Most adults will lose at least 30% of their muscle mass during their lifetimes. That frightening truth even has a scary-sounding name: sarcopenia — literally translated as the even scarier sounding “poverty of the flesh.” The “poverty” actually begins for most people around age 30. At that point, even individuals who are physically active will begin to lose some muscle mass; those who shun exercise can lose as much as 30% of their muscle mass with each passing decade.  For most people, the loss escalates somewhere around age 75.

Though there are inconsistent studies, the rates of the condition speeds up from 5% to 13%  in people ages 60 and older. For most people, the loss escalates somewhere around age 80 and older.

Symptoms and Causes

Sarcopenia simply signals the decline in skeletal muscle tissue loss of muscle mass and strength that comes with the passing of years. It’s easy to identify the symptoms when you see or feel them: loss of coordination and stamina, increased weakness, slowing or difficulty in moving and walking. Its worst attributes are that it can be a major driver of falls, can cause a loss of independence, contribute to obesity — and is even medically considered “a strong predictor of death.”

Yet until very recently, sarcopenia was simply accepted as one of the things that makes aging unadvisable for sissies. It wasn’t until the last decade or so that pharmacologists targeted it as a form of disease that could be treated, and to some extent, prevented.

While much about its causes remains a mystery, researchers have begun to isolate some of them, including:

• Reductions in nerve cells that send signals from the brain to the muscles — especially those that start movement.
• Lowered concentrations of hormones, such as growth hormones, testosterone, and insulin-like growth factor.
• Slowed ability to turn protein into energy.
• Increases in inflammation, in part because of disease.

Can a Pill Prevent It?

The primary treatment for sarcopenia is a drugfree one: exercise. More on that below.

But since the rise and recognition of muscle mass loss as a potentially treatable medical condition, researchers have begun to investigate a number of medications that may offer the hope of help. The caveat is always that they be taken in addition to an exercise regimen, not instead of one.

Drugs currently being investigated as possible treatments include:

• Hormone Replacement Therapy (HRT) — used to supplement the loss of hormones women experience at menopause
• Testosterone supplements
• Growth hormone supplements
• Medications for treating metabolic syndrome — including insulin resistance, obesity, and hypertension.
• Several natural alternatives with anti-aging properties

Proper Nutrition Can Help

Some dietary additions may help slow the ravages of muscle deterioration that commonly accompany aging.

Importantly, protein is essential for building and muscle fibers. Yet many older adults fall far short of consuming the 50 grams per day (depending on sex, health, activity level and muscle mass) recommended for good health. And taking in some protein before and after exercising has proven to aid in muscle recovery.

In addition, leucine, the most potent amino acid that can actually stimulate muscle growth, is found in highest amounts in animal sources such as beef, chicken, and pork — and in lower concentrations in beans, nuts, and seeds.

Omega-3 fatty acids, contained in fish oil and flaxseed, has also been shown to increase rates of muscle synthesis in older adults.

And finally, Vitamin D, produced in a body when it’s exposed to sunlight and present in some foods such as fish, has also been shown to be help improve muscle mass and function. As many as 35% of the adults in the U.S. are believed to be deficient in Vitamin D.  And because it’s difficult to get a sufficient amount through sun and specific food intake, many medical practitioners recommend taking a daily supplement in pill or tincture form.

One Sure Thing: Exercise

While changes in diet offer some results, and possible drug treatments for sarcopenia remain controversial and largely untested, experts unequivocally echo the advice of other medical researchers focused on aging: exercise.

“First and foremost, there’s nothing better than physical activity, and resistance training in particular, for maintaining and improving muscle health and function,” says Nathan LeBrasseur, associate professor of Physical Medicine and Rehabilitation at the Mayo Clinic, whose current studies focus on disabling  the protein myostatin, which may help increase muscle mass and bolster resilience.

While LeBrasseur is cautiously optimistic about his clinical research on myostatins and muscles — studies have so far been confined to lab mice — his embrace of exercise as an intervention is whole-hearted. “Nothing is better than exercise,” he says. “It can actually counter aging’s effects. But to increase muscle mass, you must also increase the load on it,” says LeBrasseur, who is a fan of strength training with weights. “Monitor yourself to make  sure the weight is increasing every week so you can gauge improvement.”

But with all considerable respect due him, it is here that his doctorly advice might miss the mark for many seniors. LeBrasseur is a strapping fellow in his mid-50s. While his challenge to increase weight amounts weekly might hold appeal to many people his age and younger, those 70 and up may fail to feel the thrill of that particular competitive edge.

As they are wont to do, experts disagree on the optimal amount of exercise older adults must do to help stave off sarcopenia. “Some” every day is said to be optimal; a regimen of three times weekly is the minimum.

Lyndon Joseph, exercise physiologist with the Division of Geriatrics and Clinical Gerontology of the National Institute on Aging, recently appeared with LeBrasseur in an educational lecture on aging and muscle mass. He, too, offered unstinting accolades for the benefits and potential of exercise, but tempered it some with practicality. “Protocols all show some form of benefit, so do something you can sustain for a long period. Do what you can do, and find someone to help you maintain a regular regimen,” Joseph says. “Older adults are often challenged in training by ageism — which assumes they can do very little.”

The NIH has several articles [Kayla: link articles to https://www.nia.nih.gov/health/exercise-and-physical-activity] on how physical exercise can help you stay healthy as you age, the many benefits of being physically active, staying motivated to fit exercise into your daily routine, monitoring your activity, and a handy infographic on the four types of exercise and their benefits.

(This article was reviewed February 2025  since it originally published  November 2019.)