Behind the Paper

Preserving Strength, Preserving Independence

Working with institutionalized older adults in long-term care units in Lisbon revealed how muscle weakness, reduced mobility, and social vulnerability often coexist during ageing. Our study on sarcopenia and dynapenia also raised broader reflections on autonomy, dignity, and quality of life.

Why this research mattered to us

During my internship in long-term care units in Lisbon, I became increasingly interested in healthy ageing and the importance of preserving muscle strength and functionality throughout life. While “active ageing” is often discussed in public health, working closely with institutionalized older adults exposed me to a very different reality, one marked by frailty, dependence, reduced mobility, and, at times, loneliness.

This experience inspired our study on sarcopenia and dynapenia among institutionalized older adults in the Lisbon region. Despite the growing ageing population in Portugal, there is still limited research on muscle weakness and functional decline.

 What surprised us during data collection

One of the most memorable moments during data collection involved the handgrip dynamometer used to assess muscle strength. Some residentes, especially older men who initially believed they still had good strength, looked surprised when the device barely moved during the test. As researchers, we tried not to react, but those moments stayed with us long after the assessments ended.

The results reflected what we had been observing in practice. While confirmed sarcopenia affected around one quarter of participants, dynapenia, reduced muscle strength independently of muscle mass, was present in almost all participants.

Looking beyond the numbers: reflections and challenges

Beyond the numbers, the study also made us reflect on the daily lives of many institutionalized older adults. Several residents spent long hours seated, with limited movement and little social interaction. Although loneliness was not directly assessed in our study, these observations made us reflect on how physical decline and social isolation may coexist during ageing.

Conducting research in long-term care facilities also brought practical and ethical challenges. Some residents preferred discussing participation with family members before consenting to the study, reminding us that research involving vulnerable populations requires patience, empathy, and trust.

Another challenge was the lack of access to advanced body composition tools such as DEXA or BIA. However, this limitation reinforced one of the most important messages of our study: even simple and low-cost tools can provide valuable clinical information. Measures such as handgrip strength, calf circumference, and nutritional screening may help identify older adults at risk before severe functional decline occurs.

 What we hope people take from this research

This study changed the way we personally understand ageing. Preserving muscle strength is not only about mobility — it is closely connected to autonomy, dignity, quality of life, and potentially preventing falls, hospitalizations, and long-term institutional dependency.

As populations continue to age, promoting healthy ageing must involve more than increasing life expectancy. It should also mean preserving strength, independence, and quality of life for as long as possible.