Strength Training After 65: What Lifting Does for Muscle, Bones, and Daily Life

Walking is good. Strength training does something walking does not, and the research says even a modest amount counts. Here is what it does, how much to do, and what to put on your plate.

Many people over 65 hear "stay active" and take it to mean walking, gardening, and the occasional class. All of that helps. But if you or a parent has started to push up out of a chair with both hands, or avoid the stairs, the activity that most directly addresses that problem is lifting something heavier than you are used to, on a regular schedule.

What happens to muscle as we age

Muscle shrinks gradually with age, and strength drops along with it. It matters because the muscles in your legs are the ones that get you off the toilet, up from the couch, and up a curb.

The good news is that older muscle still responds to training. A 2022 meta-analysis pooled 21 studies and 1,610 adults aged 60 and over. People who did resistance training gained strength in the legs, arms, and grip. They also reported less depression and better scores on several quality-of-life measures [1]. The authors called the evidence preliminary and some measures, such as six-minute walk distance, did not improve. This is a useful result, not a final one.

How much is enough?

This is the question most people actually have. A 2025 network meta-analysis looked at 151 randomized trials with 6,306 adults aged 60 and over, and sorted programs into low, moderate, and high weekly volume (volume here means how many exercises, sets, and sessions you do) [2].

The finding is encouraging. Low-volume programs were the most effective for improving the Timed Up and Go test (how fast you stand, walk a short distance, turn, and sit), the six-minute walk, lean body mass, and muscle size. Moderate and high volumes did better for leg strength, and only high volume improved fast walking speed [2]. In plain terms: a small program gets you most of the way on everyday function, and doing more buys extra strength. The benefits were mostly seen in healthy older adults. The evidence for people who are physically impaired was limited [2].

The CDC's guideline for adults 65 and older asks for at least 2 days a week of muscle-strengthening activity, alongside at least 150 minutes a week of moderate aerobic activity and activities that train balance. The CDC adds that if you cannot meet the targets, you should be as active as your abilities and conditions allow [3].

A large review of cohort studies adds a longer view. In adults generally (not only older adults), people who did muscle-strengthening activity had roughly 10 to 17 percent lower risk of death from any cause, cardiovascular disease, and diabetes than people who did none. The biggest benefit appeared around 30 to 60 minutes a week, and doing much more did not clearly add to it [4]. These are observational studies, so they show an association, not proof that lifting caused the lower risk.

What about bones?

Bone responds to load, and strength training is a common recommendation for bone health. The evidence is real but modest. A 2026 network meta-analysis of 34 trials (1,746 middle-aged and older adults) found that moderate-intensity resistance training three times a week ranked best at most skeleton sites. Compared with no exercise, it raised bone density at the femoral neck, the top of the thigh bone near the hip, with a small effect size (0.26 standard deviations), and at the trochanter, the bony point on the outside of the hip. At the lumbar spine, total hip, and Ward's triangle, there were no statistically significant differences between the training options, so the authors say the rankings should be read with caution [5].

Take that as "lifting is likely to help bones, and we do not yet know the perfect recipe." If you have been diagnosed with osteoporosis, the form of the exercise matters. Ask your physician which movements are safe for your spine and hips before you start. That is a conversation for your physician and a qualified trainer.

What about falls?

The evidence on falls is more specific than "exercise prevents falls." A 2026 umbrella review (a review of 41 systematic reviews) found high-certainty evidence that balance and multicomponent exercise reduced fall rates by 23 to 34 percent. It also noted that direct evidence that rebuilding muscle itself lowers falls is still limited [6]. So the honest summary is that strength and balance work are usually combined, and the best-supported fall-prevention programs include balance training.

