1932

Abstract

The global population is rapidly aging, with predictions of many more people living beyond 85 years. Age-related physiological adaptations predispose to decrements in physical function and functional capacity, the rate of which can be accelerated by chronic disease and prolonged physical inactivity. Decrements in physical function exacerbate the risk of chronic disease, disability, dependency, and frailty with advancing age. Regular exercise positively influences health status, physical function, and disease risk in adults of all ages. Herein, we review the role of structured exercise training in the oldest old on cardiorespiratory fitness and muscular strength and power, attributes critical for physical function, mobility, and independent living.

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2022-01-27
2024-03-29
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Literature Cited

  1. 1. 
    WHO 2011. Global health and aging NIH Publ. No. 11-7737 World Health Organ Geneva, Switz: https://www.who.int/ageing/publications/global_health.pdf
  2. 2. 
    Wiener JM, Tilly J. 2002. Population ageing in the United States of America: implications for public programmes. Int. J. Epidemiol. 31:776–81
    [Google Scholar]
  3. 3. 
    Tinker A. 2002. The social implications of an ageing population. Introduction. Mech. Ageing Dev. 123:729–35
    [Google Scholar]
  4. 4. 
    Arena R, Myers J, Williams MA et al. 2007. Assessment of functional capacity in clinical and research settings: a scientific statement from the American Heart Association Committee on Exercise, Rehabilitation, and Prevention of the Council on Clinical Cardiology and the Council on Cardiovascular Nursing. Circulation 116:329–43
    [Google Scholar]
  5. 5. 
    Ross R, Blair SN, Arena R et al. 2016. Importance of assessing cardiorespiratory fitness in clinical practice: a case for fitness as a clinical vital sign: a scientific statement from the American Heart Association. Circulation 134:e653–99
    [Google Scholar]
  6. 6. 
    Forman DE, Arena R, Boxer R et al. 2017. Prioritizing functional capacity as a principal end point for therapies oriented to older adults with cardiovascular disease: a scientific statement for healthcare professionals from the American Heart Association. Circulation 135:e894–918
    [Google Scholar]
  7. 7. 
    Sjolund BM, Wimo A, Engstrom M, von Strauss E 2015. Incidence of ADL disability in older persons, physical activities as a protective factor and the need for informal and formal care—results from the SNAC-N Project. PLOS ONE 10:e0138901
    [Google Scholar]
  8. 8. 
    Idland G, Rydwik E, Smastuen MC, Bergland A. 2013. Predictors of mobility in community-dwelling women aged 85 and older. Disabil. Rehabil. 35:881–87
    [Google Scholar]
  9. 9. 
    Fujimoto N, Prasad A, Hastings JL et al. 2010. Cardiovascular effects of 1 year of progressive and vigorous exercise training in previously sedentary individuals older than 65 years of age. Circulation 122:1797–805
    [Google Scholar]
  10. 10. 
    Fielding RA, Guralnik JM, King AC et al. 2017. Dose of physical activity, physical functioning and disability risk in mobility-limited older adults: results from the LIFE study randomized trial. PLOS ONE 12:e0182155
    [Google Scholar]
  11. 11. 
    Physical Activity Guidelines Advis. Comm 2009. Physical Activity Guidelines Advisory Committee report, 2008. To the Secretary of Health and Human Services. Part A: executive summary. Nutr. Rev 67:114–20
    [Google Scholar]
  12. 12. 
    Caspersen CJ, Powell KE, Christenson GM 1985. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep 100:126–31
    [Google Scholar]
  13. 13. 
    Wasfy MM, Baggish AL. 2016. Exercise dose in clinical practice. Circulation 133:2297–313
    [Google Scholar]
  14. 14. 
    Singh MA. 2002. Exercise comes of age: rationale and recommendations for a geriatric exercise prescription. J. Gerontol. A Biol. Sci. Med. Sci. 57:M262–82
    [Google Scholar]
  15. 15. 
    Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA et al. 2009. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med. Sci. Sports Exerc. 41:1510–30
    [Google Scholar]
  16. 16. 
