Muscle and bone work together to keep our bodies upright. So our muscles are an important part of falls prevention. 

But it’s common to lose muscle mass over time, a gradual process called sarcopenia. If ignored, sarcopenia can contribute to a more sedentary lifestyle, loss of balance, and an increased risk of osteoporosis.¹ 

The answer is different for each person, but it can help to:

• Understand how sarcopenia and osteoporosis are related
• Explore why muscle loss happens and ways we can help maintain or rebuild muscle at any age

Ways to Keep and Build Muscle at a Glance

How do muscles lose mass as we age?

Several factors can contribute to muscle loss as we age:

• Nerve damage or loss
• Anabolic resistance
• Sedentary lifestyles
• Hormone loss

“Sarcopenia starts in midlife, and you can start to counteract that today if you focus on your strength and health,” said Milica McDowell, MS, DPT, a physical therapist in Bozeman, Montana, and co-author of Walk. 

Studies show we begin to lose muscle mass around age 30–35 at a rate of 3%–8% per decade. This rate increases after the age of 60. The more you sit still, the higher that percentage of muscle loss gets. Long periods of muscle inactivity can contribute to muscle loss at any age.²

The higher your muscle mass, the greater your bone density, and the less prone you are to fractures.¹ Muscle weakness may contribute to balance problems. This can contribute to a fall, or lead to worse outcomes after a fall. Weak muscles can also lead to a more sedentary lifestyle. 

Nerve loss and reduced protein synthesis can also contribute to muscle mass loss. Nerve loss, or denervation, is when the nerves that control our muscles start to fail. Without these nerves, muscles start to atrophy or shrink in size. Muscle atrophy can lead to a loss of up to 20% of normal muscle size within three years.³ Anabolic resistance, or low protein synthesis, can also cost us muscle mass. As we age, our muscles may respond less strongly to dietary protein.⁴

Hormonal changes also affect muscle mass. Levels of hormones involved in building muscle can decrease over time. These include testosterone, insulin-like growth hormone, and growth hormone.⁵

How can you maintain muscle mass as you age?

There are many ways to maintain muscle mass, regardless of age. Exercise and a balanced diet can help us maintain muscle. Some people may also benefit from supplements when recommended by a health care professional. 

Strength training and exercise

The phrase “strength training” may conjure images of bodybuilders deadlifting dumbbells. And it's true that lifting weights or doing bodyweight exercises can help build and retain your muscle mass. But those aren't your only options. The National Institute on Aging also recommends balance exercises and aerobics.⁶ 

Muscle-strengthening exercises for older adults involve muscle contraction. Strength training requires you to fight against gravity to lift something (yourself or a weight). Gradually increasing resistance or repetitions may help maintain or build muscle. The National Institute on Aging recommends using resistance bands and hand weights as you work your way up to heavier weights. It also recommends starting with eight to 12 reps.

Aerobics, which includes cardio, is anything that increases your breathing rate. During aerobic exercise, your heart and lungs increase their workload. Over time, aerobic exercise improves the health of your heart, lungs, and circulatory system. This lowers your risk of certain conditions. Examples of aerobic exercises include swimming, walking, and even fast-paced housework. Dancing and swimming are also great examples of healthy aerobic exercises.⁶

Balance exercises can lower your risk of falls and help prevent loss of muscle mass. Consider doing balance activities three times a week, such as tai chi or balance-beam simulations. Heel-to-toe walking counts as a balance exercise. So does repeatedly sitting in and rising from a chair.

