Musculoskeletal health and the older adult.

A decline in muscle mass and function, and in the mass and integrity of the skeletal system, are well-known consequences of aging. These changes impinge on the functional performance required for independent living and contribute to frailty and fracture risk. Resistance exercise has been shown to be an effective mode to circumvent age-related changes in the muscular system, although the benefit of exercise on bone mass in the aging skeleton is comparatively modest at best. This brief review highlights results from several studies that we have undertaken in older adults, examining aspects of the resistance training prescription as well as the potential beneficial role of hormones. What is common to all of these studies is the high degree of residual plasticity that remains in aging skeletal muscle. Risk factors for falls and fracture include reduced bone mass, muscle weakness, impaired balance, and lessened visual acuity. Among these, only muscle strength is reliably enhanced with resistance exercise, which may aid in reducing hip fracture risk as well as improving the ability to undertake daily activities and maintain independence.

[1]  A. H. Norris,et al.  Effect of muscle mass decrease on age-related BMR changes. , 1977, Journal of applied physiology: respiratory, environmental and exercise physiology.

[2]  M. Pollock,et al.  Circuit Weight Training: A Critical Review of Its Physiological Benefits. , 1981, The Physician and sportsmedicine.

[3]  A. Aniansson,et al.  Physical training in elderly men with special reference to quadriceps muscle strength and morphology , 1981 .

[4]  W. Frontera,et al.  Strength conditioning in older men: skeletal muscle hypertrophy and improved function. , 1988, Journal of applied physiology.

[5]  A. Rogol,et al.  Effects of sex and age on the 24-hour profile of growth hormone secretion in man: importance of endogenous estradiol concentrations. , 1987, The Journal of clinical endocrinology and metabolism.

[6]  L. P. Novâk,et al.  Aging, total body potassium, fat-free mass, and cell mass in males and females between ages 18 and 85 years. , 1972, Journal of gerontology.

[7]  D. Atkins.  Postmenopausal estrogen therapy and cardiovascular disease. , 1992, The New England journal of medicine.

[8]  G. Kelley.  Exercise and regional bone mineral density in postmenopausal women: a meta-analytic review of randomized trials. , 1998, American journal of physical medicine & rehabilitation.

[9]  M. Pollock,et al.  Effect of resistance training on lumbar extension strength , 1989, The American journal of sports medicine.

[10]  Peter R. Cavanagh,et al.  Exercise and physical activity for older adults , 1998 .

[11]  D G Sale,et al.  Neural adaptation to resistance training. , 1988, Medicine and science in sports and exercise.

[12]  R. Marcus,et al.  Regional fat distribution by dual-energy X-ray absorptiometry: comparison with anthropometry and application in a clinical trial of growth hormone and exercise. , 1994, Clinical science.

[13]  L. Bandini,et al.  Effect of age on body composition and resting metabolic rate. , 1990, The American journal of physiology.

[14]  L. Lipsitz,et al.  High-intensity strength training in nonagenarians. Effects on skeletal muscle. , 1990, JAMA.

[15]  G. McKenzie Gillam.  Effects of frequency of weight training on muscle strength enhancement. , 1981, The Journal of sports medicine and physical fitness.

[16]  D B Burr,et al.  Muscle Strength, Bone Mass, and Age‐Related Bone Loss , 1997, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[17]  P. Sönksen,et al.  The effects of treatment with recombinant human growth hormone on body composition and metabolism in adults with growth hormone deficiency. , 1989, The New England journal of medicine.

[18]  J. Yesavage,et al.  Effects of human growth hormone, insulin-like growth factor I, and diet and exercise on body composition of obese postmenopausal women. , 1998, The Journal of clinical endocrinology and metabolism.

[19]  W. Evans.  What is sarcopenia? , 1995, The journals of gerontology. Series A, Biological sciences and medical sciences.

[20]  A. Young.  Exercise physiology in geriatric practice. , 2009, Acta medica Scandinavica. Supplementum.

[21]  R. Wiswell,et al.  Muscle hypertrophy response to resistance training in older women. , 1992, Journal of applied physiology.

