In my last column, I shared with you the importance of nutrition, particularly protein, to support our functional strength as we age. Maintaining good functional strength is important to a goal of being able to Age in Place, which is the ability to live in your own home and community safely, independently and comfortably. If you missed my prior columns, you can find them at FranklinFavorite.com.

Exercise, nutrition, hydration, social interaction and mental stimulation are areas to focus on and are things that we can do, right now. I'm going to talk about Exercise today and how it relates to keeping us functionally strong (able to do everyday activities) and supports skeletal muscle mass and bone density which goes hand in hand with being functionally strong. Having more strength, more muscle mass and stronger bones decreases our risk of accidents and better ensures that we can do the basic activities of daily living.

Age related loss of muscle mass and function is called sarcopenia. Muscle is key to motion. As we age, significant changes in muscle mass and quality take place. After about age 50, muscle mass decreases at an annual rate of 1 to 2 percent. The decline in muscle strength is even higher, amounting to 1.5 percent per year between ages 50 and 60 and 3 percent per year thereafter. Of those 65 and older, 16 to 18 percent of women and eight to 10 percent of men in the United States cannot lift ten pounds, bend forward to pick something up off the ground or kneel to the floor. After the age of 75, this increases to 66 percent of women and 28 percent of men being unable to lift more than ten pounds.

Muscle strength is strongly correlated to physical independence and fall prevention. Loss of muscle mass and strength is related to functional impairment and an increased risk for a fall. Leg strength, particularly the ability to rise from a chair, has been found to be a major predictor of frailty and mortality. Leg strength and walking gait speed are two variables predicting fall risk. Additionally, muscular endurance necessary to maintain balance under multi-task conditions such as cooking, gardening or recreational activities, and the importance of muscular power in reactive balance such as slipping on ice or tripping over a curb are important fall risk factors in older adults.

What makes the biggest difference in our skeletal muscle mass and strength? Exercise. Specifically, weight bearing and resistance-based exercise which also improve our bone density and decrease our risk of osteoporosis. Weight bearing exercise are activities that force you to work against gravity. Examples are walking, hiking, climbing stairs, playing tennis or golf (walk don't ride a cart!), and dancing. Exercise such as riding a bicycle is a weight supportive exercise. The bicycle supports our weight. While bicycling isn't weight bearing exercise, we are using our largest skeletal muscles to power the bicycle.

Resistance-based exercise is also known as strength training. Strength training is any exercise that causes the muscles to contract against an external resistance. Resistance-based exercises increase strength, mass and endurance depending on how the exercises are performed. The external resistance can be dumbbells, rubber exercise tubing or flat loop bands, your own bodyweight or any object that causes the muscle to contract. There are three movements of any resistance-based exercise: concentric, isometric and eccentric. Knowing how to utilize these movements properly, how much weight-resistance is used, the tempo of the exercise, and using proper technique to avoid injury and maximize effectiveness relative to your specific goals. Training techniques differ for strength gains, muscle mass and muscle endurance. For functional health, older adults need to focus on strength, muscle mass and muscular endurance. While most everyone can implement a walking program into their life without any type of special training or guidance, I highly recommend guidance from a qualified therapist or a trainer who specializes in senior fitness. SilverSneakers® is a good source for exercise modalities for senior adults. They have a website and a Facebook page where free information is provided to anyone and if you are a member (available through many Medicare Advantage Plans) you can attend SilverSneakers® classes for free or minimal cost if you are not a member. I personally lead two SilverSneakers® classes every week. An online resource I recommend is ElderGym.com that provides quality information and free senior workout programs that can be performed at home, outdoors or in a gym.

Stay Healthy. Be Strong. Get After It.

I'd love to hear from you about how you are enjoying this column and what topics you'd like to read about in "Let's Talk Health." I'd also be happy to answer any questions you may have or to lead you in the direction of additional resources. You can reach out to me at jsturm@franklinfavorite.com.

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