Muscle weakness contributes to fatigue, weakness, and reduced activity tolerance. Joint problems ranging from mild stiffness to debilitating arthritis (osteoarthritis) are very common. The risk of injury increases because gait changes, instability, and loss of balance may lead to falls.

The skeleton provides support and structure to the body. Joints are the areas where bones come together. They allow the skeleton to be flexible for movement. In a joint, bones do not directly contact each other. Instead, they are cushioned by cartilage in the joints, synovial membranes around the joint, and fluid.

Muscles provide the force and strength to move the body. Coordination is directed by the brain but is affected by changes in the muscles and joints. Changes in the muscles, joints, and bones affect the posture and walk, and lead to weakness and slowed movement.

Aging Changes

People lose bone mass or density as they age, especially this refers to women after menopause. The bones lose calcium and other minerals.

The spine is made up of bones called vertebrae. A gel-like cushion (called a disk) is located between each bone. The middle of the body (trunk) becomes shorter as the disks gradually lose fluid and become thinner.

Vertebrae also lose some of their mineral content, making each bone thinner. The spinal column becomes curved and compressed (packed together). Bone spurs caused by aging and overall use of the spine may also form on the vertebrae.

The foot arches become less pronounced, contributing to a slight loss of height.

The long bones of the arms and legs are more brittle because of mineral loss, but they do not change length. This makes the arms and legs look longer when compared with the shortened trunk.

The joints become stiffer and less flexible. Fluid in the joints may decrease. The cartilage may begin to rub together and wear away. Minerals may deposit in and around some joints (calcification). This is common in the shoulder.

Hip and knee joints may begin to lose cartilage (degenerative changes). The finger joints lose cartilage and the bones thicken slightly. Finger joint changes are more common in women. These changes may be inherited.

Lean body mass decreases. This decrease is partly caused by a loss of muscle tissue (atrophy). The speed and amount of muscle changes seem to be caused by genes. Muscle changes often begin in the 20s in men and in the 40s in women.

Lipofuscin (an age-related pigment) and fat are deposited in muscle tissue. The muscle fibers shrink.

Muscle tissue is replaced more slowly. Lost muscle tissue may be replaced with tough fibrous tissue.

This is most noticeable in the hands, which may look thin and bony.

Muscles are less toned and less able to contract because of changes in the muscle tissue and normal aging changes in the nervous system. Muscles may become rigid with age and may lose tone, even with regular exercise.

Effect of Changes

Bones become more brittle and may break more easily. Overall height decreases, mainly because the trunk and spine shorten.

Breakdown of the joints may lead to inflammation, pain, stiffness, and deformity. Joint changes affect almost all older people. These changes range from minor stiffness to severe arthritis.

The posture may become more stooped (bent). The knees and hips may become more flexed. The neck may tilt, and the shoulders may narrow while the pelvis becomes wider.

Movement slows and may become limited. The walking pattern (gait) becomes slower and shorter. Walking may become unsteady, and there is less arm swinging. Older people get tired more easily and have less energy.

Strength and endurance change. Loss of muscle mass reduces strength.

Common Problems

Osteoporosis is a common problem, especially for older women. Bones break more easily. Compression fractures of the vertebrae can cause pain and reduce mobility.

Muscle weakness contributes to fatigue, weakness, and reduced activity tolerance. Joint problems ranging from mild stiffness to debilitating arthritis (osteoarthritis) are very common.

The risk of injury increases because gait changes, instability, and loss of balance may lead to falls.

Some older people have reduced reflexes. This is most often caused by changes in the muscles and tendons, rather than changes in the nerves. Decreased knee jerk or ankle jerk can occur. Some changes, such as a positive Babinski reflex, are not a normal part of aging.

Involuntary movements (muscle tremors and fine movements called fasciculations) are more common in older people. Older people who are not active may have weakness or abnormal sensations (paresthesias).

People who are unable to move on their own, or who do not stretch their muscles with exercise, may get muscle contractures.


Exercise is one of the best ways to slow or prevent problems with muscles, joints, and bones. A moderate exercise program can help you maintain strength, balance, and flexibility. Exercise helps the bones stay strong.

Talk to a doctor before starting a new exercise program. It is important to eat a well-balanced diet with plenty of calcium. Women need to be particularly careful to get enough calcium and vitamin D as they age.

Postmenopausal women and men over age 70 should take 1,200 mg of calcium per day. Women and men over age 70 should get 800 international units (IU) of vitamin D daily. If you have osteoporosis, talk to your provider about prescription treatments.

How to prevent losing bone density and muscle mass?

Maintaining our bone density is increasingly important. When we experience bone density loss, our bones tend to become more brittle and are more likely to fracture as part of an injury or fall.

Maintain Your Strength

Wolff’s Law (a law developed by the German anatomist and surgeon Julius Wolff in the 19th century) best explains these changes in bone density.

It states that our bones will adapt to the loads that we place on them. If we increase a load, the bone responds by remodeling itself. Over time, our bones become stronger to withstand loads placed on them.

The opposite of this also is true: If the load on our bones decreases, bones will inevitably become weaker, because they lack the proper stimulus required for continued remodeling.

Put simply, placing added weight on our bones — which happens when we lift weights regularly at the gym — will help them stay healthy and strong. When you practice a sedentary lifestyle (one that doesn’t include lifting any weights) the bone is not stimulated to remodel. The result? Bones become weaker.

Exercise is the Answer

The loss of muscle mass that’s associated with aging is called sarcopenia. When you don’t activate the muscle — and instead limit your amount of physical activity — your loss of muscle mass and their associated functions accelerates. Put another way: If we don’t use it, we lose it! We need muscular strength to help prevent falls.

As we age, we should prioritize preserving our bone density and maintaining our muscle mass as part of our everyday health. Targeting these two factors can help aging individuals prevent the onset and progression of osteoporosis and sarcopenia.

Significant losses in muscle mass and bone density are associated with an increased risk of falls and fractures. These types of injuries are associated with increased rates of mortality. By working to preserve our bone density and muscle mass, we can significantly reduce our risk of falls and fractures.

Exercise alone may not combat the onset and progression of osteoporosis and sarcopenia. Individuals should consult a primary care doctor to explore additional options that can aid in reducing the risk of fractures.

If you need a free consultation concerning the possible ways of fighting the loss of muscle mass and bone density, please get in touch with our qualified expert and ask any questions you are interested in.