Callahan DM, Tourville TW, Miller MS, Hackett SB, Sharma H, Cruickshank NC, Slauterbeck JR, Savage PD, Ades PA, Maughan DW, Beynnon BD, Toth MJ. Chronic disuse and skeletal muscle structure in older adults: sex-specific differences and relationships to contractile function. Am J Physiol Cell Physiol 308: C932-C943, 2015. First published March 25, 2015; doi:10.1152/ajpcell.00014.2015.-In older adults, we examined the effect of chronic muscle disuse on skeletal muscle structure at the tissue, cellular, organellar, and molecular levels and its relationship to muscle function. Volunteers with advanced-stage knee osteoarthritis (OA, n ϭ 16) were recruited to reflect the effects of chronic lower extremity muscle disuse and compared with recreationally active controls (n ϭ 15) without knee OA but similar in age, sex, and health status. In the OA group, quadriceps muscle and single-fiber cross-sectional area were reduced, with the largest reduction in myosin heavy chain IIA fibers. Myosin heavy chain IIAX fibers were more prevalent in the OA group, and their atrophy was sex-specific: men showed a reduction in crosssectional area, and women showed no differences. Myofibrillar ultrastructure, myonuclear content, and mitochondrial content and morphology generally did not differ between groups, with the exception of sex-specific adaptations in subsarcolemmal (SS) mitochondria, which were driven by lower values in OA women. SS mitochondrial content was also differently related to cellular and molecular functional parameters by sex: greater SS mitochondrial content was associated with improved contractility in women but reduced function in men.Collectively, these results demonstrate sex-specific structural phenotypes at the cellular and organellar levels with chronic disuse in older adults, with novel associations between energetic and contractile systems. mitochondria; physical activity; ultrastructure; myosin AGING AND DISEASE are frequently accompanied by reduced functional capacity and the development of physical disability (18). Reductions in physical activity with age are well documented (28,60,68) and promote chronic disease (31,44,53) and disability. As a result of their temporal coordination, it is difficult to disentangle the relative influence of age, disease, and physical inactivity on skeletal muscle biology and, in turn, the progression toward physical disability. Indeed, many of the muscle phenotypes that accompany aging and chronic disease, such as atrophy and contractile dysfunction, closely mimic those that accompany muscle disuse (1,46). Whether developed gradually or rapidly following a clinical event, muscle disuse in chronic conditions, such as heart failure or chronic obstructive pulmonary disease, is characterized by its persistent nature, as numerous studies reveal reduced habitual activity levels in these populations (28,60,68). Our understanding of the effects of chronic disuse on skeletal muscle size and structure is limited, in part, by the fact that it would be unethical to experimentally impose ...