Sarcopenia: Why We Lose Muscle as We Age and What We Can Do About It
By APA Physiotherapist, Ben Howie
Introduction: Is losing muscle just part of getting older?
As we age, it is normal to experience some changes in muscle mass and strength. Activities that once felt easy, such as getting out of a chair, climbing stairs or carrying shopping, can gradually become more difficult.
Significant age-related loss of muscle strength and function is known as sarcopenia.
Sarcopenia is more than simply losing muscle size. It can affect strength, balance, mobility and our ability to perform everyday activities independently.
The good news is that getting older does not mean we have to accept becoming weak. Research shows that appropriately prescribed exercise, particularly resistance training, can help maintain and improve strength and physical function throughout later life.
What is sarcopenia?
Sarcopenia is a condition characterised by a progressive loss of muscle strength, muscle quantity or quality, and physical performance.
Importantly, strength is a key component of sarcopenia. Someone may not notice significant changes in muscle size but may still experience a decline in their ability to produce force.
This can affect everyday activities such as:
Getting up from a chair
Climbing stairs
Carrying shopping
Walking longer distances
Getting up from the floor
Maintaining balance
Over time, these changes can contribute to reduced independence and an increased risk of falls.
Why do we lose muscle as we age?
Sarcopenia develops through a combination of age-related changes and lifestyle factors.
Ageing
As we age, our muscles become less responsive to the signals that stimulate growth and repair. Changes also occur in our nervous system, hormones and ability to recover from physical stress.
Reduced physical activity
We often become less active as we get older due to work changes, illness, injury, pain or simply changes in lifestyle.
This can create a cycle: Less activity → reduced strength → everyday activities become harder → even less activity
Illness and inactivity
Periods of illness, hospitalisation or bed rest can result in significant losses in strength, particularly in older adults.
Nutrition
Adequate nutrition, including sufficient protein and overall energy intake, is also important for maintaining muscle health.
Why does strength matter?
Strength isn't just about lifting weights in the gym.
It allows us to perform the activities that keep us independent.
Good strength helps us:
Get out of a chair
Climb stairs
Carry objects
Walk safely
Get up from the floor
Participate in hobbies and exercise
As strength declines, everyday tasks can become more challenging.
Maintaining strength is therefore an important part of maintaining independence.
Can we prevent or slow muscle loss?
Yes.
While some changes in muscle mass are a normal part of ageing, research shows that muscle remains adaptable throughout life.
Resistance training is one of the most effective ways to improve strength and physical function in older adults, including those with sarcopenia. Combining resistance exercise with other forms of exercise, such as balance and aerobic training, can provide additional benefits.
It is never too late to start.
What type of exercise helps?
1. Resistance training
Resistance training provides the stimulus needed to maintain and build muscle strength.
Exercises might include:
Sit-to-stands or squats
Step-ups
Calf raises
Leg press
Rows
Chest press
Hip strengthening
The important principle is progressive overload. As strength improves, exercises should gradually become more challenging.
You don't necessarily need to lift very heavy weights. The appropriate starting point will depend on your current strength and physical abilities.
2. Balance training
Balance exercises can help maintain confidence and physical function and are particularly important for people at increased risk of falls.
Examples include:
Tandem standing or walking
Single-leg balance
Step-and-reach exercises
Functional balance activities
3. Aerobic exercise
Walking, cycling, swimming and other cardiovascular activities are important for maintaining general health and fitness.
A combination of resistance, aerobic and balance exercise can help support overall physical function as we age.
What about nutrition?
Exercise and nutrition work together to support muscle health.
Adequate protein provides the building blocks required for muscle maintenance and repair. However, nutritional requirements vary between individuals, particularly for people with medical conditions or those recovering from illness.
If you are concerned about your nutrition or have experienced unintentional weight loss, speaking with a GP or dietitian can be helpful.
What if I'm already losing strength?
It is never too late to improve.
A physiotherapist can assess your:
Muscle strength
Balance
Mobility
Functional capacity
Falls risk
Exercise tolerance
They can then develop an exercise programme appropriate to your current abilities and gradually progress it over time.
For someone who is very deconditioned, this might initially involve simple exercises such as supported sit-to-stands and balance exercises. Someone who is already active may be able to begin with more challenging resistance exercises.
The important thing is to start at the right level and progressively build from there.
Myth vs Fact
Myth:
“Losing muscle is just part of getting older.”
Fact:
Some muscle loss is associated with ageing, but significant reductions in strength and physical function can often be slowed or improved through exercise and appropriate lifestyle strategies.
Myth:
“I'm too old to start lifting weights.”
Fact:
Older adults can improve strength and physical function through appropriately prescribed resistance training.
Myth:
“Walking is enough to maintain muscle strength.”
Fact:
Walking is excellent for general health, but resistance training provides a more direct stimulus for maintaining and improving muscle strength.
Myth:
“Once I've lost muscle, I can't get it back.”
Fact:
Muscle and strength remain adaptable throughout life. Resistance training can improve strength and physical function even in older adults with sarcopenia.
The Take-Home Message
Getting older doesn't mean you have to accept becoming weak.
Sarcopenia can affect strength, mobility, balance and independence, but there are effective ways to maintain and improve physical function.
Resistance training is one of the most important tools we have for maintaining strength as we age.
Combined with regular physical activity, balance training, adequate nutrition and appropriate recovery, exercise can help you stay strong, independent and able to do the things you enjoy.
You don't have to stop getting stronger just because you're getting older.
References
· Bahat, Gülistan, and Alfonso Cruz-Jentoft. “Putting Sarcopenia at the Forefront of Clinical Practice.” European Journal of Geriatrics and Gerontology, vol. 1, no. 2, 24 Oct. 2019, pp. 43–45, 10.4274/ejgg.galenos.2019.82. Accessed 25 Aug. 2026.
· Chen, Yu Chang, et al. “Is Moderate Resistance Training Adequate for Older Adults With Sarcopenia? A Systematic Review and Network Meta-Analysis of RCTs.” European Review of Aging and Physical Activity, vol. 20, no. 1, 29 Nov. 2023, 10.1186/s11556-023-00333-4. Accessed 25 Aug. 2026.
· Du Rietz, Matilda, and Susanne Beischer. “Assessment of Muscle Strength in Elderly as a Screening Method for Sarcopenia in Primary Care: A Scoping Review.” BMJ Open, vol. 14, no. 11, Nov. 2024, p. e085190, 10.1136/bmjopen-2024-085190. Accessed 25 Aug. 2026.
· Ferreira, Luis Fernando, et al. “The Effect of Different Exercise Programs on Sarcopenia Criteria in Older People: A Systematic Review of Systematic Reviews With Meta-Analysis.” Archives of Gerontology and Geriatrics, vol. 105, Feb. 2023, p. 104868, 10.1016/j.archger.2022.104868. Accessed 25 Aug. 2026.
· Haase, Christoffer Bjerre, et al. “Sarcopenia: Early Prevention or Overdiagnosis?” BMJ, vol. 376, 13 Jan. 2022, p. e052592, 10.1136/bmj-2019-052592. Accessed 25 Aug. 2026.