    Physical Activity Guidelines Advis. Comm 2008. Physical Activity Guidelines Advisory Committee Report Washington, DC: US Dep. Health Hum. Serv.
  17. 17. 
    Bonafiglia JT, Preobrazenski N, Islam H et al. 2021. Exploring differences in cardiorespiratory fitness response rates across varying doses of exercise training: a retrospective analysis of eight randomized controlled trials. Sports Med 51:1785–97
    [Google Scholar]
  18. 18. 
    Powell KE, Paluch AE, Blair SN. 2011. Physical activity for health: What kind? How much? How intense? On top of what?. Annu. Rev. Public Health 32:349–65
    [Google Scholar]
  19. 19. 
    Franklin BA, Thompson PD, Al-Zaiti SS et al. 2020. Exercise-related acute cardiovascular events and potential deleterious adaptations following long-term exercise training: placing the risks into perspective—an update: a scientific statement from the American Heart Association. Circulation 141:e705–36
    [Google Scholar]
  20. 20. 
    Eijsvogels TM, Molossi S, Lee DC et al. 2016. Exercise at the extremes: the amount of exercise to reduce cardiovascular events. J. Am. Coll. Cardiol. 67:316–29
    [Google Scholar]
  21. 21. 
    Iwasaki K, Zhang R, Zuckerman JH, Levine BD. 2003. Dose-response relationship of the cardiovascular adaptation to endurance training in healthy adults: How much training for what benefit?. J. Appl. Physiol. 95:1575–83
    [Google Scholar]
  22. 22. 
    Bouchard C, Rankinen T. 2001. Individual differences in response to regular physical activity. Med. Sci. Sports Exerc. 33:S446–51
    [Google Scholar]
  23. 23. 
    Whipple MO, Schorr EN, Talley KMC et al. 2018. Variability in individual response to aerobic exercise interventions among older adults. J. Aging Phys. Act. 26:655–70
    [Google Scholar]
  24. 24. 
    Bouchard C, Sarzynski MA, Rice TK et al. 2011. Genomic predictors of the maximal O2 uptake response to standardized exercise training programs. J. Appl. Physiol. 110:1160–70
    [Google Scholar]
  25. 25. 
    Montero D, Lundby C. 2017. Refuting the myth of non-response to exercise training: ‘non-responders’ do respond to higher dose of training. J. Physiol. 595:3377–87
    [Google Scholar]
  26. 26. 
    Bijnen FC, Caspersen CJ, Feskens EJ et al. 1998. Physical activity and 10-year mortality from cardiovascular diseases and all causes: the Zutphen Elderly Study. Arch. Intern. Med. 158:1499–505
    [Google Scholar]
  27. 27. 
    Sundquist K, Qvist J, Sundquist J, Johansson SE. 2004. Frequent and occasional physical activity in the elderly: a 12-year follow-up study of mortality. Am. J. Prev. Med. 27:22–27
    [Google Scholar]
  28. 28. 
    Osawa Y, Abe Y, Takayama M et al. 2021. Physical activity and all-cause mortality and mediators of the association in the very old. Exp. Gerontol. 150:111374
    [Google Scholar]
  29. 29. 
    Fried LP, Tangen CM, Walston J et al. 2001. Frailty in older adults: evidence for a phenotype. J. Gerontol. A Biol. Sci. Med. Sci. 56:M146–56
    [Google Scholar]
  30. 30. 
    Keadle SK, McKinnon R, Graubard BI, Troiano RP. 2016. Prevalence and trends in physical activity among older adults in the United States: a comparison across three national surveys. Prev. Med. 89:37–43
    [Google Scholar]
  31. 31. 
    Harvey JA, Chastin SF, Skelton DA. 2013. Prevalence of sedentary behavior in older adults: a systematic review. Int. J. Environ. Res. Public Health 10:6645–61
    [Google Scholar]
  32. 32. 
    Garatachea N, Pareja-Galeano H, Sanchis-Gomar F et al. 2015. Exercise attenuates the major hallmarks of aging. Rejuvenat. Res. 18:57–89
    [Google Scholar]
  33. 33. 
