The Journals of Gerontology Series A In the Public Domain

1995. Vol. 50A (Special Issue), 41-44

Age, Gender, and Muscular Strength

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Ben F. Hurley

Department of Kinesiology, College of Health and Human Performance, University of Maryland, College Park.

Muscular strength can be measured by cable tensiometry, non-motorized dynamometry (e.g., handgrip dynamome-
ter), motorized dynamometry, or with free weights or exercise machines. Advantages and disadvantages of each are
discussed. Cross-sectional studies indicate that isometric and concentric strength levels peak between the second and
third decade, remain unchanged until the fourth or fifth decade, and start to decline from about the fifth decade at a
rate of12% to 15% per decade until the eighth decade in men. Greater strength losses in both men and women have
been suggestedfrom the few longitudinal studies available on this topic. However, concentric strength levels in women
tend to peak sooner, start to decline earlier, and decrease at a slightly slower rate than men. Age- and inactivity-
induced sarcopenia explains some but not all of the losses in strength with age. There is a need to determine the
separate roles of disease, inactivity, and normal aging on these losses. Newfindingsfrom the Baltimore Longitudinal
Study of Aging suggest a preservation of eccentric strength levels with age in women.

ACCURATE
L
and reliable assessments of muscular
strength in the elderly are important because of the
many health and functional implications associated with the
loss of strength and muscle mass with age (Hyatt et al.,
1990; Buchner and deLateur, 1991; Bassey et al., 1992;
Buchner and Wagner, 1992). Strength measurements are
usually performed with either a cable tensiometer, a non-
motorized dynamometer (e.g., hand-grip dynamometer), a
motorized dynamometer (e.g., an isokinetic device), or with
free weights or exercise machines using a one- or three-
repetition maximum test.
The cable tensiometer consists of a cable connected
through a tension dial indicator. As tension on the cable
increases, a riser on the dial indicator is deflected and causes
needle movement in proportion to the amount of force
generated against the cable. This device can provide accu-
rate and reliable strength measurements (McArdle et al.,
1994). It is also portable, inexpensive, easy to administer,
and allows for testing a wide range of angles and muscle
groups. However, cable tensiometry can only measure iso-
metric force. Thus, it cannot provide any information about
the dynamics of muscle force generation.
The most common form of non-motorized dynamometry
used in strength and aging research is the hand-grip dyna-
mometer. It has been used for strength assessment in many
cross-sectional and longitudinal aging studies (Clement
1974; Viitasaloetal., 1985; Cauley et al., 1987;Kallmanet
al., 1990;Bembenetal., 1991; Sipila etal., 1991; Era etal.,
1992; Bassey and Harries, 1993; Rantanenetal., 1994). The
hand-grip dynamometer has many of the same advantages as
the cable tensiometer. It is portable, inexpensive and easy to
administer, but it does not offer the wide range of angles and
muscle group testing provided by the cable tensiometer. This
limitation results in a major disadvantage for use in aging
research because it means that you can only evaluate a
muscle group that may not be representative of those used
for maintaining posture, mobility, and stability. In addition,
age-associated strength losses occur sooner and at a faster
rate in the lower body than in the upper body (Asmussen and
Nielsen, 1962; Bemben et al., 1991; Frontera et al., 1991).
Although it may be argued that strength assessments with
hand-grip dynomometers predict falls in the elderly (Wick-
ham et al., 1989), there are many more studies using motor-
ized dynamometers (i.e., isokinetic devices) that have dis-
tinguished fallers from nonfallers based on dorsal flexion,
plantar flexion, or quadricep strength (Whipple et al., 1987;
Gehlsen and Whaley, 1990; Lord et al., 1991). Neverthe-
less, when it is necessary to test large numbers of people in
short time periods at many locations, and cost is an impor-
tant factor, hand-grip dynamometry may be the instrument
of choice.
Strength assessment through repetition(s) maximum (i.e.,
the maximal weight or resistance that can be moved through
a range of motion for a specified number of repetitions) with
free weights or exercise machines has several advantages
over cable tensiometry, non-motorized dynamometry, and
motorized dynamometry. One advantage is that the repeti-
tion maximum (RM) test (e.g., 1-RM) is more representa-

