“…Moreover, the amount of connective tissue also increases with aging, resulting in increased internal work, which in turn leads to increased energy requirement and thus reduced mechanical efficiency. Thus morphological changes in skeletal muscle with aging include a reduction of fiber cross-sectional area, loss of fiber number, and increases in extramyocyte space and connective tissue (Caccia et al, 1979;Chung and Ng, 2006;Grimby and Saltin, 1983;McCarter and McGee, 1987;Payne et al, 2003). The etiology of age-associated changes in muscle morphology is believed to be multifactorial, and includes reduced physical activity, increased insulin resistance, and impaired endocrine function (e.g., low testosterone, growth hormone, and thyroxine) (Evans, 2004).…”