AARP Smart Guide to Muscle Health

30 ways to maintain your strength — and your independence — as you age

Matt Alderton,

AARP

Reviewed by

George LeBus, M.D.

Comments

Published January 31, 2025

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Strength training and muscle mass provide all sorts of health benefits, regardless of your age. But because of sarcopenia — the gradual loss of muscle mass, strength and function due to aging — strength training is especially important for older adults, who typically lose nearly a third of their muscle mass between the ages of 50 and 70.

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The good news: While it’s normal to lose existing muscle as you get older, it’s possible at any age to build new muscle to replace it. To find out how, we asked doctors, physical therapists, personal trainers and dietitians to explain why older adults experience muscle loss and to advise them about how they can slow or reverse it.

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AGING AND MUSCLE

1. Muscle loss is natural

When it comes to muscle, the human body behaves like a slow-motion roller coaster: It spends years ascending, peaks, then falls precipitously. “The body gradually puts on muscle through your 30s and into your 40s, but from your 40s onward it becomes a lot harder to both maintain existing muscle and put on new muscle,” says Jonathan Packer, M.D., an orthopedic surgeon and sports medicine physician at the University of Maryland Medical Center in Baltimore.

Starting in their 40s, the average person loses approximately 8 percent of their muscle mass every decade, says rehabilitation physician Mooyeon Oh-Park, M.D., chief medical officer and senior vice president at Burke Rehabilitation Hospital in White Plains, New York. “Between ages 40 and 80, you lose almost 40 percent of your muscle,” Oh-Park says. “That’s muscle size, or mass. But muscle’s physiological function is strength, and that unfortunately declines at an even faster speed — almost double that of muscle mass.”

2. Muscle loss is common

If you feel like you’re weaker than you used to be, that’s because you probably are, says Wendy Batts, a regional master instructor for the National Academy of Sports Medicine and assistant professor of exercise science at PennWest California in California, Pennsylvania.

3. Weight gain can amplify the risks of muscle loss

Most Americans are at their heaviest by the time they reach middle age, according to the National Institutes of Health (NIH), which says the average adult in the U.S. gains 30 pounds from age 20 to age 50. In fact, obesity rates are highest among adults ages 40 to 59, 46.4 percent of whom are obese, according to the U.S. Centers for Disease Control and Prevention (CDC). (With an obesity rate of 38.9 percent, adults 60 and over don’t fare much better.)

“When we’re older, we tend to be more sedentary, so the weight we gain starts being more and more fat and less and less muscle,” says Atul Patel, M.D., a physical medicine and rehabilitation physician at Kansas City Bone & Joint Clinic in Overland Park, Kansas, and treasurer of the American Academy of Physical Medicine and Rehabilitation. The combination of less muscle and more weight can worsen the negative health impacts of obesity.

4. Muscle loss can lead to fatal falls

Falls are the leading cause of death among adults 65 and older, according to the CDC, which says 3 million older adults visit emergency rooms each year because of falls. Researchers say muscle weakness plays a major role in fall risk.

“There are so many older adults who cannot even get out of a chair without using their hands, and that in and of itself is a fall risk. That signals that their legs are no longer strong enough to get them up,” says physical therapist Jennifer Nash, an associate professor of physical therapy at the University of Nevada, Las Vegas, and a certified exercise expert in aging adults. “A lot of older adults … never go back home after that hip fracture or blow to the head. So strength and balance are really important.”

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MEDICAL ISSUES AND MUSCLE LOSS

5. Keep moving

While it’s critical to grow and maintain muscle as you age, many older adults have conditions that make exercise in general — and strength training in particular — more difficult. That’s why it’s important to consult a doctor, physical therapist or certified fitness professional before you begin an exercise program, Oh-Park notes.

“(Older adults) may have arthritis, for example, or they may have tendonitis,” she says. However, having a condition like arthritis doesn’t mean you can’t build strength. It means you might have to do it differently. “Movement of any kind … would help build strength and mobility versus doing nothing at all,” Batts says.

