Norager, C. B., M. B. Jensen, M. R. Madsen, and S. Laurberg. Caffeine improves endurance in 75-yr-old citizens: a randomized, double-blind, placebo-controlled, crossover study. J Appl Physiol 99: 2302-2306, 2005. First published August 4, 2005 doi:10.1152/japplphysiol.00309.2005.-This study investigated the effect of caffeine on physical performance in healthy citizens aged Ն70 yr. The randomized, double-blind, placebo-controlled, crossover study was conducted in 15 men and 15 women recruited by their general practitioner. Participants abstained from caffeine for 48 h and were randomized to receive one capsule of placebo and then caffeine (6 mg/kg) or caffeine and then placebo with 1 wk in between. One hour after intervention, we measured reaction and movement times, postural stability, walking speed, cycling at 65% of expected maximal heart rate, perceived effort during cycling, maximal isometric arm flexion strength, and endurance. Analysis was by intention to treat, and P Ͻ 0.05 was regarded as significant. Caffeine increased cycling endurance by 25% [95% confidence interval (CI): 13-38; P ϭ 0.0001] and isometric arm flexion endurance by 54% (95% CI: 29 -83; P ϭ 0.0001). Caffeine also reduced the rating of perceived exertion after 5 min of cycling by 11% (95% CI: 5-17; P ϭ 0.002) and postural stability with eyes open by 25% (95% CI: 2-53; P ϭ 0.03). Caffeine ingestion did not affect muscle strength, walking speed, reaction, and movement times. At the end of the study, 46% of participants correctly identified when they received caffeine and placebo. Caffeine increased exercise endurance in healthy citizens aged Ն70 yr, but the participants' reasons for stopping the test may have varied between subjects, as the cycling test was done at ϳ55% of maximal oxygen consumption. Further studies are required to investigate whether caffeine can be utilized to improve the physical performance of elderly citizens. fatigue; perceived exertion; postural stability; elderly CAFFEINE INGESTION INCREASES the endurance of young people exercising at 60 -85% of their maximal oxygen uptake (12,13,38). It also seems to improve endurance as measured by repeated submaximal isometric contraction (34) and decreases the rate of perceived exertion during exercise (6, 9, 37). Typically, doses of ϳ6 mg/kg caffeine (equivalent to 4 cups of coffee) were used in these studies.With a growing number of elderly with a physically active lifestyle and many elderly participating in rehabilitation programs, the endurance-enhancing effect of caffeine is of increasing interest in this age group. However, the enduranceenhancing effect of caffeine found in young subjects has not previously been examined in the elderly.The aim of this study was to investigate whether 6 mg/kg caffeine improves physical performance and reduces the perceived effort during work in healthy citizens aged Ն70 yr. The main hypothesis was that caffeine would improve cycling endurance at 65% of expected maximal heart rate, and the secondary hypothesis was that caffeine would improv...