How to Protect Against Age-Related Muscle Loss

September 26, 2025

An middle-aged Asian man practices outdoor fitness by stretching in a public park

If you’ve hit middle age and notice that running up a flight of stairs takes more effort than it used to, you may not be imagining it. “Sarcopenia, or age-related muscle loss, typically begins around age 50 and accelerates from there,” says Susan Ratay, DO, a family physician at University Hospitals and President of the Cleveland Academy of Osteopathic Medicine.

Muscle loss can make daily tasks more challenging. Over time, it may also make it harder for you to stay active and independent. The good news: There are things you can do to keep your body strong and prevent, delay or even reverse muscle loss.

Why You Lose Muscle as You Age

Sarcopenia increases with age and affects men and women equally. It’s usually a result of aging, but can also occur with chronic diseases like kidney disease, diabetes and cancer.

There are a variety of factors that increase muscle loss with age:

Muscles become less responsive to dietary protein and exercise.
Muscle fibers begin to lose their ability to heal and rebuild as quickly as they once did.
The nerves that tell the muscles to contract start deteriorating.
The fast-twitch muscle fibers that help drive quick, forceful movements (like getting up from a chair) break down.
Certain hormones that help build muscle decrease.
Proteins known as catabolic cytokines increase and speed up muscle wasting.
Muscle loss is worsened by the tendency to move less as we age.

Starting in midlife, sarcopenia triggers a loss of about 0.5-1 percent of your muscle mass a year. “Muscle strength decreases by 1.5 to 5 percent per year from this point onward,” says Dr. Ratay. “It becomes clinically significant when people are in their 60s and 70s.” Between the ages of 65 to 80, you could lose as much as 8 percent of your muscle mass each decade.

The Role of Hormones

Hormonal changes can affect muscle health in men and women.

Women: The loss of estrogen during menopause contributes significantly to muscle loss. “Research suggests that declining estrogen, particularly estradiol, is associated with accelerated reductions in muscle mass, strength and neuromuscular function during and after menopause,” says Dr. Ratay.
Men: As men get older, their levels of anabolic hormones (hormones that promote muscle growth) decrease, which can make it harder to maintain muscle mass and strength. This is especially true of testosterone, says Dr. Ratay. “Lower total and free testosterone levels are linked to greater age-related acceleration of muscle loss,” says Dr. Ratay.

She adds that other hormones, such as growth hormone IGF-1, and vitamin D, also help men and women maintain muscle mass and strength. “But the impact of estrogen on muscle loss is more pronounced in women due to the abrupt decline at menopause,” she says.

Signs of Sarcopenia

Common signs of age-related muscle loss may include:

Low energy
Increased fatigue, including muscle fatigue
Reduced grip strength
Slower walking speed
Difficulty climbing stairs
Trouble rising from a chair
Poor balance
Slower recovery from injury

Together, these symptoms can increase the risk of falls, frailty and loss of independence, says Dr. Ratay.

Diagnosing Sarcopenia

There’s no single test to diagnose age-related muscle loss or how severe it is. “The diagnosis of sarcopenia relies on a combination of clinical screening, muscle strength testing, muscle mass measurement and assessment of physical performance,” says Dr. Ratay. Tests may include:

SARC-F questionnaire: This brief quiz assesses your symptoms around strength and physical performance.
Muscle strength: A device called a dynamometer is most often used to assess handgrip strength by measuring how much force is used when it’s squeezed. Lower limb strength (such as knee extension strength) may also be measured.
Muscle mass: A type of low-dose X-ray called a DEXA scan is used to measure the amount of lean muscle in your arms and legs compared to your height. Other tests like bioelectrical impedance analysis (which uses a small electrical signal to estimate your muscle mass), muscle ultrasound or other measurements may also be taken.
Physical performance: These tests may include:
- Gait Speed Test: Measures how fast you walk.
- Short Physical Performance Battery: Measures function in your lower body through balance, gait speed and chair stand tests.
- Timed Up and Go: Measures mobility by having you rise from a chair, walk a short distance, turn around and go back and sit down.

Preventing, Managing and Treating Sarcopenia

Certain lifestyle changes can help prevent and treat age-related muscle loss. “Treatment is primarily focused on lifestyle modifications, especially resistance-training and optimized nutrition, which have the strongest evidence for improving muscle mass and function,” says Dr. Ratay.

Exercise: Moving your body on a regular basis can increase strength and reverse muscle loss. “Resistance training is the most effective type of physical activity for preventing or delaying sarcopenia in all adults,” says Dr. Ratay. “It should be considered the first-line treatment, and its benefits extend to both healthy older adults and those with established sarcopenia or frailty.”
Programs that combine resistance training with aerobic, balance and flexibility training are even better at helping improve physical performance. “They’re particularly effective for helping prevent falls and enhancing mobility,” she says.
Diet: Dr. Ratay recommends following a Mediterranean-like diet that includes plenty of fresh fruits and vegetables, whole grains, lean proteins, legumes, nuts and olive oil. “Adherence to the Mediterranean diet is associated with better muscle function and reduced risk of sarcopenia,” she says.
Additionally, she recommends higher protein intake (approximately .45 to .55 grams of protein per pound of your body weight each day) and focusing on leucine-rich protein sources like dairy, lean meats, fish and legumes. She also suggests talking to your healthcare provider about taking a vitamin D supplement, especially if you have a deficiency or get limited sun exposure.

Eating enough protein and doing strength-training exercises is key to building and maintaining muscle mass and strength as you age. Doing both can be especially beneficial for postmenopausal women and men with age-related testosterone decline, says Dr. Ratay. “The combination of protein with exercise is critical, since nutrition alone offers only modest improvements in muscle health.”