    Valenzuela PL, Morales JS, Pareja-Galeano H et al. 2018. Physical strategies to prevent disuse-induced functional decline in the elderly. Ageing Res. Rev. 47:80–88
    [Google Scholar]
  34. 34. 
    Saltin B, Blomqvist G, Mitchell JH et al. 1968. Response to exercise after bed rest and after training. Circulation 38:VII1–78
    [Google Scholar]
  35. 35. 
    Krainski F, Hastings JL, Heinicke K et al. 2014. The effect of rowing ergometry and resistive exercise on skeletal muscle structure and function during bed rest. J. Appl. Physiol. 116:1569–81
    [Google Scholar]
  36. 36. 
    Kortebein P, Symons TB, Ferrando A et al. 2008. Functional impact of 10 days of bed rest in healthy older adults. J. Gerontol. A Biol. Sci. Med. Sci. 63:1076–81
    [Google Scholar]
  37. 37. 
    Coker RH, Hays NP, Williams RH et al. 2015. Bed rest promotes reductions in walking speed, functional parameters, and aerobic fitness in older, healthy adults. J. Gerontol. A Biol. Sci. Med. Sci. 70:91–96
    [Google Scholar]
  38. 38. 
    McGuire DK, Levine BD, Williamson JW et al. 2001. A 30-year follow-up of the Dallas Bedrest and Training Study: I. Effect of age on the cardiovascular response to exercise. Circulation 104:1350–57
    [Google Scholar]
  39. 39. 
    Levine BD. 2008. VO2max: What do we know, and what do we still need to know?. J. Physiol. 586:25–34
    [Google Scholar]
  40. 40. 
    Vanderburgh PM, Katch FI. 1996. Ratio scaling of VO2max penalizes women with larger percent body fat, not lean body mass. Med. Sci. Sports Exerc. 28:1204–8
    [Google Scholar]
  41. 41. 
    Sarma S, MacNamara J, Livingston S et al. 2020. Impact of severe obesity on exercise performance in heart failure with preserved ejection fraction. Physiol. Rep. 8:e14634
    [Google Scholar]
  42. 42. 
    Hothi SS, Tan DK, Partridge G, Tan LB. 2015. Is low VO2max/kg in obese heart failure patients indicative of cardiac dysfunction?. Int. J. Cardiol. 184:755–62
    [Google Scholar]
  43. 43. 
    Carrick-Ranson G, Hastings JL, Bhella PS et al. 2013. The effect of age-related differences in body size and composition on cardiovascular determinants of VO2max. J. Gerontol. A Biol. Sci. Med. Sci. 68:608–16
    [Google Scholar]
  44. 44. 
    Blair SN, Kohl HW 3rd, Paffenbarger RS Jr. et al. 1989. Physical fitness and all-cause mortality. A prospective study of healthy men and women. JAMA 262:2395–401
    [Google Scholar]
  45. 45. 
    Kodama S, Saito K, Tanaka S et al. 2009. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA 301:2024–35
    [Google Scholar]
  46. 46. 
    Binder EF, Birge SJ, Spina R et al. 1999. Peak aerobic power is an important component of physical performance in older women. J. Gerontol. A Biol. Sci. Med. Sci. 54:M353–56
    [Google Scholar]
  47. 47. 
    Kavanagh T, Mertens DJ, Hamm LF et al. 2003. Peak oxygen intake and cardiac mortality in women referred for cardiac rehabilitation. J. Am. Coll. Cardiol. 42:2139–43
    [Google Scholar]
  48. 48. 
    Myers J, Prakash M, Froelicher V et al. 2002. Exercise capacity and mortality among men referred for exercise testing. N. Engl. J. Med. 346:793–801
    [Google Scholar]
  49. 49. 
    Drinkwater BL, Horvath SM, Wells CL. 1975. Aerobic power of females, ages 10 to 68. J. Gerontol. 30:385–94
    [Google Scholar]
  50. 50. 
    Fleg JL, Morrell CH, Bos AG et al. 2005. Accelerated longitudinal decline of aerobic capacity in healthy older adults. Circulation 112:674–82
    [Google Scholar]
  51. 51. 
    Jackson AS, Sui X, Hebert JR et al. 2009. Role of lifestyle and aging on the longitudinal change in cardiorespiratory fitness. Arch. Intern. Med. 169:1781–87
    [Google Scholar]
  52. 52. 
    Loe H, Rognmo O, Saltin B, Wisloff U. 2013. Aerobic capacity reference data in 3816 healthy men and women 20–90 years. PLOS ONE 8:e64319
    [Google Scholar]
  53. 53. 
    Ogawa T, Spina RJ, Martin WH 3rd et al. 1992. Effects of aging, sex, and physical training on cardiovascular responses to exercise. Circulation 86:494–503
    [Google Scholar]
  54. 54. 
    Fleg JL, Lakatta EG. 1988. Role of muscle loss in the age-associated reduction in VO2 max. J. Appl. Physiol. (1985) 65:1147–51
    [Google Scholar]
  55. 55. 
    Morey MC, Pieper CF, Cornoni-Huntley J. 1998. Is there a threshold between peak oxygen uptake and self-reported physical functioning in older adults?. Med. Sci. Sports Exerc. 30:1223–29
    [Google Scholar]
  56. 56. 
    Shephard RJ. 2009. Maximal oxygen intake and independence in old age. Br. J. Sports Med. 43:342–46
    [Google Scholar]
  57. 57. 
    Ainsworth BE, Haskell WL, Leon AS et al. 1993. Compendium of physical activities: classification of energy costs of human physical activities. Med. Sci. Sports Exerc. 25:71–80
    [Google Scholar]
  58. 58. 
    Ainsworth BE, Haskell WL, Whitt MC et al. 2000. Compendium of physical activities: an update of activity codes and MET intensities. Med. Sci. Sports Exerc. 32:S498–504
    [Google Scholar]
  59. 59. 
    Baumgartner RN, Koehler KM, Gallagher D et al. 1998. Epidemiology of sarcopenia among the elderly in New Mexico. Am. J. Epidemiol. 147:755–63
    [Google Scholar]
  60. 60. 
    Frisoli A Jr., Chaves PH, Ingham SJ, Fried LP. 2011. Severe osteopenia and osteoporosis, sarcopenia, and frailty status in community-dwelling older women: results from the Women's Health and Aging Study (WHAS) II. Bone 48:952–57
    [Google Scholar]
  61. 61. 
    Evans WJ. 2010. Skeletal muscle loss: cachexia, sarcopenia, and inactivity. Am. J. Clin. Nutr. 91:1123S–27S
    [Google Scholar]
  62. 62. 
    Kallman DA, Plato CC, Tobin JD 1990. The role of muscle loss in the age-related decline of grip strength: cross-sectional and longitudinal perspectives. J. Gerontol. 45:M82–88
    [Google Scholar]
  63. 63. 
    Lindle RS, Metter EJ, Lynch NA et al. 1997. Age and gender comparisons of muscle strength in 654 women and men aged 20–93 yr. J. Appl. Physiol. 83:1581–87
    [Google Scholar]
  64. 64. 
    Lavin KM, Roberts BM, Fry CS et al. 2019. The importance of resistance exercise training to combat neuromuscular aging. Physiology Bethesda 34:112–22
    [Google Scholar]
  65. 65. 
    McGregor RA, Cameron-Smith D, Poppitt SD. 2014. It is not just muscle mass: a review of muscle quality, composition and metabolism during ageing as determinants of muscle function and mobility in later life. Longev. Healthspan 3:9
    [Google Scholar]
  66. 66. 
    Metter EJ, Conwit R, Tobin J, Fozard JL 1997. Age-associated loss of power and strength in the upper extremities in women and men. J. Gerontol. A Biol. Sci. Med. Sci. 52:B267–76
    [Google Scholar]
  67. 67. 