What this means for you

Here is a starting point, not a prescription:

• 2 days a week. That matches the CDC target of at least 2 days [3].
• A handful of exercises that cover the big muscles. A sit-to-stand from a chair, a supported squat or leg press, a row, a chest press, a step-up onto a low step, and a heel raise make a reasonable set. In the largest review, low weekly volume was enough for most of the everyday-function gains [2].
• Build up slowly. Begin with a light weight or band and 5 to 10 repetitions, depending on the exercise, and add load only when those repetitions feel comfortable. Skip any exercise that feels like too much and use an easier version.
• Add balance practice. Heel-to-toe walking and standing from a chair are on the CDC list [3].
• Be consistent, then add. Once those repetitions feel comfortable, adding sets or a session is how the extra leg strength comes. In the 151-trial review, moderate and high weekly volume did better for leg strength than low volume [2].

In winter, this is easier than people expect. Strength work does not need a trail or a clear sidewalk, and Rochester's long cold season is a good reason to do it indoors.

At RSF, classes have up to 12 people. A session starts with a warm-up, then moves through bodyweight and floor exercises such as push-ups, one-leg balance, closed-eye balance, and work with dumbbells, resistance bands, and other equipment. The last few minutes of class are set aside for stretching, so flexibility improves along with strength. A new client begins with an assessment, then starts with light work, usually 5 to 10 repetitions depending on the exercise. New clients do not do every exercise, especially the advanced ones. Everything is modified to what that person can do today, and over time they work up to the harder movements.

Where stretching fits

Strength gets the attention, but flexibility is part of moving well. Stiff hips and hamstrings can make it harder to get out of a chair, take a full step, or reach a low shelf. The evidence on stretching is simpler than most people expect.

A 2026 meta-analysis of 79 randomized trials (3,287 healthy people) found that regular static stretching, where you hold a position without bouncing, gave a moderate gain in lower-body flexibility. The gain did not differ significantly by age, sex, or fitness level, though results varied between trials [9]. A larger 2025 review of 189 studies found that flexibility gains levelled off at about 10 minutes of stretching per week over a training program (and about 4 minutes in a single session), and the people who started out stiffest improved the most [10]. Most participants in that larger review were in their 20s, with an average age under 30, so the older-adult evidence rests mainly on smaller trials. One of them randomly assigned 51 women averaging 66 years old to one of three home-based programs (static stretching, dynamic stretching, or eccentric exercise) three times a week for six weeks. All three improved hamstring flexibility and ankle motion. The eccentric group also gained more strength and walking speed, so stretching alone did not match it on function [11].

That is why a few focused minutes at the end of class is a sensible use of time. More stretching does not appear to be better, and stretching does not replace strength work. Gains in flexibility came from regular practice, so a short routine you will actually do is worth more than a long one you skip.

Eating to support strength

Training signals the muscle to build. Protein supplies the material, and food first is a sensible default.

A 2022 meta-analysis of 74 randomized trials looked at adding protein for healthy adults, most of them doing resistance training. More protein gave small extra gains in lean mass. In adults 65 and over, the benefit showed up at about 1.2 to 1.6 grams of protein per kilogram of body weight per day [7]. For a person who weighs 150 pounds (68 kg), that works out to roughly 80 to 110 grams a day. The gain was small and the evidence for strength and walking tests was weaker, so protein is a helper, not a substitute for lifting. These findings apply to people who are also doing resistance training [7].

A 2026 umbrella review looked at people with sarcopenia (age-related muscle loss). It found that adding protein supplementation to exercise gave larger gains in muscle mass and grip strength than exercise alone [6].

What that looks like in food, using things you can buy at Wegmans or the Public Market:

• Breakfast: eggs with whole-grain toast, or plain Greek yogurt with berries and walnuts.
• Lunch: a can of salmon or sardines on a salad, or lentil soup with a side of cottage cheese.
• Dinner: chicken, fish, tofu, or beans with vegetables and a whole grain.
• Snack: a glass of milk, a hard-boiled egg, or hummus with vegetables.

