When it comes to strength in older adults, use it or lose it – DCU study reveals

A new study led by researchers at the School of Health and Human Performance at Dublin City University (DCU) has found that the axiom of “use it or lose it” is very real when it comes to physical strength and cognitive function in people over the age of 65.

The research, jointly funded by the Irish Research Council and Medfit Proactive Healthcare, Blackrock, and performed in collaboration with University College Dublin followed 53 people over the age of 65 years for one year after they had completed a fully-supervised 12 week training programme.

It found that any improvements that were made were reversed over the course of the year as participants failed to follow the training regime they had initially been supervised on.

Once regular training ceased, improvements in strength were lost, cognitive function declined and body fat increased. It also found that less than a fifth remained engaged in strength-promoting exercises after the programme had finished.

In the follow-up design, the research team documented the change in exercise habits over the course of a year, the effects these habits had on various markers of fitness, and what these older adults described as barriers and facilitators to their exercise habits.

Regular exercise is recognised by health experts as a key weapon in the battle against lifestyle-related chronic diseases, and there is increasing interest in the benefits of ‘resistance’ training or strength-promoting exercise in older adults.

However, few older adults actively participate in this form of exercise despite the well-described benefits in terms of maintenance of muscle size and strength that comes with strength-promoting exercise training.

Lead Investigator and Associate Professor of Sport and Exercise Physiology at DCU, Dr Brendan Egan said: “While the people in our original training intervention demonstrated impressive gains in a number of health markers including muscle strength, and loss of body fat, one year later most of these improvements were back to pre-training levels. This was largely explained by a lack of participation in sufficient exercise of the right type in order to maintain these initial gains from training”.

“There is a clear demonstration of the principle of reversibility, which is often stated as the axiom ‘use it or lose it’. The fact that so few people continued to participate in strength-promoting exercise means that we were not at all surprised by the declines in fitness outcomes”.

The study title “Exercise Maintenance in Older Adults 1 Year After Completion of a Supervised Training Intervention” was published in the Journal of the American Geriatrics Society, and reveals a number of important considerations for supporting this older population in their exercise habits, especially those targeting muscle strength.

Key Findings

One year after completing a supervised exercise training intervention, 91% of participants remained engaged in structured exercise training, but only 19% of participants remained engaged with strength-promoting exercise on a regular basis.

Compared to their improvements in fitness after the end of the initial training period, chest strength, leg strength, muscle mass of the arms and legs, and cognitive function had declined, whereas body fat (especially trunk, or belly, fat) had increased.

Semi-structured interviews with 12 of the participants revealed that the major barrier to strength-promoting exercise for these older adults was a general aversion to the gym environment especially the claustrophobic climate, lack of social setting, and general “youth” environment that made the gym less appealing to them.

It was also notable that affordability of gym memberships was also considered to be a barrier.

On the positive influences, an enjoyable social aspect to exercise and the benefits of feeling improvements in strength were key facilitators to those who stayed engaged with strength-promoting exercise.

Dr. Egan suggests that the provision of affordable, group-based exercise sessions in a community setting, preferably with peers of similar abilities and interests would be paramount in making regular strength-promoting exercise attractive to this population.

While some form of exercise is better than no exercise, Dr. Egan noted that “offsetting age-related declines in muscle strength and function requires some form of strength-promoting exercise, be that gym-based or even using one’s own bodyweight, but unfortunately, aerobic exercise alone is insufficient for achieving these goals”.

Research Team

Dr Brendan Egan, School of Health and Human Performance, DCU.

Dr. James, F. Timmons, Institute for Sport and Health School of Public Health, Physiotherapy and Sports Science, University College Dublin.

Colin Griffin, Santry Surgery Clinic

Dr. Karl Cogan, Institute for Sport and Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin.

Dr. James Matthews, Institute for Sport and Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin.