Musculoskeletal Ageing

7/23/2019 Musculoskeletal Ageing

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The Human MusculoskeleSystem and Aging

PH 131 PhysiologyGroup 3


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Objectives

1. To discuss the physiological state of the musculoskesystem at different life stages.

2. To discuss processes involved in the maintenance of

musculoskeletal system.

3. To identify measures in properly dealing with the ag

musculoskeletal system.


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Main functions for homeostaMovement. Support. Heat produ


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STAGES OF LIFE


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DEVELOPMENT


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Bone and muscle development

Bone and muscles are derived from the meso Skeletal muscles form by the fusion of

mononucleated myoblasts to form multinucle

myotubes.

Bone development occurs by two processes:intramembranous ossificationand endochondra

ossification

UNSW Embryology. Musculoskeletal System Development. Retrieved 17 September 2015 from https://embryology.mau/embryology/index.php/Musculoskeletal_System_Development#Somite_Development


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Differentiation of the somite

Myotomedifferentiates into the epimere and the hyp

which give rise to the epaxial and hypaxial muscles r

UNSW Embryology. Musculoskeletal System Development. Retrieved 17 September 2015 from https://embryology.m

au/embryology/index.php/Musculoskeletal_System_Development#Somite_Development


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Differentiation of the somite

Cardiac muscledevelops from mesodermal cells that mand envelop the developing heart while it is still in the f

endocardial heart tubes

Smooth muscledevelops from mesodermal cells that m

and envelop the developing gastrointestinal tract and v

Muscle satellite cells are also formed during embryon

development, which persist in a quiescent state in the a

muscles

Tortora, G.J. & Derrickson B. (2009). Principles of anatomy and physiology (12thed.). John Wiley & Sons, Inc


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Waves of muscle formation

Commitment to myogenic lineage -MYOGENIC REGULATORY FACTORS

Primary myogenesis- occurs in the

Secondary myogenesis - occurs in th

gives rise to bulk of the fetal muscle

Postnatal muscle growth - involves s

cells

Schoenwolf, G.C., Bleyl, S.B., Brauer, P.R. & Francis-West, P.H. (2009). Larsen's human embryology,4th edition. New Yo

LivingstoneMyogenesis. Retrieved from http://neuromuscular.wustl.edu/mother/myogenesis.html


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Osteogenesis (Bone formation) 3 Skeleton Lineage

- The somites generate the axial skeleton

- The lateral plate mesoderm generates the limb skeleto

- The cranial neural crest gives rise to the branchial arch

craniofacial bones and cartilage

Modes of Ossification- Intramembranous Ossification

- Endochondral Ossification

Osteogenesis: The Development of Bones - Developmental Biology - NCBI Bookshelf. Retrieved 20 September 2015 f

nlm.nih.gov/books/NBK10056/


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Osteogenesis (Bone formation) Intramembranous Ossification

- In the skull, neural crest-derived mesenchymal cells prolifera

condense into compact nodules.

- Some of these cells develop into capillaries; others change th

become osteoblasts, committed bone precursor cells. The o

secrete a collagen-proteoglycan matrix that is able to bind ca

- Occasionally, osteoblasts become trapped in the calcified ma

become osteocytes.

- As calcification proceeds, bony spicules radiate out from the

ossification began.

Osteogenesis: The Development of Bones - Developmental Biology - NCBI Bookshelf. Retrieved 20 September 2015 fronih.gov/books/NBK10056/


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Osteogenesis (Bone formation)- The entire region of calcified spicules

becomes surrounded by compact

mesenchymal cells that form the

periosteum. The cells on the inner

surface of the periosteum also

become osteoblasts and deposit

osteoid matrix parallel to that of the

existing spicules. In this manner,

many layers of bone are formed.

Osteogenesis: The Development of Bones - Developmental Biology - NCBI Bookshelf. Retrieved 20 September 2015 frnlm.nih.gov/books/NBK10056/


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Osteogenesis (Bone formation) Endochondral Ossification

- Involves the formation of cartilagetissue from aggregated m

cells, and the subsequent replacement of cartilage tissue by b

- Can be divided into five stages:

- the mesenchymal cells are commited to become cartilage cells.

