Based on the history provided sarcopenia (2016) Already 10 years since the 1st diagnosis = it's a natural progressive decline of muscle specially after 60Years of age and actually decreases the protein synthesis in body. Vitamin D supplementation have not shown much improvement so a detailed assessment is important to rule out other contributing factors.

• Sit-to-stand (chair squats) • Squats • Lunges • Step-ups • Calf raises • Leg press (if gym access is available) 2. Upper Limb Strengthening • Wall push-ups → progressing to push-ups • Dumbbell biceps curls • Shoulder press • Seated row or resistance band row • Triceps extensions 3. Core Strengthening • Bridges • Bird-dog • Modified planks • Pelvic tilts

⚠️ Disclaimer This advice is based on the information provided and is for educational purposes only. It does not replace a physical examination or medical diagnosis. Your father’s symptoms are suggestive of advanced sarcopenia (age-related muscle loss) with long-standing muscle weakness and reduced muscle quality. Since there has been no major improvement despite protein intake and supplements, this requires a detailed evaluation rather than only dietary management. Even controlled diabetes can contribute to progressive muscle decline over time.

Consult physiotherapy for diet & lifestyle, exercise.

Sarcopenia can improve with the right combination of progressive strengthening exercises, balance training, and proper nutrition. In such cases, physiotherapy plays a very important role in improving muscle strength, mobility, and overall quality of life.

Walking will be the best exercise along with a well balanced diet.

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The best resistance training exercises for sarcopenia in older adults include push-ups, heel raises, butterfly wings, and high knees. These exercises can help increase muscle strength and mass when performed consistently. Walking can help maintain muscle strength in older adults with sarcopenia, but resistance training is more effective for building and preserving muscle mass and strength. Regular walking may improve mobility and overall fitness, but it's not enough to fully counteract age-related muscle loss. Suggest you to do first exercises under expert supervision, later it can done on his own.

low muscle strength and declining physical performance are the primary drivers of frailty and falls, tailored physical rehabilitation stands out as the ultimate first-line treatment

Hi proper exercise and diet is the right combination

Hey there! Resistance strength training increases blood flow to muscles and joints. And it nourishes muscles. And also exercises maintain hormones in body .Feel free to connect with me. As it needs proper examination. Click on the consult button on your right to connect with me with in 2 minutes. Regards Your physio

The best exercise are push ups , sit to stand, progressive loading Walking , Consuming high-quality protein (such as the eggs) within 30 to 60 minutes immediately following his physiotherapy sessions can significantly maximize muscle protein synthesis.