Lifestyle changes

Exercise isn’t your only path to preventing muscle loss. Staying hydrated is important for muscle function, muscle mass retention, and overall health.⁷ Without enough water, your body may not effectively clear out lactic acid. Lactic acid is a chemical that builds up in your muscles as you exercise. Staying hydrated may support muscle function during and after exercise. Dehydration also constricts your capillaries. This shrinks the blood flow your muscles need during a workout. When you don’t drink enough water, your potassium and sodium—both of which are key to muscle function—may become unbalanced.⁸

Getting healthy sleep can also support your muscle mass. Studies show that when you don’t get enough sleep, you can lose muscle mass and muscle function.⁹ If you have trouble winding down at night, consider a pair of blue-light glasses. You can also make changes to your sleep hygiene, like cutting down on meals or screen time before bed. You might also try one of these natural ways to get better sleep.

Adding a walk to your daily routine may also help maintain muscle mass. Walking keeps your leg muscles engaged and can also decrease your risk of stroke. Walking may also support mood and mental health, according to the Heart Foundation.¹⁰ Depending on your pace, a walk can also count as aerobics.

Diet changes

Including more protein in your diet can also help improve your muscle mass. Your body needs protein because it breaks down into amino acids, which repair and build muscle tissue. But don’t focus solely on protein when changing your diet. Foods with omega-3s may also help dampen muscle inflammation and boost tissue repair. Adding iron to your diet helps support myoglobin in skeletal muscles, which helps keep oxygen flowing to your muscle tissue.¹¹

You may want to seek out foods rich in dairy or omega-3 fatty acids. Here are some foods that can provide nutrients involved in muscle health:¹²

• Eggs
• Milk
• Whole-grain breads
• Fish (mackerel, salmon)
• Beans and legumes (peas, lentils)
• Fruits
• Poultry
• Tofu
• Avocados
• Nuts and seeds
• Leafy greens

Supplements and vitamins

Diet alone may not provide all the nutrients our muscles need. Some people may need to add supplements to round out their diets. If this is a concern of yours, reach out to your health care professional. 

For example, many people need to supplement their diets with magnesium. Of the 400+ chemical reactions magnesium is involved in in our bodies, many involve muscles.1³ Getting the right amount of magnesium may protect against sarcopenia, according to some research.¹⁴ Supplements can help you reach healthy magnesium levels.

Your doctor might recommend that you take supplements for any of the 13 essential vitamins you might be low on. 

Vitamins can help you avoid micronutrient deficiencies that are bad for your muscle health.¹⁵ Because muscle mass is so closely tied to bone health, you might also be advised to focus on vitamins that support your bones, too. Talk to your doctor before taking any supplements. 

Here's what to know about several key vitamins and how they support muscular health. 

What to do if you are experiencing loss of muscle mass

If you’ve lost muscle, you may be able to rebuild it. Exercise is one way to support muscle health. Hydration and a balanced diet may also help support muscle maintenance or rebuilding. You’ll need a combination of exercise, hydration, and dietary changes to combat sarcopenia.

Remember: Maintaining muscle mass is not all about weight training. Aerobics, walking, swimming, and balance exercises all help you rebuild or retain muscle. Everyone’s health needs are different. Talk to your doctor before starting a new diet, supplement, or exercise program.

Frequently asked questions

At what age do you start to see muscle loss?
Muscle mass can begin to decline around ages 30–35, with research estimating losses of about 3%–8% per decade. The rate may increase after age 60.² 

Can you regain muscle mass at any age?
Physical activity may help people maintain or rebuild muscle, depending on their health and abilities. A health care professional can help determine which activities are appropriate. Adjusting your diet and hydration may also help you regain muscle mass at any age.

What exercises should older adults not do?
Aerobic, balance, and strength exercises are always options for many older adults.⁶ If you’re beginning strength training, ask a health care professional what type and amount of resistance are appropriate for you.

What exercises can older adults do regularly?
Any amount of movement is helpful. Walking, dancing, and swimming are examples of activities older adults may choose based on their health and abilities. So are balance exercises, resistance bands, and reps of sitting down and rising from a chair.⁶ Be sure to check with a health care provider before starting new exercises.