- the committed mesenchyme cells condense into compact nodu

differentiate into chondrocytes- the chondrocytes proliferate rapidly to form the model for the b

- the chondrocytes stop dividing and increase their volume dram

becoming hypertrophic chondrocytes.

- the invasion of the cartilage model by blood vessels.



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Osteogenesis (Bone formation)



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Growth during infancy

healthy & normal growth is very important Musculoskeletal system = physical foundation

growth & development

306 bones & cartilage elements at birth

Cranium = undergoes molding(fontanelles/soclose)

cartilagebone = ossification

Pikechiropractic. (2014). Growing up healthy: musculoskeletal milestones in babys first year. Retrieved September 20, 20

pikefamilychiropractic.com/growing-healthy-musculoskeletal-milestones-babys-first-year/


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Fontanelle/Soft Spot


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Growth during infancy

Birth to 6 months: 1/2 -1 inch/month; 5-7 oz/ Around 5 months: double of weight at birth

6 to 12 months: 1cm/month; 5-7 oz/week

1 year old: triple of weight at birth




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Musculoskeletal Milestones

1. Lifting & supporting thehead (head control)

2. Rolling over

3. Keeping upright

position4. Crawling

5. Walking




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Growth during puberty

- Peak bone massis achieved- End of puberty = end of bone growth (#awtsu

- Many factors affect bone growth (ex: increase

hormones, endocrinological disorders)

- Early vs. Late developers

http://skeletaldevelopment.weebly.com/adolescence.htmlBuckler, J. M. H. (1984). Skeletal age changes in puberty. Department of Pediatrics and Child Health. Retrieved on Septehttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC1628448/
http://skeletaldevelopment.weebly.com/adolescence.htmlhttp://skeletaldevelopment.weebly.com/adolescence.htmlhttp://skeletaldevelopment.weebly.com/adolescence.html


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MAINTENANCE & REPA


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Muscle Maintenance & Repair

Muscles are able to acquire energy in 2 ways:respiration and anaerobic respiration.

Aerobic Respiration - an oxygen-requiring process that the

whenever tasked to produce low to moderate amount of forc Anaerobic Respiration - in producing a high amount of force

use lactic acid fermentation (form of anaerobic r.) to produ

Taylor, T. (n.d.). Muscular System. Retrieved September 20, 2015, from http://www.innerbody.com

html


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Myoglobin - red pigment found in muscles; contains iron andallows the muscles to perform aerobic respiration in the abse

oxygen.

Creatine Phosphate - donates its phosphate group to ADP t

ATP to provide extra energy for the muscle.

Glycogen - energy-storing; found in muscle fibers; made up oglucoses -> muscles break glucoses off of glycogen to provide

fuel supply.


html


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Muscle Fatigue - muscle quickly tires and loses ability to cont

when muscles run out of energy from aerobic/anaerobic resp

Fatigued muscle = (Low levels of oxygen, glucose, and ATP) + (H

ADP and lactic acid (waste products))

Oxygen Debt (Recovery Oxygen Uptake) - extra oxygen the

intake in order to restore the muscle cells to their resting stat


html


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Bone Maintenance & Repair

The maintenance of bones can be summarizetwo processes: bone modeling and remodelin

BONE MODELING: Addition of new bone

BONE REMODELING: Replacement of old bon

new bone

http://www.ncbi.nlm.nih.gov/books/NBK45504/


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http://www.ncbi.nlm.nih.gov/books/NBK45504/

MODELING REMODELIN

acquisition of new bone for theright bone morphology and mass bone can be formed without

prior resorption

required for changes inmechanical loading adolescence

change of the old bobone

bone resorption and required for repa

stress/fracture and accumulation of n

calcium homeostaoptimizatio

most of huma


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[Source here]


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AGING


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"The ageing process is of course a biologicawhich has its own dynamic, largely beyond

control... active contribution is no lon

possible."