[22]  U. Barzel,et al.  Estrogens in the prevention and treatment of postmenopausal osteoporosis: a review. , 1988, The American journal of medicine.

[23]  L. Larsson,et al.  Muscle strength and speed of movement in relation to age and muscle morphology. , 1979, Journal of applied physiology: respiratory, environmental and exercise physiology.

[24]  P. Era,et al.  Effects of strength and endurance training on isometric muscle strength and walking speed in elderly women. , 1996, Acta physiologica Scandinavica.

[25]  P. Kannus,et al.  Randomized Controlled Study of Effects of Sudden Impact Loading on Rat Femur , 1998, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[26]  R. Marcus,et al.  Effect of a Sustained Program of Resistance Training on the Acute Growth Hormone Response to Resistance Exercise in Older Adults , 1994, Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme.

[27]  H. Kemper,et al.  The Effect of Exercise Training Programs on Bone Mass: A Meta-analysis of Published Controlled Trials in Pre- and Postmenopausal Women , 1999, Osteoporosis International.

[28]  J D Williamson,et al.  Association of muscle strength with maximum walking speed in disabled older women. , 1998, American journal of physical medicine & rehabilitation.

[29]  J. Nichols,et al.  Efficacy of Heavy‐Resistance Training for Active Women over Sixty: Muscular Strength, Body Composition, and Program Adherence , 1993, Journal of the American Geriatrics Society.

[30]  R. Marcus,et al.  Once‐Weekly Resistance Exercise Improves Muscle Strength and Neuromuscular Performance in Older Adults , 1999, Journal of the American Geriatrics Society.

[31]  R. Wiswell,et al.  Oral arginine does not stimulate basal or augment exercise-induced GH secretion in either young or old adults. , 1999, The journals of gerontology. Series A, Biological sciences and medical sciences.

[32]  D. Downham,et al.  Heavy‐resistance training in older Scandinavian men and women: short‐ and long‐term effects on arm and leg muscles , 1995, Scandinavian journal of medicine & science in sports.

[33]  D. Raab,et al.  Light resistance and stretching exercise in elderly women: effect upon strength. , 1988, Archives of physical medicine and rehabilitation.

[34]  A. Bostom,et al.  Postmenopausal estrogen therapy and cardiovascular disease. , 1992, The New England journal of medicine.

[35]  M. Pollock,et al.  Effect of training frequency and specificity on isometric lumbar extension strength. , 1990, Spine.

[36]  M. Pollock,et al.  Effect of Reduced Training Frequency on Muscular Strength* , 1988, International journal of sports medicine.

[37]  R. Woledge,et al.  Hormone replacement therapy increases isometric muscle strength of adductor pollicis in post-menopausal women. , 1999, Clinical science.

[38]  W. Evans,et al.  Changes in Skeletal Muscle with Aging: Effects of Exercise Training , 1993, Exercise and sport sciences reviews.

[39]  A. Hicks,et al.  A longitudinal trial of weight training in the elderly: continued improvements in year 2. , 1996, The journals of gerontology. Series A, Biological sciences and medical sciences.

[40]  Obert,et al.  Effects of human growth hormone in men over 60 years old. , 1990, The New England journal of medicine.

[41]  M. Fiatarone,et al.  The etiology and reversibility of muscle dysfunction in the aged. , 1993, Journal of gerontology.

[42]  R. Marcus,et al.  Comparative effects of high- and low-intensity resistance training on thigh muscle strength, fiber area, and tissue composition in elderly women. , 1996, Clinical physiology.

[43]  K. Yarasheski,et al.  Effect of growth hormone and resistance exercise on muscle growth and strength in older men. , 1995, The American journal of physiology.

[44]  H. Frost,et al.  On Our Age‐Related Bone Loss: Insights from a New Paradigm , 1997, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[45]  Exercise and regional bone mineral density in postmenopausal women: a meta-analytic review of randomized trials. , 1998 .

[46]  R. Woledge,et al.  Muscle weakness in women occurs at an earlier age than in men, but strength is preserved by hormone replacement therapy. , 1993, Clinical science.

