Inclusion criteria |
• ≥65 years of age |
• Independently mobile with an SPPB score 4–12 |
• Access to transportation |
• Capable of providing informed consent (cognitively intact) |
• Negative diagnostic (12-lead ECG), submaximal Graded Exercise Testing (GXT) (if applicable) |
Exclusion criteria |
• Obesity (body mass index (BMI) >30) |
• Serum creatinine >1.4 because of risk of lactic acidosis with metformin |
• History of structured, regular resistance exercise training within the past year (more than two times per week consistently) |
• Chronic aspirin or non-steroidal anti-inflammatory drug (NSAID) use (unless it can be safely stopped prior to the biopsies) and any other use of an anticoagulant (e.g., Coumadin) or history of bleeding |
• History of alcoholism or liver disease |
• History of hypo- or hypercoagulation disorders including subjects taking Coumadin |
• Any end-stage disease and/or a life expectancy less than 1 year |
• Neurological, musculoskeletal, or other disorder that would preclude them from completing resistance training and all performance tests |
• Uncontrolled hypertension, unstable or exercise-induced angina pectoris or myocardial ischemia, or congestive heart failure |
• Diabetes mellitus: HgbA1C >6.5, or fasting glucose >126 mg/dl, or 2-h glucose (on oral glucose tolerance test (OGTT)) >200) |
• Any other medical condition that would interfere with testing or increase one's risk of complications during exercise, as judged by the study physicians |
• Any other condition or events considered exclusionary by the Principal Investigator and/or physician, such as non-compliance |
• Lidocaine allergy (1% lidocaine is the local anesthetic used during the muscle biopsy procedure) |
• Currently receiving androgen or anabolic therapy |