Accelerated Longitudinal Decline of Aerobic Capacity in Healthy Older Adults

Abstract

Background-The ability of older persons to function independently is dependent largely on the maintenance of sufficient aerobic capacity and strength to perform daily activities. Although peak aerobic capacity is widely recognized to decline with age, its rate of decline has been estimated primarily from cross-sectional studies that may provide misleading, overly optimistic estimates of aging changes. Methods and Results-To determine longitudinal rate of change in aerobic capacity and the influence of age, gender, and physical activity on these changes, we performed serial measurements of peak treadmill oxygen consumption (peak V O 2 ) in 375 women and 435 men ages 21 to 87 years from the Baltimore Longitudinal Study of Aging, a community-dwelling cohort free of clinical heart disease, over a median follow-up period of 7.9 years. A linear mixed-effects regression model was used to calculate the predicted longitudinal 10-year rate of change in peak V O 2 , expressed in milliliters per minute, for each age decade from the 20s through the 70s after adjustment for self-reported leisure-time physical activity. A longitudinal decline in peak V O 2 was observed in each of the 6 age decades in both sexes; however, the rate of decline accelerated from 3% to 6% per 10 years in the 20s and 30s to Ͼ20% per 10 years in the 70s and beyond. The rate of decline for each decade was larger in men than in women from the 40s onward. Similar longitudinal rates of decline prevailed when peak V O 2 was indexed per kilogram of body weight or per kilogram of fat-free mass and in all quartiles of self-reported leisure-time physical activity. When the components of peak V O 2 were examined, the rate of longitudinal decline of the oxygen pulse (ie, the O 2 utilization per heart beat) mirrored that of peak V O 2 , whereas the longitudinal rate of heart rate decline averaged only 4% to 6% per 10 years, and accelerated only minimally with age. Conclusions-The longitudinal rate of decline in peak V O 2 in healthy adults is not constant across the age span in healthy persons, as assumed by cross-sectional studies, but accelerates markedly with each successive age decade, especially in men, regardless of physical activity habits. The accelerated rate of decline of peak aerobic capacity has substantial implications with regard to functional independence and quality of life, not only in healthy older persons, but particularly when disease-related deficits are superimposed. (Circulation. 2005;112:674-682.)

Circulating ceramides are inversely associated with cardiorespiratory fitness in participants aged 54–96 years from the Baltimore Longitudinal Study of Aging

“…Longitudinal sex differences in the levels of ceramides with aging were also previously described in BLSA population, with women showing a steeper trajectory of increase than men (Mielke et al ., 2015). On the other hand, as reported by Fleg and colleagues, men tend to have higher values of VO 2 peak, but a greater decline with aging in the levels of VO 2 peak compared to women (Fleg et al ., 2005). In addition, many gender‐related factors could influence the relationship between ceramides and VO 2 peak, some of which in the current study we were not be able to fully account for, such as sex‐specific differences in lipid metabolism (Varlamov et al ., 2015) and sex‐specific plasticity of the cardiovascular system to fitness and physical activity in older adults (Parker et al ., 2010).…”

“…Oxygen consumption was calculated every 30 s, and the highest value was determined to be the VO 2 peak, expressed in milliliters per kilogram per minute (mL kg −1  min −1 ). Gas concentrations were initially measured in BLSA by either dedicated O 2 and CO 2 analyzers or a medical mass spectrometer (Perkin‐Elmer MGA‐1110) (Fleg et al ., 2005), while a MedGraphics D‐Series Gas Exchange System (Medgraphics; Medical Graphics Corporation, St Paul, MN, USA) has been introduced since 2002. Consequently, all the analyses carried out in the present study were adjusted for time of the visit (before/after 2002).…”

“…Using this operational definition, the decline in fitness starts around the age of thirty and continues at approximately 10% per decade. It accelerates even further toward the end of the lifespan, even in healthy persons (Fleg et al ., 2005). Cardiorespiratory fitness is a critical determinant of physical function in older adults and an accurate indicator of cardiovascular and overall health.…”

Exercise-training-induced changes in metabolic capacity with age: the role of central cardiovascular plasticity

“…Typically, maximal oxygen consumption (VO 2max ) falls steadily from 35 to 40 years of age at a rate of ∼10 % per decade (Fleg et al 2005;Hawkins and Wiswell 2003;McGuire et al 2001a;Ogawa et al 1992;Tanaka and Seals 2008). Although this decline in aerobic capacity with increasing age is often considered to be inevitable, it seems that this fall can be decelerated, maintained, or even reversed in the elderly by maintaining a high level of physical activity (Faulkner et al 2008;Fujimoto et al 2010;Grimsmo et al 2010;Heath et al 1981;McGuire et al 2001b;Murias et al 2010;Osteras et al 2005;Posner et al 1986;Rogers et al 1990;Trappe et al 2013;Trappe et al 1996).…”

Age-graded reductions in quadriceps muscle strength and peak aerobic capacity in COPD

“…Aging has been associated with a progressive decline in quadriceps muscle strength and peak V O 2 in healthy subjects 8,9 . Quadriceps muscle strength and peak V O 2 have been demonstrated to decline over time in outpatients with COPD [10][11][12] .…”