FUNCTIONAL AND METABOLIC CONSEQUENCES OF SARCOPENIA

The capacity of older men and women to adapt to regularly performed ex ercise has been demonstrated by many laboratories. Aerobic exercise re sults in improvements in functional capacity and reduced risk of devel oping type II diabetes in the elderly. High intensity resistance train ing (above 60% of the 1 repetition maximum) causes large increases in strength in the elderly, and resistance training significant increases muscle size. Resistance training also significantly increases energy requirements and insulin action of the elderly. We recently demonstrat ed that resistance training has a positive effect on multiple risk fac tors for osteoporotic fractures in previously sedentary post-menopausa l women. Because the sedentary lifestyle of individuals in a long-term care facility may exacerbate losses of muscle function, we applied th is same training program to frail, institutionalized elderly men and w omen. In a population of 100 nursing home residents, a randomly assign ed high intensity strength training program resulted in significant ga ins in strength and functional status. In addition, spontaneous activi ty, measured by activity monitors, increased significantly in those pa rticipating in the exercise program; there was no change in the sedent ary control group. Before the strength training intervention, the rela tionship of whole-body potassium and leg strength was relatively weak (r(2) = 0.29, P < 0.001), indicating that in very old persons muscle m ass is an important but not the only determiner of functional status. Thus exercise may minimize or reverse the syndrome of physical frailty prevalent among very old individuals. Because of their low functional status and high incidence of chronic disease, there is no segment of the population that can benefit more from exercise training than the e lderly.