Review
Resistance Exercise for the Aging Adult: Clinical Implications and Prescription Guidelines

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Abstract

Sarcopenia and weakness are known to precipitate risk for disability, comorbidity, and diminished independence among aging adults. Resistance exercise has been proposed as a viable intervention to elicit muscular adaptation and improve function. However, the reported prevalence of resistance exercise participation among US adults aged >50 years is very low. This may be largely attributable to inconsistency in study results that fail to fully inform the clinical and public health community of its overall value. Therefore, the purpose of this commentary review is to report the findings of recently published meta-analyses that systematically examined the overall value of resistance exercise among healthy aging adults for strength and lean body mass outcomes. Evidence reveals that not only is resistance exercise very effective for eliciting strength gain and increases in lean body mass, but that there is a dose-response relationship such that volume and intensity are strongly associated with adaptations. These findings reflect and support the viability of progression in resistance exercise dosage to accommodate optimal muscular adaptive response. Progressive resistance exercise should thus be encouraged among healthy adults to minimize degenerative muscular function associated with aging.

Section snippets

Resistance Exercise and Aging

There is considerable variation in muscular atrophy and weakness among aging adults, which is suggested to be somewhat attributable to the peak in mass and strength attained earlier in life.15 Therefore, even though significant adaptation are possible in the “oldest old,”16 it may be expected that the benefits of early intervention will translate to preservation of long-term health and independence. Research has identified a disproportionate decline of strength and muscle mass, indicating that

Whole Body Muscular Strength

Previous meta-analyses to examine the effects of resistance exercise for strength have restricted the primary outcome to a single strength measure (ie, knee extensors).25, 26 Considering the disproportionately greater loss of lower-body strength and muscle mass that occurs during aging, as well as the relevance of lower-limb strength to locomotion, instrumental activities of daily living, and risk of slip-and-fall accidents,27 these analyses are quite salient. However, in order to improve

Lean Body Mass

Lean body mass is regarded as a convenient parameter related to pathology, as well as a viable surrogate indicator of skeletal muscle tissue. However, as has been the case with strength outcomes, there is a great deal of inconsistency reported in the literature pertaining to the dose-response relationship of resistance exercise for muscular adaptation. Previous meta-analyses have restricted the evaluation of lean body mass as a secondary outcome or have synthesized data from across combined

Resistance Exercise Prescription Recommendations

Current guidelines for physical activity in older adults have been developed by the American College of Sports Medicine and American Heart Association.33 These “minimum” recommendations call for “muscle-strengthening activity” to be performed 2 or more nonconsecutive days per week, using a single set of 8-10 resistance exercises for the whole body, and at a moderate to high level of effort that allows 10-15 repetitions.33 Although the established guidelines provide a basis for maintaining

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    Funding: None.

    Conflict of Interest: None.

    Authorship: Both authors had complete access to the data and a played a significant role in writing the manuscript.

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