Function First: Redefining Healthy Ageing

Ageing is an inevitable part of life, but how we age is something we can influence. 

One of the biggest factors thought to influence the way we age is the decline of muscle mass. We've been looking into the evolving conversation around sarcopenia and healthy ageing. ‘Sarcopenia’, a term first coined in 1989,refers to the progressive loss of skeletal muscle mass and strength with age. 

Though research has traditionally focused on the loss of muscle mass and its impact on movement as we age, there has been a shift in recent years from solely focusing on muscle mass, towards an emphasis on neuromuscular function - muscle strength, power and coordination. ‘Dynapenia’, the age-related loss of muscle strength and power not caused by disease or injury, is a term that is gaining increasing traction in conversations about healthy ageing. In contrast to sarcopenia, which refers primarily to the loss of muscle mass, dynapenia highlights the decline in neuromuscular function - how well muscles function, not just their size. The real problem isn’t just shrinking muscle, it’s what we lose along with it: the ability to move well, respond quickly, and stay independent. 

Neither the loss of muscle mass nor a decline in function are inevitable parts of ageing: these are risks associated with being sedentary, rather than with ageing itself. The loss of strength, balance, and mobility is not a given, and it’s something we can prevent with the right kind of movement.

The shift: from bulk to usefulness

Thanks to the latest global guidelines - including the 2018 EWGSOP2 (Cruz-Jentoft et.al, 2019) and 2023 ANZ consensus (Zanker et.al, 2023) - we now know that muscle mass alone isn’t the best predictor of how well we age. It’s function -  how strong, fast, and coordinated we are - that really matters. We need to start prioritising muscle strength and functional performance as the key indicators of healthy ageing. By programming these skills into our training, we can improve our ability to carry out Activities of Daily Living (ADLs), such as getting out of a chair, climbing stairs or carrying groceries, which are all central to maintaining our independence as we age.​

A few key stats:

• Muscle power (the ability to generate force quickly), which is one of the key factors in preventing falls, declines faster than muscle mass or strength as we age.

• Low muscle strength has been linked to a higher risk of hospitalisation independent of muscle mass. 

• A gait speed (how fast we walk) under 0.8 m/s is linked to higher hospitalisation and loss of independence.

• People with poor chair-rise performance (getting up out of a chair) are significantly more likely to experience recurrent falls. 

By helping people improve their muscle function, we can help them retain their independence, grow in confidence and keep moving, regardless of their age.  

What actually works? Movement that builds function

The most effective exercise programmes incorporate different facets of muscle function - power, speed, strength, coordination and functional task practice - that allow the body and brain to work together to enhance real-world capacity and keep us doing the things we love.​

At Nature Moves, we’ve been adopting a task-based, peer-supported approach that allows older adults to engage in physical activity at their own level, fostering agency, inclusion, and enjoyment. We’ve been putting evidence into action in outdoor, inclusive sessions across the UK.​ Everyone is welcome to participate, regardless of age.

Since sarcopenia is a lifelong process, preventative strategies are crucial, and starting in midlife (ages 40-60) allows us to avoid substantial muscle loss later in life. That said, improvements in power generation and muscle strength are possible well into our eighth and ninth decades, so wherever you are in life, now is a great time to start.

To help tackle the effects of sarcopenia and dynapenia, the research suggests the following interventions.

1. Progressive Strength Training

Regular resistance training - whether through bodyweight movements, resistance bands, or weights - has been shown to significantly improve gait speed, grip strength, and overall quality of life.​

Our sessions build functional strength through real-world movements in order to improve our ability to carry out Activities of Daily Living (ADLs): think squats onto benches, getting up and down from the ground, and loaded carries - all scaled to ability. 

2. Power Training

Power training is critical for healthy ageing. This is the ability to move quickly - to catch yourself when you trip or to rise from a chair without momentum.​ Power declines up to 2x faster than muscle mass with age, so it’s important that we keep training the skill. 

We incorporate power exercises into our sessions, aiming to improve functional movements such as sit-to-stands, and integrate reaction-focused games that require quick bursts of movement - safely and with support.​

3. Balance & Neuromuscular Training

As we age, proprioception and reflexes decline, making balance and coordination training essential parts of any programme for older adults. Neuromuscular training improves gait, reduces postural sway, and decreases fall risk. 

Nature Moves sessions take place outdoors, meaning participants are exposed to a variety of terrains: training outdoors on grass, slopes, steps, and forest paths builds balance by default. Add in one-leg stands, walking on beams, and gentle agility drills, and you can begin to develop the skills you need for building fall resilience.​

4. Task-Specific Movement

We train for everyday movements: getting off the floor, carrying shopping, and climbing stairs. Our task-specific movement training improves the ability to perform these everyday activities, which directly correlates with independence and quality of life.​

From floor-to-stand practice to real-world carries and ground navigation, our sessions mimic daily life - helping people maintain the skills that matter most.​

Training to age well 

We can’t avoid ageing. What we can do is ensure that we are training to maintain and improve our quality of life as we age, so we can continue participating in the things we love most. That means being able to:

• Rise from the ground without help

• Catch yourself if you stumble

• Walk to the shop with confidence

• Stay engaged, independent, and active - on your own terms.​

Nature Moves is just one example of how we can take the science of sarcopenia and dynapenia and turn it into real, lasting impact in people’s lives. By focusing on strength, power, balance, and functional movement -  all within a social, supportive setting - we’re helping older adults move better, feel stronger, and stay independent for longer.

You can’t press pause on ageing, but you can train for it.

Bibliography

Cruz-Jentoft, A.J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., Cooper, C., Landi, F., Rolland, Y., Sayer, A.A., Schneider, S.M., Sieber, C.C., Topinkova, E., Vandewoude, M., Visser, M., Zamboni, M.; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. (2019). Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 48(1):16-31. doi: 10.1093/ageing/afy169. 

Hadouchi, M., Kiers, H., de Vries, R. et al. (2022) Effectiveness of power training compared to strength training in older adults: a systematic review and meta-analysis. Eur Rev Aging Phys Act 19, 18. https://doi.org/10.1186/s11556-022-00297-x

Sivritepe, R., Siyer, O.K., Tiril, S.M., Basat, S.U. (2024). Do we know about dynapenia? North Clin Istanb. 11(6):593-599. doi: 10.14744/nci.2024.48642.

Zanker, J., Sim, M., Anderson, K., Balogun, S., Brennan-Olsen, S.L., Dent, E., Duque, G., Girgis C,M., Grossmann, M., Hayes, A., Henwood, T., Hirani, V., Inderjeeth, C., Iuliano, S., Keogh, J., Lewis, J.R., Lynch, G.S., Pasco, J.A., Phu, S., Reijnierse, E.M., Russell, N., Vlietstra, L., Visvanathan, R., Walker, T., Waters, D.L., Yu, S., Maier, A.B., Daly, R.M., and Scott, D. (2023) Consensus guidelines for sarcopenia prevention, diagnosis and management in Australia and New Zealand. J Cachexia Sarcopenia Muscle. (1):142-156. doi: 10.1002/jcsm.13115.