Population-based study of age- and sex-related differences in muscle density and size in thoracic and lumbar spine: the Framingham study

Relative age-related deficit in trunk muscle density was greater in women than men whereas the relative decrease in muscle mass with age was similar in both sexes. The greater muscle fat content and greater age-related fat accumulation among women may contribute to women suffering more functional disabilities than men. A better understanding of the effect of aging on trunk musculature will have implications for physical function, disability, pain, and risk of injury in older adults. Thus, we determined the age- and sex-related differences in muscle density and size of both thoracic and lumbar trunk muscles. In this cross-sectional study, muscle density and size were measured from quantitative computed tomography (QCT) scans for 10 trunk muscle groups at different vertebral levels in 250 community-based men and women aged 40 to 90 years from the Framingham Offspring and Third Generation cohorts. Trunk muscles in men were 20-67% larger and had 5-68% higher density than in women. The relative age-related deficits in muscle size were similar in both sexes, and decreased on average by similar to 8% per decade in both sexes. In contrast, women had greater age-related decreases in muscle density than men (- 17% in women, and - 11% in men, p < 0.01). Age-related declines varied by specific muscle, tending to be greater for outer trunk muscles than for paraspinal muscles, but within a given muscle the age-related changes in muscle density and size were similar among spinal levels. This comprehensive study of trunk muscle deficits with increasing age may have important implications for physical function, disability, pain, and risk of injury in older adults. The greater levels of mobility impairments with aging in women may in part be explained by greater proportion of intramuscular fat tissue and greater age-related fat accumulation in trunk muscles in women than in men.