Frailty and Sarcopenia
- Dr. Brian Abelson
- 5 hours ago
- 7 min read
Frailty and sarcopenia are not just medical terms. They are real conditions that shape how we walk through the world, how resilient we are to stress, and how long we can remain active and independent. Sarcopenia reflects a loss of muscle mass and strength, while frailty represents a broader decline in physiological reserve across multiple systems. Together, they influence far more than movement. They affect metabolic, cardiovascular, neurological, and immune function, gradually shifting the trajectory of long-term health.
Understanding these conditions gives us knowledge and power. Once we recognize what is happening in our bodies, we can take meaningful steps to protect ourselves and the people we care about. The research is clear. Muscle health is whole-body health.
Below are key scientific facts that bring these concepts to life.
Article Index
Key Facts You Should Know
Muscle Loss Begins Earlier Than Most People Realize
Muscle decline does not start in old age. It begins quietly in midlife. After the age of forty, adults lose about one percent of muscle mass each year, and this accelerates after sixty. Strength declines even faster because strength relies on both muscle fibers and the nervous system working together (Mitchell et al., 2012).
This early slope explains why building and maintaining strength in midlife becomes one of the most powerful investments for healthy aging.
Sarcopenia Strongly Predicts Falls and Mobility Decline
People with sarcopenia face up to a threefold increase in falls and mobility problems compared to those with healthy muscle mass (Landi et al., 2012). Lower limb power plays a central role in gait speed and balance. When leg strength fades, so does independence. A simple change in walking speed can predict future health years in advance.
Frailty Dramatically Increases Vulnerability to Stress
Frailty reflects a loss of physiological reserve. Even a minor stressor such as a cold, mild dehydration, or a small injury can lead to significant functional decline. Frail older adults are up to five times more likely to require hospitalization from minor illness and often recover more slowly, both physically and emotionally (Clegg et al., 2013).
This is why small events can have big consequences later in life.
Sarcopenia Increases Mortality Risk Even in Otherwise Healthy Adults
A large meta-analysis of more than thirty four thousand participants found that sarcopenia increases mortality risk by approximately sixty percent, regardless of age or existing illnesses (Beaudart et al., 2017). Low muscle strength has become so closely tied to survival that many researchers consider it a vital sign of aging.
Muscle Tissue Functions as a Critical Endocrine Organ
Skeletal muscle is far more than a mechanical structure. It produces signaling molecules called myokines that influence inflammation, metabolism, immune function, and even brain health. As muscle mass decreases, the body loses this protective biochemical support, leading to higher inflammation and metabolic disruption (Pedersen and Febbraio, 2012).
Maintaining muscle protects the entire system.
Sarcopenia Is Closely Linked to Insulin Resistance and Cognitive Decline
Most of the glucose you consume is normally stored or used inside skeletal muscle. When muscle mass declines, the body loses its primary site for glucose disposal. This forces the pancreas to work harder, raises circulating insulin, and gradually drives insulin resistance. Older adults with sarcopenia show significantly higher rates of metabolic syndrome and type 2 diabetes (Leenders et al., 2013).
This relationship goes far beyond sugar control. Chronic insulin resistance affects the brain. Research now shows a strong association between type 2 diabetes and Alzheimer’s disease, to the point where some neuroscientists refer to Alzheimer’s as a “type 3 diabetes” model of metabolic dysfunction. Insulin resistance impairs neuronal energy metabolism, increases amyloid accumulation, and accelerates inflammation within the brain.
In this context, maintaining muscle mass becomes one of the most powerful tools not only for glucose regulation but also for long-term cognitive health. Strength training protects the brain by improving insulin sensitivity, reducing the inflammatory load, and stabilizing glucose metabolism across the entire system.
Frailty Accelerates Cognitive Decline
Frailty affects the brain through reduced blood flow, chronic inflammation, and mitochondrial decline. Research shows that frail individuals experience faster decreases in memory, processing speed, and executive function, and face a greater risk of dementia (Robertson et al., 2013).
This highlights the profound connection between physical resilience and cognitive health.
Hospitalization Accelerates Muscle Loss at an Alarming Rate
Muscle loss during bed rest is rapid. Healthy older adults can lose more than one kilogram of lean tissue in less than two weeks of inactivity (Kortebein et al., 2007). This explains why even short hospital stays can cause lasting declines in strength, balance, and mobility. Maintaining movement during illness or hospitalization becomes essential.
Exercise Reverses Sarcopenia Even Late in Life
One of the most hopeful findings in aging research is that muscle responds to training at any age. Progressive resistance exercise increases muscle mass and strength even in people in their nineties. In one landmark study, nonagenarians gained one hundred seventy four percent in strength after only eight weeks of training (Fiatarone et al., 1990).
It is never too late to regain strength.
Manual Therapy Enhances Strength Training Outcomes
When manual therapy reduces pain, improves joint mobility, and restores more efficient movement patterns, patients are able to train more effectively. This improves neuromuscular activation, reduces fall risk, and enhances functional performance (Bialosky et al., 2018).
This is where Motion Specific Release becomes an essential part of restoring stability and confidence.
The Good News: Frailty and Sarcopenia Are Highly Treatable
Although these conditions are common, they are not inevitable. Aging does not equal decline. Research consistently shows that meaningful improvement is possible at any age, even well into the eighties and nineties.
