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Functional and metabolic consequences of sarcopenia.

Sarcopenia associated with the normal aging process is often combined with the detrimental effects of a sedentary lifestyle in older adults, leading to a significant reduction in reserve capacity of the neuromuscular system. A clear example of the aging effect is the pattern of reduction in muscle strength after the sixth decade for both isometric and concentric contractions. However, older adults are relatively stronger for movements in which muscles lengthen, due to the inherent advantage of eccentric contractions, plus their stiffer muscle structures and prolonged myosin cross-bridge cycles. Also, the capacity for physiological adaptations in the motor pathways remains into very old age when an appropriate exercise stimulus is given, and older adults can obtain adaptations in both enhanced neural control of motor units and increased protein synthesis leading to moderate muscle hypertrophy. Since periods of sedentary lifestyle or bed rest due to illness can have severe detraining consequences on the neuromuscular function of an older person, long-term prevention strategies are advocated to avoid excessive physical impairments and activity restrictions in this age group.