When we think about ageing well, we often focus on heart health, strong bones or keeping our minds sharp.
But there’s another part of healthy ageing that’s just as important and often overlooked: our muscles.
An estimated one in five Australians over 60 are living with sarcopenia, an age-related loss of muscle mass and strength that can affect mobility, independence and quality of life. And while more than 90 per cent of older Australians recognise muscle health is important, very few have spoken to their doctor about it.
“It was not on my radar at all”
For Sydney grandmother Phillippa Harrington, muscle loss was not something she saw coming.
“It was not on my radar at all. I knew that as you got older you became weaker but that was all.”
After back surgery at 35, followed by further surgeries on her shoulders and feet, her strength and mobility were deeply affected.
“I could not do normal activities, and it particularly hit me when my workplace started fitness classes which I was not able to participate in.
“I wish I had been told by the doctor or physiotherapist after back surgery how important it was to get fit, about core strength,” she says.
It was only recently, at 79, that things began to change.
“The rebuilding of strength and confidence, particularly when using stairs, has only come in the last 12 months when I started to undertake one-on-one sessions with a physiotherapist. I started to see significant changes.”
Now, her motivation is simple. “I still have a lot of living to do. I want to be able to keep up with my loved ones, play with my grandkids and see my friends. Without the muscle strength, I just can’t do it.”
The signs that are easy to dismiss
Muscle loss is often missed because it can look like ageing.
“It is often not picked up earlier due to the lack of screening and awareness,” says GP Dr Jeremy Keh. “Measurements are not routinely performed in GP clinics, for example grip strength or sit-to-stand testing, and symptoms are often not reported from patients themselves. Rather, the comment of ‘I’m just getting old’ is used.”
Dr Keh says warning signs may include frequent falls, difficulty holding cups or opening jars, trouble going up and down stairs, or needing extra effort to get up from a chair.
Why women need to pay attention earlier
Although muscle loss affects everybody, women face particular challenges as they age.
“Women tend to start with a generally lower muscle mass giving a smaller ‘buffer’,” Dr Keh says.
“As women age and enter menopause, we see a natural decline in oestrogen which results in a decrease in muscle synthesis and an increase in fat mass.”
That combination can increase the risk of falls, fractures and osteoporosis. For that reason, Dr Keh says early intervention is important, particularly around perimenopause.
“Increasing strength/resistance training, vitamin D and calcium supplementation, and increasing protein intake or oral nutritional supplement are all key factors,” he says.
The nutrition mistakes many are making
Dietitian Louise Murray says one of the biggest issues she sees is people eating less as they get older.
“As we get older, appetite naturally declines, and people often think, ‘I’m not doing as much, so I don’t need to eat as much,’” she says. “It’s a normal part of ageing, not a signal that the body needs less nutrition.”
A breakfast of cereal, toast and fruit may feel balanced, but Louise says it often lacks the protein older adults need.
“It can be very difficult to meet protein requirements with only two or three meals a day, especially if someone has a poor appetite and is choosing higher-carbohydrate options.”
So, how much protein do you actually need? As we age, our bodies generally need more protein, not less.
“For people over 60, protein requirements increase to around 1.2 grams per kilogram of body weight,” Louise says. “For example, someone who weighs 70 kilos would need about 84 grams of protein a day.”
Meeting this target requires a conscious effort, she adds. “Most people don’t have a clear sense of what that looks like in real food.”
For example, Louise says 100 grams of cooked chicken provides roughly 25 to 30 grams of protein.
“Most people are around 30 percent short of their protein needs as they age unless they make deliberate changes.”
Simple ways to add more protein
Louise recommends eating to a routine, rather than relying only on appetite: having three main meals a day at regular times and adding snacks or supplements if needed.
The aim is to include protein at each meal. Dairy foods can be a simple place to start.
“Something like cheese and crackers as a snack, or adding yoghurt to breakfast, are quick and simple ways to boost protein intake.”
For those with a smaller appetite, drinking may sometimes feel easier than eating.
“When appetite is low, it’s often easier to drink than to eat,” Louise says. “This is where oral nutritional supplements, such as Ensure, can be a practical way to help meet daily requirements.”
What to ask your doctor
If you’re concerned about your strength, balance or mobility, Dr Keh says the first step is raising it with your GP.
“Ask directly to receive a muscle health screening,” he says.
Because while muscle loss might feel like a normal part of ageing, it’s not something you have to accept as inevitable.
As Phillippa says, “I wish I had been told how important it was to get fit. But now I am a lot fitter than a lot of my age group. It’s better late than never.”
