Why is muscle strength so important for healthy ageing?

Muscle strength is not just a matter of performance: it is one of the strongest measurable predictors of how healthily you age. Research in older adults shows that weak handgrip strength is associated with a higher risk of death, cognitive decline, depression, more falls and fractures. These are associations, not proven cause and effect, but their consistency across multiple outcomes is striking.

The age-related loss of muscle mass and strength, known as sarcopenia, is the concrete downside of this. People with sarcopenia are more likely to fall, become disabled, be hospitalised, and ultimately to be admitted to a nursing home and to have a shorter lifespan. Quality of life declines noticeably.

What makes muscle loss particularly insidious is how quickly it happens during inactivity or bed rest. After just five days of lying flat you lose significant muscle strength, even if you are otherwise healthy. In the first two weeks, strength declines faster than the muscles visibly shrink, which suggests that the nerve signals controlling the muscles also deteriorate.

The good news: resistance training demonstrably works well. Based on more than 137 systematic reviews involving over 30,000 participants, regular resistance training improves muscle strength, muscle mass, walking speed, balance and several other aspects of physical functioning in healthy adults. For older men, a combination of strength and balance training yields the greatest benefits for leg muscle strength, balance and mobility.

Nutrition also plays a role: a healthy diet in younger and middle age is associated with better muscle preservation later in life, although that relationship has been studied to a limited extent. Creatine supplements on top of resistance training appear to produce slightly greater strength gains in older women in programmes lasting at least six months, but the evidence for this is still thin, and two researchers had ties to the creatine industry, which calls for caution.