Strength and muscle as you age

How do you keep muscle mass as you get older?

Strength training, also called resistance training, is the best-supported way to keep muscle and strength as you age. Older adults who keep it up over the long term preserve their strength, power, muscle mass and function¹.

How often: Adults, including those aged 65 and over, should aim for muscle-strengthening activities at moderate or greater intensity, working all major muscle groups, on at least 2 days a week^2,6. That means your legs, hips, back, chest, shoulders, arms and core. If you're 65 or older, also aim for varied activity that emphasises balance and strength, at moderate or greater intensity, on at least 3 days a week, to improve how well you can do everyday things and prevent falls⁶. These are minimums to aim for, and doing more is fine. Any strength activity is better than none, so doing less isn't wasted. Older adults should be as physically active as their abilities allow.

What to expect: Every training plan tested in healthy adults did better than no exercise for both muscle strength and muscle size⁷. In adults 65 and older, training increases muscle size, though size responds less consistently than strength⁸. So don't judge your progress by size alone.

How much is enough: The best amount for older adults isn't clear yet. Steady, regular sessions matter more than finding the perfect plan. If you want a number, the US and UK guidelines suggest 8–12 repetitions for each muscle group⁹.

Why does muscle mass matter for metabolism?

Muscle is a main site where your body takes up sugar (glucose) from the blood. Muscle loss with age is thought to reduce the muscle available for this job⁵.

Muscle loss can begin as early as age 25 and speeds up after that. By age 80, about 40% of the thigh muscle has been lost⁵. Ageing also brings a loss in the metabolic quality of muscle, which is linked to a higher risk of insulin resistance and type 2 diabetes¹⁰.

Strength training can help. In older adults, 3–6 months of moderate-intensity resistance training could raise whole-body insulin sensitivity by about 10–30%⁵. This isn't down to bigger muscles alone: the gains are also linked to muscle responding better to insulin, so small changes in size don't mean the training isn't working⁵.

For older adults with type 2 diabetes, resistance training has helped blood sugar control, blood fats, lean mass and muscle strength. Its effects on body weight, fat mass and heart health remain unclear¹¹. If you have diabetes or take medicines, strength training is an addition to your care and doesn't replace it. Talk to your doctor or a diabetes organisation before changing anything about your treatment.

Large studies that followed people over time link muscle-strengthening activities with 15% lower risk of death from any cause and 17% lower incidence of diabetes compared with doing none¹². These show an association, not cause and effect. How much extra muscle raises the energy you burn at rest isn't clear yet.

When to check with a health professional

If you're starting exercise after a long break, it's always a good idea to see your doctor first.

For an injury or a health condition, see a health professional, such as your doctor or a physio. If you live with a long-term condition such as diabetes, or a heart, lung or bone condition, ask your doctor or physio what is right for you.

Call your local emergency number for chest pain or pressure (or pain spreading to the arm, neck, jaw or back, especially with sweating or feeling sick), severe breathlessness, fainting or collapse, signs of a stroke, a serious injury, or someone who isn't safe.

For anything else, such as a sore muscle or joint, ease off. See a doctor or other health professional if it persists or gets worse.