The Importance of Skeletal Muscle Strength to Physical Function in Older Adults

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Abstract
It is intuitive that strength is a determinant of physical function, and hence, logical to ask whether age-related decline in strength is an important cause of functional impairment in older adults. Interestingly, the few studies which address this question report inconsistent results and often fail to find a strong relationship between strength and function. It appears that several theoretical issues about the relationship between strength and function are not widely appreciated: (a) the relationship between strength and function is specific for physical function; (b) relative strength is more closely related to function than absolute strength; (c) the relationship should be curvilinear and involves a threshold; and (d) the threshold strength required for good function is activity-specific. Analysis of existing data supported the importance of these concepts. However, whether strength training can improve functional status in older adults is unclear. Rigorously designed randomized controlled trials are needed that address whether long-term effects of exercise on functional status are possible, and how best to promote adherence to exercise in older adults.

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