    Fatouros IG, Kambas A, Katrabasas I et al. 2005. Strength training and detraining effects on muscular strength, anaerobic power, and mobility of inactive older men are intensity dependent. Br. J. Sports Med. 39:776–80
    [Google Scholar]
  68. 68. 
    McKendry J, Breen L, Shad BJ, Greig CA 2018. Muscle morphology and performance in master athletes: a systematic review and meta-analyses. Ageing Res. Rev. 45:62–82
    [Google Scholar]
  69. 69. 
    Tanaka H, Seals DR. 2008. Endurance exercise performance in Masters athletes: age-associated changes and underlying physiological mechanisms. J. Physiol. 586:55–63
    [Google Scholar]
  70. 70. 
    Chambers TL, Burnett TR, Raue U et al. 2020. Skeletal muscle size, function, and adiposity with lifelong aerobic exercise. J. Appl. Physiol. 128:368–78
    [Google Scholar]
  71. 71. 
    Gries KJ, Raue U, Perkins RK et al. 2018. Cardiovascular and skeletal muscle health with lifelong exercise. J. Appl. Physiol. 125:1636–45
    [Google Scholar]
  72. 72. 
    Trappe S, Hayes E, Galpin A et al. 2013. New records in aerobic power among octogenarian lifelong endurance athletes. J. Appl. Physiol. 114:3–10
    [Google Scholar]
  73. 73. 
    Arbab-Zadeh A, Dijk E, Prasad A et al. 2004. Effect of aging and physical activity on left ventricular compliance. Circulation 110:1799–805
    [Google Scholar]
  74. 74. 
    Bhella PS, Hastings JL, Fujimoto N et al. 2014. Impact of lifelong exercise “dose” on left ventricular compliance and distensibility. J. Am. Coll. Cardiol. 64:1257–66
    [Google Scholar]
  75. 75. 
    Carrick-Ranson G, Hastings JL, Bhella PS et al. 2014. The effect of lifelong exercise dose on cardiovascular function during exercise. J. Appl. Physiol. 116:736–45
    [Google Scholar]
  76. 76. 
    Shibata S, Fujimoto N, Hastings JL et al. 2018. The effect of lifelong exercise frequency on arterial stiffness. J. Physiol. 596:2783–95
    [Google Scholar]
  77. 77. 
    Zampieri S, Pietrangelo L, Loefler S et al. 2015. Lifelong physical exercise delays age-associated skeletal muscle decline. J. Gerontol. A Biol. Sci. Med. Sci. 70:163–73
    [Google Scholar]
  78. 78. 
    Carrick-Ranson G, Sloane NM, Howden EJ et al. 2020. The effect of lifelong endurance exercise on cardiovascular structure and exercise function in women. J. Physiol. 598:2589–605
    [Google Scholar]
  79. 79. 
    Howden EJ, Sarma S, Lawley JS et al. 2018. Reversing the cardiac effects of sedentary aging in middle age—a randomized controlled trial: implications for heart failure prevention. Circulation 137:1549–60
    [Google Scholar]
  80. 80. 
    Klitgaard H, Mantoni M, Schiaffino S et al. 1990. Function, morphology and protein expression of ageing skeletal muscle: a cross-sectional study of elderly men with different training backgrounds. Acta Physiol. Scand. 140:41–54
    [Google Scholar]
  81. 81. 
    Hawkins SA, Wiswell RA, Marcell TJ. 2003. Exercise and the master athlete—a model of successful aging?. J. Gerontol. A Biol. Sci. Med. Sci. 58:1009–11
    [Google Scholar]
  82. 82. 
    Dube JJ, Broskey NT, Despines AA et al. 2016. Muscle characteristics and substrate energetics in lifelong endurance athletes. Med. Sci. Sports Exerc. 48:472–80
    [Google Scholar]
  83. 83. 
    Mikkelsen UR, Agergaard J, Couppe C et al. 2017. Skeletal muscle morphology and regulatory signalling in endurance-trained and sedentary individuals: the influence of ageing. Exp. Gerontol. 93:54–67
    [Google Scholar]
  84. 84. 