George LeBus, M.D., an orthopedic shoulder, knee and sports medicine surgeon with Texas Orthopaedic Associates, OrthoLonestar, in Fort Worth, Texas, echos this: “Movement and therapeutic exercise are some of the best treatments for arthritis. We commonly see patients who attribute their inability to exercise due to arthritis; however, exercise is one of the most evidence-based treatments.”

6. Strong muscles make strong joints

While some health conditions make strength training more difficult, osteoporosis is one that can benefit from it. “Osteoporosis, characterized by weakened and brittle bones, increases the risk of fractures,” Batts says. “Older adults with osteoporosis may need to avoid high-impact exercises and focus on low-impact activities that promote bone and muscle health without increasing the risk of injury. Weight-bearing exercises are good for individuals with this condition and can help prevent instances where falls and fractures are a concern.”

Muscle health and joint health are closely related. “For example, one of the primary causes of knee pain at all ages is weakness in the hips, the core and the quads. Because when your muscles are weak, it puts more stress on the joints,” Packer says.

7. Chronic diseases can accelerate muscle loss

When you have a chronic disease, you might lose even more muscle at an even faster rate. “Some medical conditions — having a baseline like diabetes or heart disease, for example — can make you lose muscle mass in an accelerated manner,” Oh-Park says. Among the many conditions that can cause muscle loss or muscle weakness are hormonal diseases like Addison’s disease and hypothyroidism; neurological conditions like multiple sclerosis and amyotrophic lateral sclerosis (ALS); kidney disease; infections like flu, Lyme disease and meningitis; and cancer.

8. Strength fades during hospital stays

Extended hospital stays can be disastrous for muscle health. In a 2024 issue of the journal Geriatric Nursing, for example, researchers reported a 2 to 5 percent decline in muscle mass per day among hospital patients on bed rest. Immobile older adults can lose up to 10 percent of their muscle mass during a seven-day hospital stay, and reduced muscle mass can cause up to a 40 percent reduction in muscle strength, they added. “If you’re going to be in the hospital for any reason, I would make an effort to try to get up as much as possible — as long as you’re cleared by the medical staff and can do so safely,” Packer says.

9. Recovery requires focus

Once you're discharged from the hospital, make sure to have a recovery plan that will get you moving again, Packer recommends. LeBus notes that it is important to keep your eyes on the goal. “Recovery can take a long time but is achievable,” he says. “I generally tell patients that muscle takes as long or longer to regain as it does to lose it — so patience and diligence are important, and patients can expect a prolonged recovery, particularly after a long period of being 'down' following an injury or surgery.” Formal therapeutic exercise programs like home health or outpatient physical therapy are often essential to help patients regain their baseline levels of strength or function.

10. Medications can impact muscle mass

Chronic diseases and hospital stays aren’t the only things that affect muscle health. Medications also can be problematic, according to geriatric physician Shane Speirs, M.D., president and chief medical officer with HealthyU Clinics, a provider of primary and specialty care services in Arizona and California.

“There are many medications across the spectrum that can cause muscle weakness in some way, shape or form as a side effect — mostly with long-term use. And I will tell you, there are too many to list," Speirs says. Among the many medications that can potentially cause muscle weakness are cholesterol-lowering drugs like statins and fibrates; corticosteroids such as prednisone; cancer therapies, including chemotherapy; and even hair loss treatments like finasteride. Be sure to read about the side effects with your prescriber or pharmacist and talk to your doctor about maintaining muscle while on these medications.

11. Weight-loss drugs can be muscle-loss drugs

Speaking of medications, many patients who take popular new weight-loss drugs like Ozempic, Wegovy and Mounjaro report muscle loss as an unintended side effect. If you do use one of these medications, be sure to add a muscle-building regimen to your daily life to stave off muscle loss. Although researchers are working on variants of weight-loss drugs that can reduce or prevent muscle loss, exercise is still the weight-loss prescription of choice for most health care providers.

12. Hormones play a role

If you’re wondering why sarcopenia happens, hormones probably are a major culprit. “In the past, we thought you lost muscle consistently over time. But really, it’s a bell-shaped curve: You gain muscle, muscle, muscle; then it kind of plateaus; and then you start dropping muscle. And it drops off especially fast starting at age 60,” Patel says. “That might have to do with testosterone in men and estrogen in women. Both of those hormones play a role in the maintenance of muscle function. … And it’s harder to gain muscle back when your hormones are against you.”