Effective strategies include:
Progressive resistance training
Balance and mobility exercises
Adequate protein intake
Vitamin D optimization
Avoiding prolonged inactivity
Manual therapy that restores movement and reduces pain
With the right approach, strength improves, gait becomes steadier, mobility increases, and confidence returns. Our bodies remain adaptable throughout life, often far more than we realize.
References
Beaudart C et al. Health outcomes of sarcopenia. Journal of Clinical Endocrinology and Metabolism. 2017
Bialosky JE et al. Mechanisms of manual therapy. Journal of Orthopaedic and Sports Physical Therapy. 2018
Clegg A et al. Frailty in older adults. The Lancet. 2013
Fiatarone MA et al. High intensity strength training in nonagenarians. Journal of the American Medical Association. 1990
Kortebein P et al. Functional impact of ten days of bed rest. Journal of Gerontology. 2007
Landi F et al. Sarcopenia and risk of falling. Journal of the American Medical Directors Association. 2012
Leenders M et al. Age related decline in muscle mass. American Journal of Clinical Nutrition. 2013
Mitchell WK et al. Sarcopenia and aging muscle. Biogerontology. 2012
Pedersen BK and Febbraio MA. Muscles as endocrine organs. Physiological Reviews. 2012
Robertson DA et al. Frailty and cognitive impairment. Age and Ageing. 2013
DR. BRIAN ABELSON, DC. - The Author
With over 30 years of clinical experience and having treated more than 25,000 patients, Dr. Brian Abelson is the creator of the Motion Specific Release (MSR) Treatment Systems—a powerful, evidence-based approach designed to achieve effective, lasting results.
As an internationally best-selling author, Dr. Abelson is dedicated to sharing knowledge and techniques that benefit the broader healthcare community. His passion for continuous learning drives him to integrate cutting-edge methodologies into the MSR programs, with a strong focus on multidisciplinary collaboration.
At the heart of his work is a commitment to patient-centered care, constantly evolving to advance treatment methods. Dr. Abelson practices at Kinetic Health in Calgary, Alberta, Canada, where he helps patients move beyond pain to achieve lasting health and improved function.
Why Choose Our MSR Courses and MSR Pro Services?
Elevate your clinical practice with our Motion Specific Release (MSR) courses and MSR Pro services, offering a comprehensive, evidence-based approach to musculoskeletal care.
Proficiency in MSR goes beyond videos or articles—they’re only the beginning. True mastery requires immersive, hands-on training to deepen your knowledge of anatomy, biomechanics, and precise tactile skills. MSR is a journey of focused practice, real-time feedback, and mentorship that transforms knowledge into expertise.
Here’s why you should join us:
Proven Methodology: Developed by Dr. Brian Abelson, an international best-selling author with over 30 years of clinical experience, MSR integrates the most effective elements of osseous and myofascial therapies. With a success rate exceeding 90%, our approach helps set a new industry standard.
Comprehensive Training: Our courses blend rigorous academic content with innovative techniques. You’ll master essential areas, including orthopedic and neurological examinations, myofascial treatment, fascial expansion, and osseous adjusting and mobilization.
Extensive Resources: As an MSR Pro subscriber, you have access to a vast library of over 200 MSR procedures, fillable PDF forms, instructional videos, and in-depth articles. From patient intake to tailored exercise prescriptions, our resources equip you for clinical success.
Tailored Support: Refine your diagnostic skills and expand your treatment techniques with ongoing support through over 750 videos, including 200 technique videos, 250 exercise videos, and 160 MSK articles. This extensive library features over 50 musculoskeletal condition articles, all designed to support you in clinical practice. Our resources are dynamic, with regular updates to articles, technique videos, and new additions to our educational curriculum.
Innovation and Growth: We emphasize continuous learning and innovation, giving you the tools to adapt and thrive in complex clinical scenarios. Our courses and resources are designed to foster professional growth, keeping you at the forefront of musculoskeletal therapy.
Unlock your practice's full potential with our MSR courses and MSR Pro services. Achieve outstanding clinical outcomes and join a community of forward-thinking practitioners dedicated to excellence in patient care.
YouTube Channel
Explore Dr. Abelson’s YouTube Channel, home to over 200,000 subscribers and over 37 million views. The channel showcases hundreds of Motion Specific Release (MSR) procedures, including techniques that integrate Fascial Expansion and Traditional Chinese Medicine principles.
You’ll also find:
70+ essential physical examination videos
A wide range of MSK condition tutorials
Hundreds of mobility and strengthening exercises
A full playlist dedicated to Yang Style Tai Chi, which Dr. Abelson has taught for many years.
Disclaimer:
The content on the MSR website, including articles and embedded videos, is intended for educational and informational purposes only. It is not a substitute for professional medical advice; only certified MSR practitioners should practice these techniques. By accessing this content, you assume full responsibility for your use of the information, acknowledging that the authors and contributors are not liable for any damages or claims that may arise.
This website does not establish a physician-patient relationship. If you have a medical concern, consult a healthcare provider who is appropriately licensed. Users under the age of 18 are not permitted to use the site. The MSR website may also feature links to third-party sites; however, we bear no responsibility for the content or practices of these external websites.
By using the MSR website, you agree to indemnify and hold the authors and contributors harmless from any claims, including legal fees, arising from your use of the site or violating these terms. This disclaimer constitutes part of the understanding between you and the website's authors regarding the use of the MSR website. For more information, read the full disclaimer and policies in this website.