Exercise Prescription

Let me say the most important thing first: sarcopenia is not “just what happens when you get old.” It’s a disease that can be detected—and one that actually improves with exercise and diet. This post is written for two kinds of people: you, if an older adult at home has recently started walking slower or can’t open jars; and you, if you’re past fifty and starting to feel your stamina isn’t what it used to be. The second group is actually more important, because the latest 2025 Asian consensus pulled the age to start paying attention forward to fifty. ...

Recently I was spending time with an older adult, and he said to me: “Life really doesn’t need to be that long. I’m already in my 80s, why would I still go exercise and work out? I already go out and walk several times a day, that’s already very good!” Honestly, the first half—“life doesn’t need to be that long”—stumped me. That’s a question about the meaning of life, not something I can answer in a few sentences in clinic. But the second half—“walking several times is enough”—happens to be my own specialty, and I’m confident about this: walking is great, but for an 80-something older adult, relying just on walking really isn’t quite enough. I’ll start from here in the rest of this post. ...

Let’s start with the most important point: telling people to exercise rarely works, not because you haven’t said enough, but because you’re talking to the wrong “stage." Psychology research shows that when someone changes a habit (starting to exercise, quitting smoking, or controlling their diet), they go through five stages, and what works at each stage is completely different. Throwing an exercise routine at someone who hasn’t even considered moving is like pitching a loan to someone who isn’t looking to buy a car. It’s bound to fail. ...