How do you train smart for lasting muscle strength in older age?
Research shows that training volume matters in older adults: a low volume is already enough to maintain daily functioning and muscle mass, while you need more volume if you want to increase your maximum leg strength. If you already have muscle loss, the combination of strength training, balance exercises and a protein-rich diet delivers the most measurable gains.
For maximum leg strength you need a moderate or high training volume. A low volume is not enough for that. But if your main goal is to get up more easily, walk better and function in daily life, then a low training volume is already sufficient: low volumes produced the biggest gains in walking ability and muscle mass in healthy older adults over 60.
In older adults with serious muscle loss (sarcopenia), the effects are clearest when strength training is combined with balance exercises and a protein-rich diet. That three-part approach improved walking speed by 0.20 metres per second and scored more than 3.5 points better on a standard physical functioning test, both above the threshold at which an improvement is also noticeable in real life. Hand-grip strength increased by over 5 kg. Strength training combined with nutritional supplements, but without balance training, also improved leg muscle strength and muscle mass considerably. Strength training alone, without added nutrition or balance work, is effective too, but the improvements stayed on average just below the clinically noticeable threshold values.
Combined training that brings together strength, balance and endurance works less well for sarcopenia than pure strength training when it comes to muscle strength and walking speed. Standing on a vibration platform does not help here: studies in people with sarcopenia found no demonstrable difference in leg muscle strength or walking speed compared with doing nothing.
On training frequency, model-based estimates suggest that around 1,220 activity-units per week would be optimal for hand-grip strength, and that 600 activity-units per week could already make a difference for walking speed. These are, however, calculations based on models rather than direct experiments, and the precise translation into training days and sets per week remains uncertain.
In ordinary healthy older adults, strength training also improves mental wellbeing and the experience of pain, and reduces depressive complaints. No effect was found on the overall quality-of-life score or on the 6-minute walking distance as a whole. For older adults with sarcopenia, the combined programme of strength, balance and nutrition is the most effective approach that the current body of research shows, although a conversation with your doctor or physiotherapist is a sensible step to tailor the programme to your needs.
This answer draws on several combined summaries of dozens of studies and a number of individual studies in people. The certainty of the evidence differs by sub-question. For the combined programme of strength, balance and nutrition in sarcopenia, the researchers themselves judge the evidence to be of high certainty. For the comparison of training volumes in healthy older adults and for pure strength training in sarcopenia, the certainty is moderate. Estimates of the optimal training dose come from model calculations and are therefore the least certain. For the smaller programme study with 42 participants, the outcomes are promising but generalising them calls for caution.
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