- Gorm

WHO, n.d., Defining Old. Retrieved from http://www.who.int/healthinfo/survey/ageingdefnolder/en/on Sept 19, 2015


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Factors that hasten the aging pr1. Lifestyle2. Stress3. Excessive exposure to harsh environments4. Humoral Factors

Lif t l


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Lifestyle Refers to the chosen way of life of a person

Sedentary Lifestyle- characterized by lack of

physical activity which will, in turn, causeloss of bone and muscle mass, and increase

amount of body fat.

Bad habits/ Vices- refers to activities such as

smoking, alcohol drinking, drugs, etc. which

may damage the body. Unhealthy Diet- choosing unhealthy meals

which prevents the body from receiving vital

nutrientsMcLaughin, K.J. (2013). 6 Things That Make You Age Faster .And How to Avoid Them. Retrieved from http://www.doctorsheathings-that-make-you-age-faster-and-how-to-avoid-them on Sept. 19, 2015Gerardo. (2013). The Seven Most Common Factors in Premature Aging. Retrieved from http://www.afpafitness.com/researc

premature-aging-factors on Sept. 17, 2015

St


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Stress

Reaction of the body to an exte

stimulus

Causes the body to adapt by pr

wear and tear of the organs.

May cause various metabolical a

physiological problems.

Promotes development of wrin

eyebags, etc.

May cause worsening of postur

McLaughin, K.J. (2013). 6 Things That Make You Age Faster .And How to Avoid Them. Retrieved from http://www.doctorshaging/6-things-that-make-you-age-faster-and-how-to-avoid-them on Sept. 19, 2015Gerardo. (2013). The Seven Most Common Factors in Premature Aging. Retrieved from http://www.afpafitness.com/resea

premature-aging-factors on Sept. 17, 2015


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Excessive exposure to harsh environments

Sunlight- Has Ultraviolet Rays which has vario

adverse health effects

Heat- May cause dehydration and in extreme

burns.

Cold- Prolonged exposure may cause drying athinning of the skin. May also cause dehydrat

Gerardo. (2013). The Seven Most Common Factors in Premature Aging. Retrieved from http://www.afpafitness.com/

articles/common-premature-aging-factors on Sept. 17, 2015

Humoral Factors


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Humoral Factors Refers to factors transported by the blood such as hormones

Hormones which may affect musculoskeletal aging:

1. Parathyroid Hormone- Affects calcium and phosphate lev

may cause osteoporosis2. Estrogen- minimize loss of calcium from bone. Decrease i

after menopause

3. Testosterone- Involved in development of muscle bulk and

Increases growth hormone production

4. Growth Hormone- Promotes increase in muscle mass, andgrowth. Naturally decreases with age.

Hurd, R. (2014).Aging Changes in Hormone Production. Retrieved from https://www.nlm.nih.gov/medlineplus/ency/articl2015Hormones of the Reproductive System. (2013) Retrieved from http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/Sept 20, 2015Pietrangelo, A. (2014). The effects of testosterone on the body. Retrieved from http://www.healthline.com/health/low-testo

on Sept. 20, 2015


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DETERIORATION OF TH

SKELETAL SYSTEM


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Vitamin and Mineral deficiency Calcium is one of the main minerals

found in bone and is crucial in

maintaining bone density

About 30% of ingested calcium is

actually absorbed.

Lack of Calcium can lead to lowerbone density which increases risk of

fractures and damage.

Office of the Surgeon General (2004). 6. Determinants of Bone Health. Bone Health and Osteoporosis: A Report of the Surg

(MD). Retrieved from: http://www.ncbi.nlm.nih.gov/books/NBK45503/#_NBK45503_pubdet_ on Sept 19, 2015.

A. D. A. M. (2014). Calcium and bones. Retrieved from: https://www.nlm.nih.gov/medlineplus/ency/article/002062.htm on S


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Vitamin and Mineral deficiency Vitamin Daids in the body's

absorption of calcium.

Lack of Vitamin D uptake can lead

to decreased levels of calcium

in the body which, in turn,

contributes to decreased bonedensity.

