age is due to both the decrease in the number of muscle fibres and in the muscle fibre size. The type 2 fast twitch fibres seem to be mostly effected and appear to reduce in size, rather than the slow twitch Type 1 muscle fibres. This may explain why the elderly people in the general population often struggles to carry out movements that require quick, strong muscle contractions, such as climbing stairs and getting up off the floor.
In the Connective Tissue
The functional stiffness of tendon seems to decrease as we age, despite the tendon collagen becoming stiffer. The end result is a decrease in the spring like properties of the muscle-tendon unit and subsequent decrease in performance.
In the Nervous System
As we get older the number of motor units in our muscles reduces. Each motor unit appears to then have to supply more muscle cells. This is possibly why the number of type 2 fibres reduces in certain older people.
Ageing is often accompanied by inflammatory disorders, which can add to muscle loss in older people. Strategies that might combat inflammatory disorders include Omega 3 fatty acids which has been shown to alleviate systemic inflammation and increase muscle volume and strength, and Vitamin D which is important for the maintenance of skeletal health and the immune system and prevent muscle wasting.
The good news is that healthy, active older adults can preserve their ability to activate their muscle motor units optimally. In master athletes it was found that more than four sessions of intense exercise per week, preserved lean muscle mass into old age. Research has concluded that the decline in muscle mass was more likely to be due to lifestyle choices, such as sedentary lifestyle and poor nutrition.
It is clear though that physical fitness is a key factor for managing health through all stages of life, and that it should be promoted. Master athletes do not exhibit the same declines in muscle mass and function as sedentary older adults. Therefore generic exercise should be avoided in preference to a fitness plan tailored to the individual. By empowering patients to take responsibility for their own health we may be able to reduce the detrimental effects of ageing.
Tideland M, Trouwborst I, Clark BC. Skeletal muscle performance in ageing. Journal of Cachexia, Sarcopenia and Muscle 2018;9(1):3-19
Wroblewski AP, Amati F,Smiley MA, Chronic exercise preserves lean muscle mass in master athletes. The Physician and sports Medicine 2011;39(3):172-178