Resistance Training for Older Adults.

13 December 2021
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Research over the years demonstrates that resistance training is a powerful intervention to counter muscle disuse, combat muscle strength and mass loss, and reduce frailty and its consequences on physical functioning, independence, quality of life, mobility, well-being, and the management of chronic disease (Fragala et. al., 2019).

Unfortunately, as we age, a variety of biological changes take place. From the age of approximately 30 years old, we start to lose skeletal muscle mass, strength, and functioning, leading to a decrease in physiological resilience. Muscle loss usually accelerates after 60 years of age, however, individuals who have been physically inactive are found to double their risk of future mobility limitation compared to those who have always exercised.

For many older adults, resistance training is a great incentive in combating the fears and barriers associated with ageing. The fact is that muscle disuse is preventable and reversible, and resistance training can reduce the signs and symptoms of many diseases and chronic conditions. Not only does resistance training promote health, strength, flexibility, and physical function, it can ease the pain and suffering of those dealing with chronic conditions like arthritis, osteoporosis, and diabetes.

Given the undesirable physical consequences of aging, strategies for both prevention and treatment are invaluable for older adults. Resistance exercise training can increase muscle fibres and improve muscle quality, bone density, metabolic health and insulin sensitivity. As PT’s if we can help our clients manage their chronic health conditions with appropriate exercise, we can improve their quality of life, extend independent living and reduce the risk of falls and fractures.

Benefits of Resistance Training

There are various forms of resistance training that will benefit older adults and help to improve their power input, muscle strength and muscle mass. Often considered a ‘medicine’, resistance training can transform an older adult in ways not thought possible. Unfortunately, however, despite large amounts of research, many older adults are reluctant to change due to concerns around safety, fear, health, pain, fatigue and a lack of social support (Fragala et. al., 2019). 

According to Thomas & Burns (2016), the benefits of resistance training for older adults far outweigh any disadvantages, and this needs to be communicated. Increases in lean body mass, metabolic rate, and bone density and decreases in injury and falls highlight the need for such intervention. Muscle wasting, associated with local or systemic inflammation, escalates as we get older, so exercise becomes even more important as various age-related sensory and motor changes take place (including the inability to balance and the increased risk of falling). Unfortunately, as we age and as our lives get busier, we are often too tired to exercise due to hormonal factors and a decrease in oestrogen and testosterone. Luckily for us, skeletal muscles can grow without hormones; however, in order to stimulate growth hormones, intense exercise and high intensity is required. 

Even though it’s harder to build muscle after 50 years of age, we must incorporate resistance training in our workouts to regain and keep muscle mass. In fact, we need to move and exercise more as we age, not less. If we don’t exercise, we blunt our response to muscle gain and oxidative damage caused by unhealthy habits, including smoking, nutrient deficient diets, toxins, obesity, alcohol and medications.

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Falls & Fear of Falling

We all know that falling is not part of the ageing process and that anyone can fall at any time. However, it is common knowledge that the risk of falling increases as we get older, and falls are one of the most frequent and serious problems facing the elderly. Falls have a proven association with mortality, morbidity, reduced functionality and premature rest home admissions; if we can improve strength and balance, we might be able to correct a large portion of this outcome. The problem with falling is that it is often the result of multiple risk factors, including age, disease, and the presence of hazards in the environment (ACC, 2021).

Even though falling can be a part of a more serious medical condition, including Parkinson’s disease, cerebral palsy, multiple sclerosis, or even a stroke, most falls can be caused by personal risk factors. Nevertheless, it is wise to get plenty of rest and engage in mental and physical activity to get the body and mind in sync with each other. 

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Encouraging Strength & Balance Training for Older Adults

To help keep our older adults on their feet, we must eliminate all risks and encourage confidence, health, and independence. By improving bone health, strength and balance, we reduce the chance of injury or developing a problem or a disease. Exercise programmes, therefore, need to target lower limb strength and balance. Exercising in supervised groups and carrying out individually prescribed exercises in the gym are both effective strategies.

Performed two to three days per week, at an adequate intensity (70-85% of 1RM) and volume of two to three sets per exercise, resistance exercises can work favourably in all older adults. Resistance training is known to improve balance and preserve bone health, can reduce the risk of numerous chronic diseases including osteoporosis, arthritis, heart disease and type 2 diabetes, and can provide cognitive benefits. Low intensity balance exercises along with coordination exercises are useful for fall prevention, as well as strength training exercises to build the quadriceps, hip abductors/extensors, back extensors, shoulders and the arm muscles (Dionyssiotis, 2012).


Even in the absence of chronic disease, aging is a fact of life that manifests itself differently between individuals depending on genetics, environment, behaviours and demographics. Typically, aging decreases skeletal muscle mass, strength, and functioning and can lead to a decrease in resilience and vulnerability to challenging events. Lower mortality and an increased average lifespan exacerbate the growth of chronic disease morbidity and age-related mobility impairments. The loss includes physical disability, mobility impairment, falls, and decreased independence and quality of life (Fragala et. al., 2019).

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