Office of the Surgeon General (2004). 6. Determinants of Bone Health. Bone Health and Osteoporosis: A Report of the Surg(MD). Retrieved from: http://www.ncbi.nlm.nih.gov/books/NBK45503/#_NBK45503_pubdet_ on Sept 19, 2015.


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Sedentary Lifestyle Physical activity can directly affect bone

density and strength Low impact physical activities (e.g. yoga

and pilates) help maintain good posture

and can prevent fractures by promoting

balance

High impact activities such as strength

training can cause a increased build up ofbone due to the application of mechanical

stress.

Office of the Surgeon General (2004). 6. Determinants of Bone Health. Bone Health and Osteoporosis: A Report of the Sur(MD). Retrieved from: http://www.ncbi.nlm.nih.gov/books/NBK45503/#_NBK45503_pubdet_ on Sept 19, 2015.

Seeley R., VanPutte, C., Regan J., & Russo, A. (2014). Seeleys anatomy & physiology (10th ed.). New York, NY: The Mcgraw-Hi


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DETERIORATION OF TH

MUSCULAR SYSTEM

S i


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Sarcopenia a common consequence of

normal aging that describesa gradual loss of muscle

mass and strength that

may begin at age 30

at the age of 80, muscle

strength decreases by 50%

Bemben, M. Physiology of aging. [PDF document]. retrieved from: https://www.acsm.org

S i


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Sarcopenia reduction in fiber number

or fiber sizeor combinationof the two

reduced physical activity

is a key factor

Multifactorial

Bemben, M. Physiology of aging. [PDF document]. retrieved from: https://www.acsm.org


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For healthy young adults, underequilibrium c ond

the degradation and synthesis of skeletal muscle ibalancedand dynamic process

Small imbalances between degradation and synt

accumulated over several years result to the sig

loss in muscle mass.

Marcell, T. (2003). Review article: sarcopenia: causes, consequences, and Preventions. Retrieved from: http://biomedgero

org/content/58/10/M911.full
http://biomedgerontology.oxfordjournals.org/content/58/10/M911.fullhttp://biomedgerontology.oxfordjournals.org/content/58/10/M911.fullhttp://biomedgerontology.oxfordjournals.org/content/58/10/M911.fullhttp://biomedgerontology.oxfordjournals.org/content/58/10/M911.fullhttp://biomedgerontology.oxfordjournals.org/content/58/10/M911.full


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Muscle cell changes


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g As muscles age, smoothening of

sarcolemma in muscle end plate

decreases surface area and diminishes

stimulation of muscle cells.

Cells contract slower and become

decreasingly able to recover from a

contraction and prepare for the next

one

Slowing of calciumrelease and retrievalof the sarcoplasmic reticulum with

increasing age is also an attribute

DiGiovanna, A. G. (1994). Human aging: Biological perspectives. McGraw-Hill.

M l ll h


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Muscle cell changes decrease in the number of sarcomeres within myo

causes the muscle cells they are a part of to shortthen causes them to have a reduced distance for m

the person will experience a feeling of stiffness an

decreased freedom of movement

reduced sarcomeres will also lessens strength of tmuscles

DiGiovanna, A. G. (1994). Human aging: Biological perspectives. McGraw-Hill.

D ti d MU d li


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Denervation and MU remodeling loss of motor axons due to normal aging process (loss of

motor neurons being greatest among type IImuscle fiber Either becomes reinnervated by sprouts of other axons w

vicinity (commonly from type I fibers) or denervates and

disappears

may explain why Type II (fast-twitch) fibers decline with in

age whereas Type I (slow-twitch) fibers are seemingly resiage-related atrophy until the ages of 70-80



Carlson, B. (2004). Denervation and aging of skeletal muscle, Basic Appl Myol 14(3), 135-139.