    Mikkelsen UR, Couppe C, Karlsen A et al. 2013. Life-long endurance exercise in humans: circulating levels of inflammatory markers and leg muscle size. Mech. Ageing Dev. 134:531–40
    [Google Scholar]
  85. 85. 
    McKendry J, Joanisse S, Baig S et al. 2020. Superior aerobic capacity and indices of skeletal muscle morphology in chronically trained master endurance athletes compared with untrained older adults. J. Gerontol. A Biol. Sci. Med. Sci. 75:1079–88
    [Google Scholar]
  86. 86. 
    McNeil CJ, Doherty TJ, Stashuk DW, Rice CL. 2005. Motor unit number estimates in the tibialis anterior muscle of young, old, and very old men. Muscle Nerve 31:461–67
    [Google Scholar]
  87. 87. 
    Power GA, Allen MD, Gilmore KJ et al. 2016. Motor unit number and transmission stability in octogenarian world class athletes: Can age-related deficits be outrun?. J. Appl. Physiol. 121:41013–20
    [Google Scholar]
  88. 88. 
    Am. Coll. Sports Med 1998. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med. Sci. Sports Exerc. 30:992–1008
    [Google Scholar]
  89. 89. 
    Nelson ME, Rejeski WJ, Blair SN et al. 2007. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med. Sci. Sports Exerc. 39:1435–45
    [Google Scholar]
  90. 90. 
    Garcia-Hermoso A, Ramirez-Velez R, Saez de Asteasu ML et al. 2020. Safety and effectiveness of long-term exercise interventions in older adults: a systematic review and meta-analysis of randomized controlled trials. Sports Med 50:1095–106
    [Google Scholar]
  91. 91. 
    Nelson ME, Rejeski WJ, Blair SN et al. 2007. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation 116:1094–105
    [Google Scholar]
  92. 92. 
    Martin BJ, Arena R, Haykowsky M et al. 2013. Cardiovascular fitness and mortality after contemporary cardiac rehabilitation. Mayo Clin. Proc. 88:455–63
    [Google Scholar]
  93. 93. 
    Bouaziz W, Vogel T, Schmitt E et al. 2017. Health benefits of aerobic training programs in adults aged 70 and over: a systematic review. Arch Gerontol. Geriatr. 69:110–27
    [Google Scholar]
  94. 94. 
    Huang G, Gibson CA, Tran ZV, Osness WH 2005. Controlled endurance exercise training and VO2max changes in older adults: a meta-analysis. Prev. Cardiol. 8:217–25
    [Google Scholar]
  95. 95. 
    Shibata S, Levine BD. 2012. Effect of exercise training on biologic vascular age in healthy seniors. Am. J. Physiol. Heart Circ. Physiol. 302:H1340–46
    [Google Scholar]
  96. 96. 
    Fujimoto N, Hastings JL, Carrick-Ranson G et al. 2013. Cardiovascular effects of 1 year of alagebrium and endurance exercise training in healthy older individuals. Circ. Heart Fail. 6:1155–64
    [Google Scholar]
  97. 97. 
    Ehsani AA, Spina RJ, Peterson LR et al. 2003. Attenuation of cardiovascular adaptations to exercise in frail octogenarians. J. Appl. Physiol. 95:1781–88
    [Google Scholar]
  98. 98. 
    Evans EM, Racette SB, Peterson LR et al. 2005. Aerobic power and insulin action improve in response to endurance exercise training in healthy 77–87 yr olds. J. Appl. Physiol. 98:40–45
    [Google Scholar]
  99. 99. 
    Binder EF, Schechtman KB, Ehsani AA et al. 2002. Effects of exercise training on frailty in community-dwelling older adults: results of a randomized, controlled trial. J. Am. Geriatr. Soc. 50:1921–28
    [Google Scholar]
  100. 100. 
    Malbut KE, Dinan S, Young A 2002. Aerobic training in the ‘oldest old’: the effect of 24 weeks of training. Age Ageing 31:255–60
    [Google Scholar]
  101. 101. 