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HOW TO BUILD AND MAINTAIN MUSCLE

13. Do strength training every week

You’re never too old or too weak to start strength training, according to Nash. “Even 80-year-olds and 90-year-olds can build muscle as long as you are consistently challenging your muscles,” she says. To maintain optimal muscle health, the National Academy of Sports Medicine says adults should aim for at least two or three days of strength training exercises per week. “By incorporating regular strength training into their routine, older adults can significantly improve their muscle health, physical function and overall quality of life,” Batts says.

14. Target the whole body

When you imagine muscle, you probably think about big, bulging arms or ripped, six-pack abdominals. However, strength training is a head-to-toe endeavor. “Muscle is all over the body,” Oh-Park says. “So, you need to exercise the whole body. And if you want to do a really good full-body workout, that’s probably going to take you about 45 minutes.” If you don’t have the time or attention span to train all your muscles, Packer says focus on your biggest muscle groups, which are your glutes, quads, lats and chest. “You can get in a good workout in as little as 10 or 15 minutes by focusing on those muscle groups instead of the smaller ones,” he says.

15. Focus on fatigue

If you’re new to strength training, it’s crucial to work with a professional who can teach you the proper form to avoid injury. However, understand that “safe” does not necessarily mean “comfortable.” In fact, weight training yields the best results when you’re uncomfortable. “You have to fatigue your muscle and give it a reason to get stronger,” Nash says. “If you haven’t shown it that it needs to get stronger, it won’t.”

Simply put: You must challenge your muscles to change them. To create the right challenge, Nash suggests finding your one-rep max — the most weight you can lift doing a single repetition of a given exercise — and then determining your weight selection from there. “You’re going to start at 70 to 90 percent of your one-rep max, and then you’re going to do a progression each week by increasing the load.”

16. Understand sets and reps

Strength training’s scaffolding consists of reps and sets. Reps is the number of times in a row you perform a given exercise without rest. Sets is the number of rounds you complete in that sequence.

“Doing fewer reps with heavier weights increases intensity, while doing more reps with lighter weights decreases intensity but improves endurance,” Batts explains. “For an older adult new to exercise, I highly recommend starting with one to three sets of 12 to 20 repetitions [using a lighter weight]. Each rep should be performed at a slow, controlled tempo, focusing on proper movement patterns and maintaining ideal form. This focuses on prime movers of the exercise and ensures safety.” To build muscle mass and strength over time, increase weight as you progress and perform fewer reps per set — six to 12 reps with a moderate weight, for example, or one to five reps with a heavy weight.

17. Choose your exercises wisely

For any muscle you want to work, there are many strength training exercises to choose from. Physical therapist and yoga instructor Lara Heimann, founder and CEO of LYT Yoga, has a few favorites. She recommends rows and lat pulldowns for the upper back and shoulders; planks, pushups and dead bugs for the core; and lunges, squats, hip hinges and deadlifts for the legs and glutes. Whatever you choose for your routine, prioritize compound movements that work multiple muscle groups at the same time, advises Nash. She says compound movements are a more efficient and effective way to build strength and muscle. Instead of doing a seated bicep curl, for example, try a standing bicep curl that turns into an overhead press.

18. Pick between free weights, machines, bands or bodyweight

Whether you work out at home or at a fitness club, a well-equipped gym can give you more options to choose from. But you don’t need all the bells and whistles. A 2023 study in the journal BMC Sports Science, Medicine and Rehabilitation compared the use of free weights like barbells and dumbbells with the use of cable machines. Researchers concluded that there are “no differences” in strength or muscle gains between the two and said the choice comes down to “individual preferences.” A 2019 study in the journal SAGE Open Medicine likewise found that training with elastic resistance bands can produce “similar strength gains to conventional resistance training.”