Sources

1. Riviati, N., et al. Relationship between Muscle Mass and Muscle Strength with Bone Density in Older Adults: A Systematic Review. October 2024. Found on the internet at https://pmc.ncbi.nlm.nih.gov/articles/PMC12010744/ 

2. Volpi, E., et al. Muscle Tissue Changes With Aging. Current Opinion in Clinical Nutrition and Metabolic Care. July 2004. Found on the internet at https://pmc.ncbi.nlm.nih.gov/articles/PMC2804956/ 

3. Bazarek, S., et al. Novel Technologies to Address the Lower Motor Neuron Injury and Augment Reconstruction in Spinal Cord Injury. Cells. July 2024. Found on the internet at https://pmc.ncbi.nlm.nih.gov/articles/PMC11274462/ 

4. Aragon, A., et al. Age-related muscle anabolic resistance: inevitable or preventable? Nutr Rev. March 10, 2023. Found on the internet at  https://pubmed.ncbi.nlm.nih.gov/36018750/ 

5. Gharahdaghi, N., et al. Links Between Testosterone, Oestrogen, and the Growth Hormone/Insulin-Like Growth Factor Axis and Resistance Exercise Muscle Adaptations. Frontiers in Physiology. January 2021. Found on the internet at https://pmc.ncbi.nlm.nih.gov/articles/PMC7844366/ 

6. National Institute on Aging. Three Types of Exercise and Physical Activity. June 5, 2025. Found on the internet at https://www.nia.nih.gov/health/exercise-and-physical-activity/three-types-exercise-and-physical-activity 

7. Taylor, K., et al. Adult Dehydration. StatPearls. March 5, 2025. Found on the internet at https://www.ncbi.nlm.nih.gov/books/NBK555956/ 

8. The Role of Dehydration in Vein Swelling and Leg Cramps. United Vein and Vascular Centers. Nov. 26, 2025. Found on the internet at https://unitedveincenters.com/blog/how-dehydration-affects-vein-health/ 

9. Lamon, S., et al. The Effect of Acute Sleep Deprivation on Skeletal Muscle Protein Synthesis and the Hormonal Environment. Psychological Reports. January 2021. Found on the internet at https://pmc.ncbi.nlm.nih.gov/articles/PMC7785053/ 

10. Heart Foundation. Benefits of Walking. Found on the internet at https://www.heartfoundationwalking.org.au/walking-benefits

11. Hafler, L., et al. Influence of Dietary Iron Deficiency on Hemoglobin, Myoglobin, Their Respective Reductases, and Skeletal Muscle Mitochondrial Respiration. American Journal of Clinical Nutrition. October. 1981. Found on the internet at https://www.sciencedirect.com/science/article/abs/pii/S0002916523431553?via%3Dihub 

12. Vitamins and  Minerals for Older Adults. National Institute on Aging. Found on the internet at https://www.nia.nih.gov/health/vitamins-and-supplements/vitamins-and-minerals-older-adults  

13. De Baaij, J., et al. Magnesium in Man: Implications for Health and Disease. American Physiological Society: Physiological Reviews. January 2015. Found on the internet at  https://journals.physiology.org/doi/full/10.1152/physrev.00012.2014 

14. Yang, S., et al. Association Between Oral Intake Magnesium and Sarcopenia: A Cross-Sectional Study. BCM Geriatrics. October 2022. Found on the internet at https://pubmed.ncbi.nlm.nih.gov/36273123/ 

15. Kerksick, C., et al. ISSN Exercise & Sports Nutrition Review Update: Research and Recommendations. Journal of the International Society of Sport Nutrition. August 2018. Found on the internet at https://pmc.ncbi.nlm.nih.gov/articles/PMC6090881/ 

16. Paoli, A., et al. Not Only Protein: Dietary Supplements to Optimize the Skeletal Muscle Growth Response to Resistance Training: The Current State of Knowledge. Journal of Human Kinetics. April 2024. Found on the internet at https://pmc.ncbi.nlm.nih.gov/articles/PMC11057611/