    Knowles AM, Herbert P, Easton C et al. 2015. Impact of low-volume, high-intensity interval training on maximal aerobic capacity, health-related quality of life and motivation to exercise in ageing men. Age 37:25
    [Google Scholar]
  102. 102. 
    Grace F, Herbert P, Elliott AD et al. 2018. High intensity interval training (HIIT) improves resting blood pressure, metabolic (MET) capacity and heart rate reserve without compromising cardiac function in sedentary aging men. Exp. Gerontol. 109:75–81
    [Google Scholar]
  103. 103. 
    Wewege MA, Ahn D, Yu J et al. 2018. High-intensity interval training for patients with cardiovascular disease—Is it safe? A systematic review. J. Am. Heart Assoc. 7:e009305
    [Google Scholar]
  104. 104. 
    Vidoni ED, Johnson DK, Morris JK et al. 2015. Dose-response of aerobic exercise on cognition: a community-based, pilot randomized controlled trial. PLOS ONE 10:e0131647
    [Google Scholar]
  105. 105. 
    Fiatarone MA, O'Neill EF, Ryan ND et al. 1994. Exercise training and nutritional supplementation for physical frailty in very elderly people. N. Engl. J. Med. 330:1769–75
    [Google Scholar]
  106. 106. 
    Fiatarone MA, Marks EC, Ryan ND et al. 1990. High-intensity strength training in nonagenarians. Effects on skeletal muscle. JAMA 263:3029–34
    [Google Scholar]
  107. 107. 
    Cadore EL, Casas-Herrero A, Zambom-Ferraresi F et al. 2014. Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians. Age 36:773–85
    [Google Scholar]
  108. 108. 
    Fragala MS, Cadore EL, Dorgo S et al. 2019. Resistance training for older adults: position statement from the National Strength and Conditioning Association. J. Strength. Cond. Res. 33:2019–52
    [Google Scholar]
  109. 109. 
    US Dep. Health Hum. Serv 2016. Percentage of adults aged ≥65 years meeting 2008 federal guidelines for leisure-time aerobic and muscle-strengthening activities, by age and type of activity—United States, 2000–2002 and 2013–2015. Morb. Mortal. Wkly. Rep. 65: 1019.
    [Google Scholar]
  110. 110. 
    Borde R, Hortobagyi T, Granacher U. 2015. Dose-response relationships of resistance training in healthy old adults: a systematic review and meta-analysis. Sports Med 45:1693–720
    [Google Scholar]
  111. 111. 
    DiFrancisco-Donoghue J, Werner W, Douris PC 2007. Comparison of once-weekly and twice-weekly strength training in older adults. Br. J. Sports Med. 41:19–22
    [Google Scholar]
  112. 112. 
    Taaffe DR, Duret C, Wheeler S, Marcus R 1999. Once-weekly resistance exercise improves muscle strength and neuromuscular performance in older adults. J. Am. Geriatr. Soc. 47:1208–14
    [Google Scholar]
  113. 113. 
    Fisher JP, Steele J, Gentil P et al. 2017. A minimal dose approach to resistance training for the older adult; the prophylactic for aging. Exp. Gerontol. 99:80–86
    [Google Scholar]
  114. 114. 
    Bickel CS, Cross JM, Bamman MM. 2011. Exercise dosing to retain resistance training adaptations in young and older adults. Med. Sci. Sports Exerc. 43:1177–87
    [Google Scholar]
  115. 115. 
    Centner C, Wiegel P, Gollhofer A, Konig D 2019. Effects of blood flow restriction training on muscular strength and hypertrophy in older individuals: a systematic review and meta-analysis. Sports Med 49:95–108
    [Google Scholar]
  116. 116. 
    Vechin FC, Libardi CA, Conceicao MS et al. 2015. Comparisons between low-intensity resistance training with blood flow restriction and high-intensity resistance training on quadriceps muscle mass and strength in elderly. J. Strength Cond. Res. 29:1071–76
    [Google Scholar]
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