To clarify the progression of muscle loss in nursing home residents, frail women (n = 16; age: 85 ± 9 years; residence time: 764 days) were assessed for physical activity, caloric intake, and site-specific muscle thickness (MTH) and subcutaneous fat thickness (SFT) using B-mode ultrasound at nine anatomical sites at four intervals over one year. Height, body weight, and BMI did not change. Physical activity (246 steps/day) and nutritional intake (1,441 kcal, 60.3 g protein/day) were unaltered throughout the study. Subjects experienced a significant, progressive loss of muscle indicated by decrements in anterior upper arm (20%), posterior upper arm (25%), abdomen (20%), subscapular (33%), anterior thigh (15%), posterior thigh (22%), anterior lower leg (11%), posterior lower leg (13%), and forearm (15%) MTH. At study inception, prevalence of sarcopenia was related to muscle loss in the upper leg, while upper body muscle wasting contributed to sarcopenia later and was unrelated to physical activity, nutritional input, or duration of residence.