1. Muscle Development and Loss

• Peak skeletal muscle mass is generally attained in the 20s and 30s and then gradually declines. Researches show that muscle mass among male and female adults drops about 4.7% and 3.7% per decade respectively.
• Regarding muscle strength, it drops even faster at about 14.5% and 11.8% per decade for male and female respectively as shown in another study of 120 male and female persons of middle to old age. Apart from the above study, other researchers show that muscle strength among male and female elderly persons aged over 70 was 45% and 37% respectively less than the younger adult groups.
• Although a certain degree of muscle loss is inevitable with aging, the good news is that adopting a healthier lifestyle can help improve muscle strength and maintain mobility.

2. Impact of Muscle Loss

• If the muscle loss is so severe that subsequently impairs one’s muscle strength or mobility, it may result in “Sarcopenia” . Apart from apparent wasting of the calves and thigh muscles, such patients may also encounter difficulties in daily lives frequently; such as slowness in walking, weakness in getting out of a chair, climbing stairs, lifting heavy objects, and doing household chores. In addition, researches showed that sarcopenia would increase the risk of fall, admission to residential care facilities, hospitalisation (including increase length of hospital stay) and mortality. A local study in 2014 found that the prevalence of sarcopenia among community-dwelling people aged 65 and above was 9.0%.

3. Factors that Accelerate Muscle Loss

• Apart from the impact of normal aging process, unhealthy lifestyle (such as inadequate physical activity, inadequate nutrient intake and smoking.) and diseases (such as metabolic diseases, such as type II diabetes, diseases which affect the absorption of digestive system or function of some major organs, such as chronic pulmonary obstructive disease; cardiac diseases; cancers; depression and vitamin D deficiency) could also accelerate the progress of muscle loss.

4. Strategies for Prevention of Muscle Loss

• Adopting a healthy lifestyle also helps improve one’s muscle strength and mobility. It includes maintaining a balanced diet in order to ensure adequate protein intake, and regular engagement in both muscle strengthening activities as well as aerobic physical activities. Muscle strengthening activities helps build up muscle bulk and strength whereas aerobic activities of moderate to vigorous intensity help slow down muscle loss, improve muscle endurance and cardiopulmonary function. If elderly persons suffer from chronic diseases mentioned in paragraph 3 above, are underweight or losing weight with unknown reason, they should consult a doctor promptly. Smokers must quit smoking.

5. What kind of Physical Activities Help Prevention of Muscle Loss

• For muscle strengthening activities, elderly persons could choose household chores or work which involve lifting loads. To prevent overuse or injuries, however, they should take precautions to ensure not to overload nor be over-repetitive, and to maintain a proper posture. There are three options of loads for muscle strengthening activities, they include: (1) One’s own body weight as loads; such as sitting up and doing a mini-squat; (2) Weight training machines; such as leg press and chest press machines; and (3) Small exercise equipment; such as water bottles, dumbbells, cuff weight and elastic resistance bands.
• For aerobic physical activities, the intensity level should be of moderate or above. Examples of household chores include mopping, window cleaning and walking a dog. Examples of aerobic exercise include fitness walking, Tai Chi Chuan, swimming, riding a fitness bike, and various ball games.

6. How to Do Physical Activities to Improve Muscle Strength and Mobility

• For muscle strengthening exercise, elderly persons should do it at moderate or greater intensity that involve all major muscle groups on 2 or more days a week, (with least 48 hours separating the training sessions for the same muscle group; i.e. on alternate day). Each exercise should be repeated for 1-3 sets and with 10-15 repetitions as 1 set. They should start muscle strengthening exercise with lighter loads, and then progress gradually to moderate or greater intensity.
• For aerobic physical activities, elderly persons should also progress gradually. They should target for at least 150-300 minutes of aerobic activities of moderate intensity; or at least 75-150 minutes of aerobic activities of vigorous intensity; or an equivalent combination of moderate and vigorous intensity activities throughout the week.

For elderly persons who are not able to meet the recommended duration and intensity of physical activities due to health limitations, they could still improve their health by doing lighter physical activities in accordance with their level of fitness. Please refer to: “Tips about Planning Physical Activities Programme for Elderly” . For elderly persons who have chronic diseases or any queries of their health condition, please consult a healthcare professional prior to starting a physical activity programme or increasing the intensity.