19. Rest and recover

For optimal strength gains, Nash says you should spend at least 24 hours — and perhaps as many as 48 hours — resting between weight-training sessions. “If we’re challenging the muscle enough, we’re creating small micro-tears in the muscle. That’s how the muscle is stimulated to grow bigger and stronger,” she says. “So, it’s best to allow a day or two for that repair to take place before doing an exercise again with your new, stronger muscle.”

Rest also helps prevent overuse injuries such as tendinitis or stress fractures, which may be harder and longer for older adults to recover from, according to Batts, who adds that good recovery includes light activity — not zero activity. “Engage in low-intensity activities such as foam rolling or stretching, walking, swimming or yoga on rest days. Active recovery can increase blood flow to muscles, aiding in the removal of waste products and speeding up the healing process.”

20. Embrace aerobics

Aerobic exercise and strength training are perfect bedfellows. In 2022, for example, the British Journal of Sports Medicine published two separate studies demonstrating that muscle-strengthening exercises and aerobic physical activities — walking, swimming, water aerobics, cycling and dancing — lower the risk of death from any cause. Although both work individually, they work even better in tandem, researchers concluded.

“Aerobic exercise plays a significant role in overall muscle health and strength, even though it’s often associated more with cardiovascular benefits,” explains Batts. First, it enhances circulation, which infuses muscles with the oxygen and nutrients they need for repair and growth. Second, it improves endurance, which allows muscles to perform for longer periods without fatigue. Finally, it helps with weight management, which reduces the strain on muscles and joints so they can perform better. The U.S. Department of Health and Human Services says healthy adults should do at least 150 minutes of moderate-intensity aerobic activity per week.

21. Stretch for success

Stretching is “crucial” for maintaining muscle health and overall physical function, according to Batts. “Stretching increases muscle flexibility, which is essential for maintaining full range of motion in joints. This can help older adults perform daily activities more easily and reduce the risk of injuries,” she says, adding that regular stretching can also help relieve the tension and soreness that often follows strength training, reduce back pain and other musculoskeletal issues by improving posture, and prevent injuries that occur from muscle imbalances or tightness. Aim to stretch your major muscle groups at least two to three times per week, Batts says.

22. Find your balance

If you want stronger muscles, you need better balance, according to Batts, who says balance helps maintain proper alignment and posture, which in turn enhances physical performance and reduces the risk of injury.

“Good balance ensures that muscles are used efficiently and correctly during movement, promoting muscle strength and stability,” notes Batts, who recommends improving your balance using static exercises like standing on one leg. Start by holding onto something for support, if necessary, then progress to balancing without assistance. Eventually, incorporate unstable surfaces like a balance beam or half of a foam roller.

23. Stand up for yourself

If you can’t persuade yourself to start resistance training, you can still improve your strength by making a small yet impactful adjustment to your lifestyle: Sit less and stand more. “Prolonged sitting can cause tight hip flexors, weak glutes and inhibited core muscles. This can lead to excess stress on the low back and other movement compensations, such as forward shoulders and a forward head posture,” says Batts, who adds that standing engages more muscles — particularly in the legs, core and back — compared to sitting.

Standing also promotes better posture, which reduces the risk of musculoskeletal issues like back and neck pain, and improves blood flow, which reduces the risk of tightness and stiffness. “Set reminders to stand up and move around every 30 to 60 minutes. Even short breaks can make a big difference,” Batts says.

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WHAT TO EAT AND DRINK

24. Protein, protein, protein

When it comes to building and maintaining muscle, exercise is only part of the equation. Just as important are the foods you eat — especially protein, according to Yasi Ansari, a registered dietitian and a spokesperson for the Academy of Nutrition and Dietetics. “Protein supports the immune system and bone health, and maintains, repairs and helps build muscle mass. It also helps people recover from injuries and, when consumed consistently throughout the day, can help keep energy levels stable,” says Ansari, who adds that most people need more protein as they age to maintain muscle health.

According to the U.S. Department of Agriculture’s “Dietary Guidelines for Americans,” women and men who are 51 and older should consume at least 46 grams and 56 grams of protein, respectively, every day.

