A Secret of Health in Old Age: Muscles
by Holcomb B. Noble
(from The New York Times Science,
Fred Kovaleski, a former State Department official, stares across the net at Jason Morton in the thick of their fight for the title of No. 1 tennis player in the world. Mr. Kovaleski is losing, something he has not had much experience with during the past 60 years, and he is not delighted. But in a corner of his brain is lodged a thought that is becoming more and more common in a rapidly expanding segment of the American population: I cant wait to get older.
They are actually battling to become world champion in the over-70 division at the International Tennis Federation World Championships in Palm Beach Gardens, Fla. But at the moment there is no other division and no other world. Mr. Kovaleski, of Manhattan, knows that Jan. 1 starts the year he turns 75. The odds will then suddenly shift in his favor, putting him in line to become No. 1 among the over-75s. And he can expect to hold that title for some time at least until that young pup Jason Morton, a teaching pro at Sun Lakes, Ariz., joins the over-75 age group in five years.
These senior warriors are part of a poweful new development among an elderly population that is becoming far more physically active. Many start lifting weights after they retire and continue well into their 90s. They participate in an explosion of organized games and health-club activities. The physical activity is, in turn, demonstrably improving their health and the quality and grace of their lives.
A number of recent studies show that nutrition and aerobic exercise are no longer sufficient apart from the wisdom of sidestepping things like illness and moving freight trains to protect the aging body. The research has made clear that working to restore muscle strength and bone density is crucial in realizing the potential for a healthy old age. Although they cannot turn back the clock, elderly athletes are finding that they can take part in sports requiring strong arms, legs and shoulders much longer and more successfully by using resistance-weight machines to restore muscle lost through aging.
Mr. Morton and Mr. Kovaleski provide a case in point. Mr. Morton won the over-70 competition and will try next year to win what might be called Americans first Granddad Slam national singles and doubles titles on four surfaces, the indoor, clay, grass and hard courts.
Mr. Morton lifts weights. Mr. Kovaleski does not. Whether that matters when it comes to a specific tennis match is debatable, but in day-to-day living among an older population, the value of strength-training exercise is virtually indispsutable.
For the very old and frail the simple act of crossing a room can become something of a high-wire balancing act. But with strengthened leg muscles, the endeavor becomes more routine and the risk of serious injury from a fall decreases.
The American College of sports Medicine recently released a study analyzing some 250 original research projects, most completed in the past five years.
The director of the study, Dr. Robert S. Mazzeo, a professor of exercise physiology at the University of Colorado in Boulder, said the work showed the aging process was far more complex than once thought, involving a complicated interaction of genetics, life style, disease and other factors.
In one of two startling studies, by Dr. Maria Fiatarone, Dr. William J. Evans and others at the Tufts University Research Center, nine women and men, ages 87 to 101, strengthened their arms and legs by exercising with resistance weights, which, as part of a controllable system of pulleys and cables, are safer than free weights. In eight weeks, they increased the strength in the front thigh muscles by an average of almost 175 percent. Dr. Abraham Datch, a 101-year-old retired dentist, increased his strength by 200 percent over what it was at 95.
The second study by Dr. Evans and Dr. Miriam E. Nelson, divided 40 postmenopausal women, none of whom were on hormone replacement therapy, into two groups, one that lifted weights and one that did not. The group that did not lift lost bone and muscle mass, but the other group increased its average strength to the equivalent of women 15 to 20 years younger.
Dr. Mazzeo said he was surprised to see how quicky the elderly benefited from training with resistance weights.
They can build muscle strength, Dr. Mazzeo said, and this then allows them to do other things, like aerobic exercises, that they had not been able to do, and that can then improve their cardiovascular systems.
Norman A. Fitz is a retired meteorologist from Silver Spring, Md., and a ranked tennis player in his age division for 30 years. In December, his shoulder broke down with a tear in the rotator cuff and damaged in eight other areas.
The injury should have put him out of commssion for at least a year. But after surgery, he started an elaborate program of stretching, aerobic exercise and strength-building, lifting weights for the first time in his life. His first exercise of the day, prescribed by his physical therapist, Peter Boyle, director of Sports and Spinal Physical Therapy in Washington, is simply to lie on his back on a rolling pin for five minutes, and do nothing. The rolling pin, wrapped in two towels and placed under the small of his back, helped stretch and gradually correct Mr. Fitzs posture, which had become bent from long hours at a desk, Mr. Boyle said, With Norman we were also able to re-strengthen his shoulder muscles with weight lifting and other exercise, he added.
Within six months, half the time expected, Mr. Fitz was back on the courts and soon at the top of the tennis ladder in the Mid-Atlantic over-60 division. Last month, he made a credible showing in the national grass-court championships in his division in Cedarhurst, N.Y.
Without exercise, Dr. Mazzeos study concluded, total muscle mass decreases by nearly 50 percent between ages 20 and 90. Computer tomography of individual muscles shows that after age 30 there is a decrease in cross-sectional areas of the thigh, decreased muscle density and increased intramuscle fat.
Loss of muscle mass, or atrophy, occurs notably in Type 2 muscle fibers the fast-twitch muscles used in high-intensity activities. Atrophy, a normal response to lack of use, appears to be accentuated in older people if dietary protein is not increased.
Typically, researchers say, people lose about 30 percent of their strength between 50 and 70, and another 30 percent per decade after that. At the same time, fat-free body mass declines 15 percent, which in turn slows the bodys metabolism the rate at which it converts food to energy. To make matters worse, the loss of lean body mass makes people lose energy and become more sedentary, continuing the unhealthy cycle by contributing to loss of lean body mass.
But increased physical activity can reverse that cycle. A number of studies have demonstrated that, given adequate training stimulus, older men and women show similar or greater strength gains compared with young individuals as a result of resistance training, the researchers said.
Still, because the aging process is so complex, getting and staying in shape and competing becomes more complicated as the body ages. Dr. Gari I. Wadler, a sports medicine-expert at New York University School of Medicine, said in an interview: After 30, reaction time slows, as information processing in the brain slows and nerves conduct impulses more slowly. The heart no longer pumps at the same maximal rate it once did. The arteries begin to stiffen, and oxygen is transported less efficiently. Finally, recovery time slows.
And a decline in one system drags down the others. One elderly champion of a few years ago used to say that his overall conditioning was much harder to maintain, that missing a week of tennis at his age would be like a young adults missing six months.
Eventually, everyone in the later stages of life faces a difficult decision: when to discard the strategies of youth. Sam Shore of Port Washington, N.Y., long No. 1 in the over-85 tennis group, made the transition smoothly. His strategy: If you cant speed around much anymore, go where a younger tennis person will never tread. He positioned himself in no mans land in the middle of the court a shrewd tactic for those who volley superbly, hitting the ball before it bounces. Even younger competitors were often unable to pass Sam Shore, and if they put the ball where he could reach it, he could put it and them away. Mr. Shore died in July at 92, still world champion in the over-85s division.
To watch him dancing about in his final years in tenniss no-mans land was to watch Baryshnikov in slow time at the ballet.