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.