D ti d MU d li
http://biomedgerontology.oxfordjournals.org/content/58/10/M911.fullhttp://biomedgerontology.oxfordjournals.org/content/58/10/M911.fullhttp://biomedgerontology.oxfordjournals.org/content/58/10/M911.fullhttp://biomedgerontology.oxfordjournals.org/content/58/10/M911.fullhttp://biomedgerontology.oxfordjournals.org/content/58/10/M911.full


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Denervation and MU remodeling size of remaining motor units

increase with reinnervation causes a decrease in

controlling the strength of

each contraction

may be a reason why fine

movements deteriorate with

age



Carlson B (2004) Denervation and aging of skeletal muscle Basic Appl Myol 14(3) 135-139

Protein S nthesis
http://biomedgerontology.oxfordjournals.org/content/58/10/M911.fullhttp://biomedgerontology.oxfordjournals.org/content/58/10/M911.fullhttp://biomedgerontology.oxfordjournals.org/content/58/10/M911.fullhttp://biomedgerontology.oxfordjournals.org/content/58/10/M911.full


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Protein Synthesis Declines in protein synthesisinvolved in reduced prot

Not all muscle proteins display change in synthesis rat separation of muscle proteins showed that Myosin He

Chain (MHC) synthesis rates are less for the middle ag

old aged

MHC being a key contractile protein, its reduction wou

a decline inlocomotor function andmuscle weakne

Williams, G., Higgins, M., & Lewek, M. (2002). Aging skeletal muscle: physiologic changes and the effects of training. Phys

68. doi: 10.1093/gerona/58.10.M911

Protein Synthesis


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Protein Synthesis It is not the ability to metabolize proteins that deterior

time we lose the ability to synthesize our own proteins, an

process would involve hormones.

Williams, G., Higgins, M., & Lewek, M. (2002). Aging skeletal muscle: physiologic changes and the effects of training. Phys

68. doi: 10.1093/gerona/58.10.M911

Hormones


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Hormones reduced levels of circulating anabolic hormones such as som

and testosterone (decline from middle age onwards) Increased insulin resistance with age may contribute to mu

deterioration through theinhibition of the nitric oxide cascad

responsible for the absorption of amino acids in protein synt

cortisolincreases with age and is a potent stimulus to protein

catabolism.

Knight, J. (2008) Exploring the anatomy and physiology of ageing: Part 10 - muscles and bone, Nursing Times; 104: 48

Replacement of active muscle


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Replacement of active muscle Active muscle fibers are

progressively replaced bycollagen-rich, non-contractile

fibrous tissue

Increased deposition of fats

with decreased lean muscle

tissue decreased force production

capability


Other Factors


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Other Factors

age changes in capillary structure and decrease in capillary d

in muscles increasing accumulation of lipofuscin

proper functioning of muscular system is also dependent in o

systems that change with age such as the nervous, circulato

and respiratory systems


Tendon Stiffening


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Tendon Stiffening

Tendons-Cord like tissue that attaches muscles to bon

Caused mainly by the decrease of water content due proteoglycan deficiency caused by aging.

Limits movements

Makes tendons less able to tolerate stress

Is also caused by decrease of elastin which will result in

decrease in flexibility

Malfulli, N., Renstrom, P., Leadbetter, W. (2005). Tendon Injuries: Basic Science and Clinical Medicine. Springer-Verlag Londfrom https://books.google.com.ph/books?id=71ibIKaiwFkC&pg=PA27&lpg=PA27&dq#v=onepage&q&f=false on Sept. 20Effects of AginG. (2009). OrthoInfo.com. Retrieved from http://orthoinfo.aaos.org/topic.cfm?topic=A00191 on Sept. 20, 2

ADDRESSING THE AGING


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ADDRESSING THE AGING

MUSCULOSKELETAL SYSTE

Regular Physical Activity


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Musculoskeletal agi

be delayed or preve

living a physically

lifestyle.

Elderly people wh

sedentary can benefexercise.

Seeley R., VanPutte, C., Regan J., & Russo, A. (2014). Seeleys anatomy & physiology (10th ed.). New York, NY: The Mcgra



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Regular Physical Activity Aerobic activities and strength

training programs improvemuscular performance.

Moderate activity and weight-

bearing exercises help build

bone mass and enhanceneuromuscular function.

