Skeletal Muscle Function Deficits in the Elderly: Current Perspectives on Resistance Training.

A variety of changes in skeletal muscle occur with aging. Sarcopenia is the age-associated loss of muscle mass and is one of the main contributors to musculoskeletal impairments in the elderly. Traditional definitions of sarcopenia focused on the size of human skeletal muscle. However, increasing evidence in older adults suggests that low muscle mass is associated with weakness, and weakness is strongly associated with function and disability. In recent years a global trend has shifted toward more encompassing definitions for the loss of muscle mass which include decreases in physical function. This review focuses on skeletal muscle function deficits in the elderly and how these age-associated deficits can be ameliorated by resistance training. We set forth evidence that skeletal muscle deficits arise from changes within the muscle, including reduced fiber size, decreased satellite cell and fiber numbers, and decreased expression of myosin heavy chain (MHC) isoform IIa. Finally, we provide recommendations for clinical geriatric practice regarding how resistance training can attenuate the increase in age-associated skeletal muscle function deficits. Practitioners should consider encouraging patients who are reluctant to exercise to move along a continuum of activity between "no acticity" on one end and "recommended daily amounts" on the other.