Daijiworld Media Network - Bengaluru
Bengaluru, Feb 19: Most people worry about weight gain as they grow older. Far fewer think about muscle loss. Yet sarcopenia — the gradual, involuntary loss of muscle mass and strength with age — is both common and often overlooked.
According to Dr. Pradeep Kocheeppan, Consultant Orthopaedics at Apollo Hospitals, Bannerghatta Road, Bengaluru, Indians — especially South Indians — are genetically predisposed to having lower baseline muscle mass compared to many Western populations. Combined with sedentary lifestyles, desk-bound jobs and minimal physical strain, this increases the risk of age-related muscle decline.
Modern lifestyles demand far less physical effort. Groceries are delivered, doors open automatically, and most work happens on screens. Over time, reduced resistance-based activity — especially involving the upper limbs — leads to what doctors call disuse atrophy.
Biologically, sarcopenia mainly affects type 2 (fast-twitch) muscle fibres, which are responsible for power and quick movements. These fibres help you catch yourself during a fall or lift heavy objects. Type 1 (slow-twitch) fibres, which support endurance, are relatively less affected. This explains why many older adults can manage slow, sustained activities but struggle with sudden bursts of strength.
Dr. Kocheeppan explains that fitness training must align with individual goals:
• Strength training: Focuses on increasing maximum force, typically using heavier weights with fewer repetitions (e.g., squats, deadlifts, bench presses).
• Endurance training: Sustains activity over longer durations using lighter resistance (e.g., rowing, cycling).
• Power training: Combines force and speed (e.g., plyometrics, medicine ball throws).
• Hypertrophy training: Aims to increase muscle size by lifting weights that fatigue muscles.
• Functional training: Mimics everyday movements, improving coordination and balance.
For preventing age-related muscle loss, he emphasises that strength training is non-negotiable.
Muscle loss accelerates after 40, particularly affecting type 2 fibres. Without intervention, decline becomes almost inevitable.
Adults over 40 should ideally include at least 20 minutes of strength and power exercises several times a week. However, gyms tend to have fewer senior adults, partly due to a lack of trainers experienced in guiding older individuals safely.
A structured approach is key. Doctors often assess 1RM (one-repetition maximum), the maximum weight a person can lift once. Strength training typically involves working at 80% or more of 1RM with fewer repetitions. Power training uses lighter weights — about 30–50% of 1RM — performed at higher speeds.
Strength improves muscle mass; power improves movement speed. Together with endurance and functional training, they create a balanced routine.
Muscle health is closely tied to bone health. Bones respond to the stress placed on them by muscles. Without muscle strengthening, bone density can decline.
“If a DEXA scan shows reduced bone density, exercise becomes even more critical. But sometimes, exercise alone isn’t enough,” Dr. Kocheeppan said.
In advanced cases, medications may be required. These can include anabolic agents that stimulate muscle response when combined with exercise. Optimising vitamin D and B12 levels is also crucial. Doctors may evaluate parathyroid hormone levels and prescribe treatments to improve bone density.
Newer medications such as romosozumab (marketed as Evenity) target specific pathways involved in bone loss and are administered monthly under supervision. Other treatments include ibandronic acid and injectable therapies like denosumab, which help maintain or improve bone mass.
Traditionally, bone loss was considered largely irreversible. Today, with a combination of targeted exercise and medical therapy, progression can often be slowed — and in some cases, bone density improved.
Muscle and bone health are not cosmetic concerns. They determine independence, balance, mobility and the ability to recover from illness or injury.
Strong muscles support strong bones. Strong bones enable active living. While ageing is inevitable, muscle loss doesn’t have to be — especially with timely strength training, proper nutrition and medical guidance when needed.