41
42 HURLEY
tive of the strength needed to perform functional tasks such
as lifting heavy objects from one level to another. The values
derived from this test are often more meaningful to subjects
because it tells them the amount of weight they can actually
lift. It is also more specific to the type of training they would
most likely do to enhance strength levels. For this reason,
the 1-RM test is often used to measure strength gains
resulting from strength-training programs. Nonetheless, this
testing modality has disadvantages for large-scale testing in
aging research. Pollock et al. (1991) have suggested that one
disadvantage is safety. For example, they observed a higher
rate of injury during 1-RM testing in 70- to 79-year-olds
(19.3%) than they did throughout an entire strength training
program (8.7%). In an attempt to reduce the risk of injury in
older subjects, some investigators are now using a 3-RM
test. However, others have not reported injuries from 1-RM
testing (Frontera et al., 1988; Fiatarone et al., 1990, 1994).
Another disadvantage of 1-RM testing is the difficulty in
establishing an objective criterion. Furthermore, it can re-
quire more motor learning than other testing modalities,
which could affect test reliability. For these reasons, RM
testing with free weights or exercise machines is seldom
used for strength testing in aging research unless training is
involved.
Motorized dynamometry is the most common category of
exercise devices currently used for strength testing. These
devices provide information on muscle dynamics throughout
the full range of extension and flexion. They can provide
better isolation of muscle groups and allow a more objective
criterion than the 1-RM test. The disadvantages are that they
are expensive and not specific to activities of daily living or
the type of training that older people are likely to do to
increase their strength levels. The Cybex II isokinetic device
is the dynamometer most often reported in previous strength
and aging studies. Although it is possible to get accurate and
reliable strength (peak torque) measures from the Cybex II,
it requires many manipulations by the investigator to correct
for specific problems. Unfortunately, these problems were
not corrected in many of the previously published studies
using the Cybex II and may have led to substantial measure-
ment errors (Winter et al., 1981; Sapega et al., 1982;
Murray, 1986; Murray and Harrison, 1986; Herzog, 1988).
For instance, errors ranging from 11% to 200% have been
reported from transient spikes on the Cybex II, often re-
corded as peak torque, but found to represent artifacts due to
excess acceleration of the machine's lever arm (Sapega et
al., 1982). Errors of 26% to 43% for extension and 55% to
510% for flexion have also been reported from not correcting
for the gravitational effects of the limb being tested (Winter
et al., 1981). Newer models of Cybex and other motorized
dynamometers are now computerized and have included
gravity corrections as well as corrections for other potential
sources of error. The newer models of computerized dyna-
mometers offer a long list of options that can provide much
needed information about the muscle dynamics of aging
muscle. However, investigators should not assume that all
computerized dynamometers are accurate and reliable. To
ensure accuracy and reliability, investigators should devise
their own external calibration and test-retest procedures in
addition to those provided by the manufacturer. When this is
done, accurate and reliable measures of peak torque can be
obtained with modern computerized dynamometers (Farrell
and Richards, 1986; Tredinnick and Duncan, 1988).
Strength Losses with Age
Cross-sectional studies. — Muscular strength tends to
peak between the second and third decades and remains the
same until about 45-50 years of age in men. Losses then
begin to occur at the rate of approximately 12% to 15% per
decade until the eighth decade (Clement, 1974; Larsson et
al., 1979; Murray et al., 1980; Johnson, 1982; Viitasalo et
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al., 1985; Youngetal., 1985;Kallmanetal., 1990;Bemben
et al., 1991; Frontera et al., 1991; Era et al., 1992). Isomet-
ric strength levels in the quadriceps of young men (age range
20—35 years) are about 30—47% higher than those reported
in older men (Larsson et al., 1979; Murray et al., 1980;
Johnson, 1982; Young et al., 1985; Viitasalo et al., 1985).
When comparing isometric strength levels of the same mus-
cle group in women, declines begin sooner than in men
(Asmussen and Nielsen, 1962), but appear to occur at a
slower rate from cross-sectional analysis (Clement, 1974).
Moreover, on a percentage basis, there is less total strength
loss with age in women compared to men (Young et al.,
1984; Murray et al., 1985; Harries and Bassey, 1990; Fron-
tera et al., 1991). However, one study showed no gender
differences in plantar or dorsal flexion (Danneskiold-Samsoe
et al., 1984). A 30-39% strength loss has been reported
when comparing women in their 60s and 70s to those in their
20s (Young et al., 1984; Murray et al., 1985; Stalberg et al.,
1989; Harries and Bassey, 1990). Cauley et al. (1987) and
Phillips et al. (1993) have suggested that much of the
strength decline in women after menopause can be prevented
by hormone replacement therapy (HRT). However, this
conclusion was based on cross-sectional comparisons of
women who received HRT to those who did not. Women
who receive HRT may be much different from those not
receiving it in ways that could have affected their results.
Thus, there is a need for longitudinal studies on this issue.
Age-related differences in slow-speed isokinetic peak
torque values of the quadriceps are similar to those of
isometric values in men (Larsson et al., 1979; Murray et al.,
1980; Johnson, 1982) and women (Danneskiold-Samsoe et
al., 1984; Murray et al., 1985; Stalberg et al., 1989), but
greater age-related differences are observed at faster speeds
(Larsson et al., 1979; Harries and Bassey, 1990). In addi-
tion, older men take longer to reach peak torque compared to
younger men (Murray et al., 1980). These data are supported
by the observation of greater losses in muscle power than
strength (Young and Skelton, 1994), and a close association
between age-related losses in muscle power and functional
abilities, particularly in women (Bassey et al., 1992). These
