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Physical activity and exercise in older adults

Miriam C Morey, PhD
Section Editor
Kenneth E Schmader, MD
Deputy Editor
Daniel J Sullivan, MD, MPH


In Western countries, the proportion of people over age 60 years is increasing faster than any other age group [1]. This is attributed to longer life expectancies, decreasing fertility rates, and aging of the baby boomer population. By the year 2050, over 80 million people in the United States will be over age 65 [2]. Numbers of adults over age 85 will also reach unprecedented levels. Individuals who are regularly physically active report better overall health, lower health care expenditures, and fewer mobility limitations than their sedentary counterparts [3-5].

This topic will review the benefits of physical activity in the geriatric population and make specific recommendations for how to engage older adults in appropriate exercise. Several other topics in UpToDate discuss the role of exercise in the general population. (See "The benefits and risks of exercise" and "Exercise and fitness in the prevention of cardiovascular disease" and "Exercise physiology".)


Aerobic capacity, muscle mass, and strength decline with age. These changes can have considerable impact on the ability to perform daily activities. By age alone, a healthy 80-year-old woman might be very close to the strength threshold necessary to rise from an armless chair or toilet [6].

Aerobic capacity declines at about 1 percent per year from mid-life forward and at one-half that rate among habitually active persons [7]. Loss of muscle mass and strength are also thought to accelerate after mid-life. In a study of 1880 older men and women, both men and women lost knee strength over a three-year period [8]. The decline in strength was greater in men than women, and greater among African Americans than whites. Lean-mass loss was about 1 percent per year but was accompanied by losses in strength ranging from 2.6 percent among white women to 4.1 percent among African-American men.

Thus, there is an imperative to encourage physical activity in the older population and to place emphasis on incorporating muscle-strengthening activities into an activity plan. Unfortunately, uptake of muscle-strengthening activities among older adults is low [9].

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Literature review current through: Nov 2017. | This topic last updated: Apr 03, 2017.
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