Marieb, E.N. & Hoehn K. (2013). Human anatomy & physiology (9th ed.). San Francisco, CA: Pearson Education Inc.Tortora, G.J. & Derrickson B. (2009). Principles of anatomy and physiology (12thed.). John Wiley & Sons, Inc.



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Regular Physical Activity Resistance exercises can

help build bone strengthand muscle mass.

Risk of injury associated

with the increase of

strenuous physical activity

must be assessed.

DiGiovanna, A.G. (1999). Muscle System. In Human aging: biological perspectives (8). Retrieved from http://www2.ku.edu/~lba/courses/articles/chapter%208d.pdfMarieb, E.N. & Hoehn K. (2013). Human anatomy & physiology (9th ed.). San Francisco, CA: Pearson Education Inc.Tortora, G.J. & Derrickson B. (2009). Principles of anatomy and physiology (12thed.). John Wiley & Sons, Inc.



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Regular Physical ActivityEffects of Maintaining a High Level

of Physical Activity Throughout Life

Slower decline in:

energy molecules (ATP, creatinephosphate, glycogen)

oxidative enzymes blood supply speed of movement, stamina,

endurance, Vo2max

DiGiovanna, A.G. (1999). Muscle System. In Human aging: biological perspectives (8). Retrieved from http://www2.ku.edu/~lba/courses/articles/chapter%208d.pdf



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Slower decline in:

muscle cell thickness number of muscle cells

muscle thickness muscle mass muscle strength




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Slower decline in bone minerals Decreased risk of fractures and

osteoporosis




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Regular Physical ActivityEffects of Starting or Increasin

Increases oxidative enzymes, sto capillary numbers, blood flow

oxygen from blood cell thickness, muscle strength, m speed of movement, stamina

Vo2max




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Regular Physical ActivityEffects of Starting or Increasing

Increases ease of movemenmovement, joint flexibility

Slows bone demineralization Decreases risk of falling and susta


Healthy diet


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Healthy diet

Brink, W. (2007). Preventing Sarcopenia. Life Extension. Retrieved fromhttp://www.lifeextension.com/magazine/2007/01Tortora, G.J. & Derrickson B. (2009). Principles of anatomy and physiology (12thed.). John Wiley & Sons, Inc.

Healthy diet


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Healthy dietNutritional Strategies (Life Extension Magazine)

Creatine Vitamin D

Whey protein

Brink, W. (2007). Preventing Sarcopenia. Life Extension. Retrieved from http://www.lifeextension.com/magazine/2007/01

Medications


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MedicationsAntiresorptive Drugs- slow down further bone loss

Bisphosphonates Selective estrogen receptor modulators

Estrogen replacement therapy

Hormone replacement therapy

Bone-building Drugs

Tortora, G.J. & Derrickson B. (2009). Principles of anatomy and physiology (12thed.). John Wiley & Sons, Inc.

Other Tips


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Other Tips blood testing to track hormone levels

reduce intake of alcohol and carbonated beverages do not smoke

avoid stress

Photo sources


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Photo sourcesLifeMap Sciences, Inc. (2012). Embryonic Development of the Skeletal Muscle. Retri

//discovery.lifemapsc.com/in-vivo-development/skeletal-muscle

Borland, S. (2013). Bad Habits like smoking and drinking cost a million lost years. Re

http://www.dailymail.co.uk/health/article-2403577

Stress Management. (n.d). Stress Management. Retrieved from http://www.southe

life/health/healthservices/stressmanagement.html

Citrage. (n.d.). What are the causes of sarcopenia. Retrieved from http://www.citrag

com/professional-space/sarcopenia/sarcopenia-causes?lang=en
http://www.southernct.edu/student-life/health/healthservices/stressmanagement.htmlhttp://www.southernct.edu/student-life/health/healthservices/stressmanagement.htmlhttp://discovery.lifemapsc.com/in-vivo-development/skeletal-musclehttp://www.southernct.edu/student-life/health/healthservices/stressmanagement.htmlhttp://www.southernct.edu/student-life/health/healthservices/stressmanagement.htmlhttp://discovery.lifemapsc.com/in-vivo-development/skeletal-muscle

Documents

Musculoskeletal Ageing