On calcium and vitamin D, take a food-first approach. A 2017 JAMA meta-analysis of 33 trials and more than 51,000 community-dwelling adults over 50 found that calcium and vitamin D pills, taken alone or together, did not lower the risk of hip or other fractures, and the authors did not support routine use of these supplements in healthy older adults [8]. That review tested pills, not meals, so it says nothing about dairy, fortified foods, or fish. If your doctor has recommended a supplement, keep taking it and ask before changing anything.

Talk to your doctor

Check with your physician before starting a strength program if you have heart disease, uncontrolled high blood pressure, osteoporosis, a recent fracture, joint replacement, or balance problems. Kidney disease is a specific reason to ask before raising protein, because the amounts above are for people without kidney problems. Nothing in this article replaces your own care team's advice, and nothing here should change how you take a medication.

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References

1. Khodadad Kashi S, Mirzazadeh ZS, Saatchian V. A systematic review and meta-analysis of resistance training on quality of life, depression, muscle strength, and functional exercise capacity in older adults aged 60 years or more. Biol Res Nurs 2023;25(1):88-106. https://pubmed.ncbi.nlm.nih.gov/35968662/
2. Radaelli R, Rech A, Molinari T, et al. Effects of resistance training volume on physical function, lean body mass and lower-body muscle hypertrophy and strength in older adults: a systematic review and network meta-analysis of 151 randomised trials. Sports Med 2025;55(1):167-192. https://pubmed.ncbi.nlm.nih.gov/39405023/
3. Centers for Disease Control and Prevention. Physical activity guidelines for adults 65 and older. https://www.cdc.gov/physical-activity-basics/guidelines/older-adults.html (accessed 2026-10-06)
4. Momma H, Kawakami R, Honda T, Sawada SS. Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: a systematic review and meta-analysis of cohort studies. Br J Sports Med 2022;56(13):755-763. https://pubmed.ncbi.nlm.nih.gov/35228201/
5. Zhang W, Mei J, Li X, et al. Optimal resistance exercise strategies for improving bone mineral density in middle-aged and older adults: a network meta-analysis based on exercise intensity and frequency. Calcif Tissue Int 2026;117(1). https://pubmed.ncbi.nlm.nih.gov/42573645/
6. Dharmansyah D, Rahayuwati L, Pramukti I, Mutyara K. Exercise and nutritional interventions for sarcopenia-related fall prevention in older adults: an umbrella review. J Nutr Health Aging 2026;30(6):100862. https://pubmed.ncbi.nlm.nih.gov/42208412/
7. Nunes EA, Colenso-Semple L, McKellar SR, et al. Systematic review and meta-analysis of protein intake to support muscle mass and function in healthy adults. J Cachexia Sarcopenia Muscle 2022;13(2):795-810. https://pubmed.ncbi.nlm.nih.gov/35187864/
8. Zhao JG, Zeng XT, Wang J, Liu L. Association between calcium or vitamin D supplementation and fracture incidence in community-dwelling older adults: a systematic review and meta-analysis. JAMA 2017;318(24):2466-2482. https://pubmed.ncbi.nlm.nih.gov/29279934/
9. Oba K, Matsuo S, Nakamura M, et al. Moderating effects of individual characteristics and the target lower limb muscle group on flexibility adaptations to chronic static stretching in healthy individuals: a systematic review and meta-analysis of randomized controlled trials. Sports Med Open 2026;12(1). https://pubmed.ncbi.nlm.nih.gov/42435098/
10. Ingram LA, Tomkinson GR, d'Unienville NMA, et al. Optimising the dose of static stretching to improve flexibility: a systematic review, meta-analysis and multivariate meta-regression. Sports Med 2025;55(3):597-617. https://pubmed.ncbi.nlm.nih.gov/39614059/
11. Namsawang J, Srijunto W, Werasirirat P, et al. The effects of 6-week home-based static stretching, dynamic stretching, or eccentric exercise interventions on muscle-tendon properties and functional performance in older women. J Exerc Sci Fit 2024;22(2):117-126. https://pubmed.ncbi.nlm.nih.gov/38283890/