25. Pop protein post-workout

How much protein you consume is more consequential than when you consume it. “It used to be thought that the best practice was to spread protein intake evenly throughout the day, but [new research] challenges this,” explains Ansari, who says scientists used to believe that muscles could only synthesize so much protein at one time. Now, they think there’s no limit to the amount of protein that muscles can use from any given meal. Simply put: Do what works for you, whether that’s loading up on protein during a single, protein-packed meal or eating smaller doses of it throughout the day.

26. Load up on leucine

What makes protein so useful is an essential amino acid called leucine. “Leucine is a branched-chain amino acid that activates a key signaling pathway needed to build muscle. Look for sources that offer 2.5 to 3 grams of leucine per serving. An intake of at least 30 grams of protein can offer this,” explains Ansari, who says you can get 30 to 40 grams of protein — and, therefore, 2.5 to 3 grams of leucine — by eating any of these foods, to name just a few examples: 1 cup of ground turkey; 5 ounces of chicken; 1.5 cups of Greek yogurt topped with granola; 5 to 6 ounces of cooked salmon; one can of white tuna, depending on the brand; or 1.5 cups of baked tofu, edamame or black beans.

27. Fill protein gaps with supplements

Because of reduced appetite, older adults often struggle to eat enough throughout the day. That’s why Ansari suggests a “food-first” approach to consuming protein. If you eat full, well-balanced meals and still struggle to consume enough protein, however, supplements like protein powders, shakes and bars can help.

“If you’re thinking about adding protein supplements, speak with your physician and dietitian first. There are some cases where a protein supplement would not be appropriate,” cautions Ansari, who says whey protein isolate generally provides a higher protein content and is more readily absorbed in the body, though casein, pea and rice proteins also are beneficial. Whatever variety you choose, make sure it’s compatible with any food allergies or restrictions you might have, and look for third-party testing labels like “NSF,” “NSF Certified for Sport,” “Informed Choice” or “Informed Sport.” “Products with these labels go through rigorous testing to ensure what you see on the label is what you will get. It also tests the quality of the product,” adds Ansari.

28. Consider creatine

Along with protein, bodybuilders who are trying to pack on muscle make sure they ingest creatine, an amino acid that they get via high-protein foods or through supplements. But creatine isn’t just for body builders. A 2019 study published in the Journal of Clinical Medicine suggests that creatine supplementation may also benefit older adults by helping them maintain muscle vitality. “Creatine is well-researched when it comes to strength and power output,” says Ansari, who notes that creatine might also help enhance memory, improve balance and decrease the risk of falls in older adults. Consult a physician or registered dietitian to determine the right amount and sources of creatine for your needs.

29. Check your vitamin levels

Because nutrients like calcium, niacin, vitamin D and vitamin B12 also can impact your ability to build and maintain muscle, it’s worth determining whether you’re getting enough of them in your diet. If you aren’t, supplements might help. “Connect with your physician and registered dietitian nutritionist,” Ansari says. “They can help you identify which micronutrients you may be deficient in, help with testing and provide recommendations on foods and supplements.”

30. Stay hydrated

Finally, if there’s one simple thing you can do to optimize your muscle health at any age, it’s drink more water. “Water supports the transport of nutrients within the body, supports joints, excretes waste products and so much more,” explains Ansari, who says dehydration can cause the body to cannibalize its own muscle tissue to use for energy. The National Academy of Medicine says men and women should consume 3 liters and 2.2 liters of fluid every day. “To meet fluid needs, consider setting fluid reminders, sip on fluids throughout the day [and] purchase a new water bottle that you will actually drink from — it makes a difference,” Ansari says. This can include water, low-sodium broth, dairy and herbal teas.

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Matt Alderton is a contributing writer who specializes in health and wellness, travel and technology. His work has also appeared in USA Today, Forbes and The Washington Post.

George LeBus, M.D., is an orthopedic shoulder, knee and sports medicine surgeon with Texas Orthopaedic Associates, OrthoLonestar, in Fort Worth, Texas. A former Harvard football player, he completed his medical education at UT Southwestern in Dallas, Vanderbilt University Medical Center and the Steadman Clinic in Vail, Colorado. He has specific expertise in restorative and reconstructive procedures of the shoulder and knee and in the treatment of fractures and active lifestyle injuries.