[47]  R. Marcus,et al.  Maximal muscle strength of elderly women is not influenced by oestrogen status. , 1995, Age and ageing.

[48]  F C Hagerman,et al.  Strength and skeletal muscle adaptations in heavy-resistance-trained women after detraining and retraining. , 1991, Journal of applied physiology.

[49]  S. Cummings,et al.  Is Postmenopausal Estrogen Therapy Associated With Neuromuscular Function or Falling in Elderly Women , 1995 .

[50]  Lester M. Wolfson,et al.  The Relationship of Knee and Ankle Weakness to Falls in Nursing Home Residents: An Isokinetic Study , 1987, Journal of the American Geriatrics Society.

[51]  G. Sforzo,et al.  Resilience to Exercise Detraining in Healthy Older Adults , 1995, Journal of the American Geriatrics Society.

[52]  S B Roberts,et al.  Exercise training and nutritional supplementation for physical frailty in very elderly people. , 1994, The New England journal of medicine.

[53]  W. Simpson.  Exercise: prescriptions for the elderly. , 1986, Geriatrics.

[54]  G. McKenzieGillam.  Effects of frequency of weight training on muscle strength enhancement. , 1981 .

[55]  M. Pollock,et al.  Effect of Reduced Frequency of Training and Detraining on Lumbar Extension Strength , 1992, Spine.

[56]  G. Kelley.  Aerobic Exercise and Lumbar Spine Bone Mineral Density in Postmenopausal Women: A Meta‐Analysis , 1998, Journal of the American Geriatrics Society.

[57]  K.,et al.  Differential changes in bone mineral density of the appendicular and axial skeleton with aging: relationship to spinal osteoporosis. , 1981, The Journal of clinical investigation.

[58]  T Reilly,et al.  Changes in muscle strength in women following the menopause: a longitudinal assessment of the efficacy of hormone replacement therapy. , 1999, Clinical science.

[59]  Andrew,et al.  Lack of effect of recombinant human growth hormone (GH) on muscle morphology and GH-insulin-like growth factor expression in resistance-trained elderly men. , 1996, The Journal of clinical endocrinology and metabolism.

[60]  P V Komi,et al.  Changes in isometric force- and relaxation-time, electromyographic and muscle fibre characteristics of human skeletal muscle during strength training and detraining. , 1985, Acta physiologica Scandinavica.

[61]  E. Bostofte,et al.  Postmenopausal hormone replacement therapy--clinical implications. , 1994, European journal of obstetrics, gynecology, and reproductive biology.

[62]  R. Marcus,et al.  Dynamic muscle strength alterations to detraining and retraining in elderly men. , 1997, Clinical physiology.

[63]  R L Hintz,et al.  Effect of recombinant human growth hormone on the muscle strength response to resistance exercise in elderly men. , 1994, The Journal of clinical endocrinology and metabolism.

[64]  Andrea B. Colvin,et al.  Comparison of 2 vs 3 Days/Week of Variable Resistance Training During 10- and 18-Week Programs , 1989, International journal of sports medicine.

[65]  W. Hayes,et al.  Bone compressive strength: the influence of density and strain rate. , 1976, Science.

[66]  T. Reilly,et al.  Effects of acute changes in oestrogen on muscle function of the first dorsal interosseus muscle in humans. , 1997, The Journal of physiology.

[67]  R. Wiswell,et al.  Age-dependent effect of resistance exercise on growth hormone secretion in people. , 1992, The Journal of clinical endocrinology and metabolism.

[68]  M. Fiatarone,et al.  Effects of High-Intensity Strength Training on Multiple Risk Factors for Osteoporotic Fractures: A Randomized Controlled Trial , 1994 .

[69]  M. Pollock,et al.  Exercise Training and Prescription for the Elderly , 1994, Southern medical journal.

[70]  T. Moritani,et al.  Potential for gross muscle hypertrophy in older men. , 1980, Journal of gerontology.

[71]  M. Wheat.  Exercise in the Elderly , 1992, The Western journal of medicine.

[72]  M. Kutner,et al.  Impaired growth hormone secretion in the adult population: relation to age and adiposity. , 1981, The Journal of clinical investigation.