Exercise and the elderly.

Abstract

Data from cross-sectional studies suggest that VO2max declines in adulthood at a rate of 0.40-0.45 ml.kg-1.min-1 per year in males and 0.30 ml.kg-1.min-1 per year in females. Longitudinal studies suggest that the loss is much greater for males, approximating 1.0 ml.kg-1.min-1 per year or more. The rate of loss may be greater in sedentary compared to active individuals. The decline in VO2max with age appears to be inevitable, and a major contributing factor may be the decline in maximal cardiac output. A reduced maximal heart rate is a consistent finding, and this may be due to decreased end-organ sensitivity to catecholamines. Maximal stroke volume may or may not decrease, and physical training status may be a determining factor. The most recent evidence suggests increased dependence upon the Frank-Starling mechanism, resulting in an increased stroke volume to offset the decline in maximal heart rate. Cardiac output is thought to be maintained in this manner. Use of this mechanism may depend upon the absence of underlying disease. Therefore, investigators who vigorously screen potential subjects for occult coronary disease may report findings different from those who do not. Maximal a-vO2 difference may or may not decline in the elderly. The research is divided, and there is support for both beliefs. Several factors typical of the elderly, including a decline in muscle mass, increased blood distribution to the skin during exercise, and a potentially lower capillary/fiber ratio, would contribute to a lower a-vO2 difference. On the other hand, in those subjects with reduced cardiac output, there may be greater dependence upon a-vO2 difference during maximal exercise. Pulmonary function does not appear to limit VO2max, although the elderly may be less efficient while breathing during exercise. However, the higher ventilation and higher ventilatory equivalent for oxygen observed during submaximal exercise could be due to higher relative stress in the elderly. Elderly males and females are capable of demonstrating a training effect in response to endurance training regardless of previous physical activity patterns and current training status. The degree of change with training, expressed in relative terms, appears to be comparable to that demonstrated by younger subjects. Physiological factors contributing to an increased VO2max as a result of training appear to be similar in elderly and younger subjects, with the possible exception of no change in maximal a-vO2 difference in the elderly. This point is somewhat controversial.(ABSTRACT TRUNCATED AT 400 WORDS)