findings may be explained by a selective atrophy of type lib
fibers with advanced age (Aniansson et al., 1986).
Although strength losses tend to occur earlier in the lower
extremities than the upper extremities (Bemben et al.,
1991), percentage differences between young and old
groups for upper extremity muscle groups are about the same
as those of the lower extremities (Viitasalo et al., 1985;
Kallmanetal., 1990; Bemben etal., 1991; Era etal., 1992).
 AGE, GENDER, AND MUSCULAR STRENGTH
Upper body strength values in men in their seventh or eighth
decades are reported to be 37% (Kallman et al., 1990), 38%
(Eraetal., 1992), and 42% (Viitasaloet al., 1985) less than
those in their third decade. However, cross-sectional studies
tend to underestimate the true strength losses with age
(Clement, 1974; Bassey and Harries, 1993).
Longitudinal studies. — Bassey and Harries (1993) re-
ported a 12% loss after four years in the hand-grip strength of
men over 65 years of age. During this same time period they
reported a 19% loss in women of similar age. Strength losses
ranging from 9-27% after five years (Aniansson et al.,
1983), 10-22% after seven years (Aniansson et al., 1986),
and 25-35% after approximately eleven years were ob-
served in elderly men and women (Aniansson et al., 1992).
The seven-year strength losses were accompanied by a 14%
reduction in type Ha fiber area, a 25% reduction in type lib
fiber area, and no significant change in type I fiber area
(Aniansson et al., 1986). Therefore, muscle fiber type may
explain a large portion of peak torque changes (Stalberg et
al., 1989), as well as changes in the force/velocity relation-
ship with age (Harries and Bassey, 1990).
Muscle quality. — To determine whether age affects the
quality of muscle, many investigators have attempted to
assess strength in relation to muscle mass. This is a difficult
task because of the problems associated with the measure-
ment of muscle mass. Young et al. (1984) found no differ-
ence in intrinsic strength of muscle when comparing women
in their eighth decade to those in their third decade, whereas
losses in muscle quality with age have been reported in men
(Young et al, 1985; Kallman et al., 1990; Frontera et al.,
1991; Reed et al., 1991; Overend et al., 1992). Young et al.
(1985) and Overend et al. (1992) found reductions in
strength per cross-sectional area of muscle in older men
compared to younger men. Moreover, Kallman et al. (1990)
observed losses in strength relative to muscle mass estimated
by creatinine excretion in older men. Nevertheless, prospec-
tive studies using more direct measures of muscle mass need
to be performed before any definitive conclusions can be
made concerning age and gender effects on muscle quality.
Concentric vs eccentric losses. — Dynamic muscular
exertions usually consist of a phase in which the muscle
shortens (concentric) and a phase in which the muscle resists
lengthening (eccentric). Most previous research on the ef-
fects of age on muscular strength has focused either on
isometric or only on the concentric phase of dynamic muscu-
lar exertions. One major reason for this is that dynamometers
for measuring strength have only recently had the capacity
for the measurement of the eccentric component. This phase
of exertion is an important component of many physical
tasks because it provides the necessary deceleration forces
for maintaining proper stabilization, balance, and mobility
(Duncan et al., 1989). It differs from the concentric compo-
nent by producing a different force/velocity relationship,
having a greater maximal force capacity, causing greater
loading of elastic components, and resulting in a greater
degree of delayed muscle soreness and injury when over-
loaded.
43
Only two studies could be found on the effects of age on
maximal eccentric force production (Vandervoort et al.,
1990; Poulin et al., 1992). Vandervoort et al. (1990) re-
ported some losses in eccentric strength levels with age, but
they were much less than those reported for concentric
strength. Poulin et al. (1992) found similar results at slower
velocities, and observed no age-related losses in eccentric
strength levels at faster velocities. However, both of these
investigations had small ample sizes and only studied two
age groups. We are presently studying this relationship in
participants of the Baltimore Longitudinal Study of Aging.
Our preliminary results show that both concentric and eccen-
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tric peak torque values decrease with age at the same rate in
men, but not in women. For some undetermined reason,
women tend to preserve their eccentric strength levels with
age much better than men. We are presently analyzing
stretch-shortening cycles in men and women to help further
understand these relationships.
Conclusion
Accurate and reliable strength data can be obtained from
motorized dynamometers as long as the investigator goes
through all the necessary calibration and test-retest proce-
dures. Muscular strength peaks between the second and third
decade, remains unchanged until the fourth or fifth decade,
and then declines from the fifth to the eighth decade by about
35-45% in men, based on cross-sectional observations. The
few longitudinal studies available on this topic show a higher
rate of loss with age. Women reach peak strength levels
slightly sooner and start to lose strength earlier, but total
strength losses appear to be slightly less than those in men.
There appears to be a preservation of eccentric strength
levels in women with age but not in men. Future studies
should: (1) determine whether muscle quality changes with
age, (2) identify factors other than muscle mass (e.g.,
neuromuscular, contractile, and mechanical properties) that
may contribute to age-related losses in strength, (3) deter-
mine the effects of interventions such as strength training
and growth hormone on factors affecting strength, (4) pro-
vide more information on the relationship of age- and
inactivity-induced sarcopenia to the loss of functional abili-
ties and health status, (5) assess strength losses in those over
80 years of age, and (6) determine the separate roles of
disease, inactivity, and normal aging on strength losses.
ACKNOWLEDGMENT
Address correspondence to Dr. Ben F. Hurley, Department of Kinesiol-
ogy, College of Health and Human Performance, University of Maryland,
College Park, MD 20742.
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