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1 Human Cardiovascular Research Laboratory, Department of Kinesiology and Applied Physiology, University of Colorado at Boulder, Boulder 80309; and 2 Divisions of Cardiology and Geriatric Medicine, Department of Medicine, University of Colorado Health Sciences Center, Denver, Colorado 80262
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ABSTRACT |
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 TOP
 ABSTRACT
 INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
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On the basis of cross-sectional
data, we previously reported that the absolute, but not the relative
(%), rate of decline in maximal oxygen consumption
(
O2 max) with age is greater in
endurance-trained compared with healthy sedentary women. We tested this
hypothesis by using a longitudinal approach. Eight sedentary (63 ± 2 yr at follow-up) and 16 endurance-trained (57 ± 2) women
were reevaluated after a mean follow-up period of 7 yr. At baseline,
O2 max was ~70% higher in
endurance-trained women (48.1 ± 1.7 vs. 28.1 ± 0.8 ml · kg
1 · min1 · yr1).
At follow-up, body mass, fat-free mass, maximal respiratory exchange
ratio, and maximal rating of perceived exertion were not different from
baseline in either group. The absolute rate of decline in
O2 max was twice as great
(P < 0.01) in the endurance-trained (
0.84 ± 0.15 ml · kg1 · min1 · yr1)
vs. sedentary (0.40 ± 0.12 ml · kg1 · min1 · yr1)
group, but the relative rates of decline were not different (1.8 ± 0.3 vs. 1.5 ± 0.4% per year). Differences in rates of decline in O2 max were not related to
changes in body mass or maximal heart rate. However, among
endurance-trained women, the relative rate of decline in
O2 max was positively related to
reductions in training volume (r = 0.63). Consistent with this, the age-related reduction in
O2 max in a subgroup of
endurance-trained women who maintained or increased training volume was
not different from that of sedentary women. These longitudinal data
indicate that the greater decrease in maximal aerobic capacity with
advancing age observed in middle-aged and older endurance-trained women
in general compared with their sedentary peers is due to declines in
habitual exercise in some endurance-trained women. Endurance-trained
women who maintain or increase training volume demonstrated
age-associated declines in maximal aerobic capacity not different from
healthy sedentary women.
maximal oxygen consumption; functional capacity
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INTRODUCTION |
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TOP
ABSTRACT
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
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MAXIMAL AEROBIC CAPACITY is an important indicator of physiological functional capacity and is known to decrease with advancing age (2, 13, 14, 18). The decrease in maximal aerobic capacity with age has a number of physiological and clinical implications as it is associated with increased risks for cardiovascular and all-cause mortality (1) and disability (21), and reductions in cognitive function (20), quality of life (21), and independence (21).
With the number of older adults rapidly increasing, the question of how
rates of decline in maximal aerobic capacity with age may differ among
populations is of obvious importance. In this context, largely on the
basis of cross-sectional data in men, for many years it was suggested
that the rate of decline in maximal aerobic capacity with age in
endurance exercise-trained adults was only approximately half of that
observed in healthy sedentary controls (7, 9, 11). In
contrast to this view, on the basis of cross-sectional comparisons, we
recently reported that the absolute
(ml · kg1 · min1 · yr1)
decrease in maximal oxygen consumption
(O2 max) across subject age actually
was greater in endurance-trained compared with healthy sedentary women,
although the relative (% per year) decreases were similar (6,
18). However, because of well-recognized limitations associated
with cross-sectional study designs (4), these findings
need to be confirmed with a longitudinal study.
On the basis of the important influence of habitual physical activity
on O2 max (3, 9, 14) and
correlational data from our cross-sectional comparisons (6,
18), we speculated in its previous reports (6, 18)
that the greater absolute rate of decline in
O2 max with age in the
endurance-trained women in general could be attributable to
reductions in training. However, the limited and cross-sectional
nature of the available data precluded drawing any definite conclusion
on this issue.
Accordingly, in the present investigation, we prospectively tested the hypothesis that the absolute rate of age-related decline in maximal aerobic capacity is greater in endurance-trained than in sedentary healthy middle-aged and older women. If so, we also sought to determine whether the greater rate of decline in maximal aerobic capacity in endurance-trained women was associated with declines in exercise training. To do so, we retested sedentary and endurance-trained women a mean of 7 yr after originally studying them (5, 16, 17).
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METHODS |
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TOP
ABSTRACT
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
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Subjects. We studied 24 women: 8 sedentary and 16 endurance trained aged 40-78 yr. All subjects were apparently healthy and free of overt cardiovascular diseases, as assessed by medical history questionnaire. Irrespective of training status, women >50 yr of age were further evaluated by physical examination and resting and maximal exercise electrocardiograms. All of the subject were normotensive (<140/90 mmHg), nonobese (body mass index of <30kg/m2), and nonsmokers. None of the women were taking medications, other than hormone-replacement therapy, that could affect cardiovascular function. Before participation, verbal and written explanations of the nature, purpose, and risks of the study were administered. In turn, subjects gave their written, informed consent to participate in this investigation. This study was reviewed and approved by the Human Research Committee of the University of Colorado at Boulder.
All the subjects were initially tested in years 1993-1994 (5, 16, 17) and subsequently reevaluated in 2000, with a mean follow-up period of 7 yr. At the initial testing, all endurance-trained women had placed in the top 10 for their age group in Bolder Boulder road race (the second largest 10-km road race in the United States). When these women were reevaluated in 2000, they were still actively competing in running road races. None of the sedentary subjects engaged in any type of endurance training during the follow-up period. Their sedentary status was documented by questionnaire as well asO2 max values.
Measurements.
O2 max was assessed with on-line
computer-assisted open-circuit spiromery during continuous incremental
treadmill exercise as described in detail previously (5,
16-18). Gas fractions were analyzed with a Perkin-Elmer
MGA-1100 mass spectrometer (Pomona, CA) previously calibrated with
standard gases of known concentrations. Expired air volume was measured
either with a turbine (VMM-2, Interface Associates, Laguana Niguel, CA)
or a pneumotachometer (Hans Rudolph, Kansas City, MO). There were no
differences between these two systems when ventilation and oxygen
uptake were analyzed simultaneously. These machines were calibrated
against 3- or 7-liter syringes before and after each session. Heart
rates were continuously monitored with an electrocardiogram.
O2 max, at least three of the following
four criteria were met by each subject: 1) a plateau in
oxygen uptake with increasing exercise intensity, 2) a
respiration exchange ratio of at least 1.15, 3) an
achievement of the age-predicted maximal heart rate (±10 beats/min),
and 4) a rating of perceived exertion of at least 18 units
(10). The same individualized protocol was used at the
baseline and follow-up periods.
Body mass was measured with a physician's balance scale (Detecto, Webb
City, MO) to the nearest 0.1 kg. Body fat percent was estimated from
the sum of five-site skinfold measurements with a Lange caliper.
Fat-free mass was subsequently calculated as the difference between
total body mass and estimated fat mass. Waist circumference was
measured at the umbilicus, and hip circumference was determined at the
maximum circumference of the buttocks. Measurements of plasma lipid and
lipoprotein concentrations were performed by the General Clinical
Research Center Core Laboratory at the University of Colorado Health
Sciences Center as previously described (16, 17). Arterial
blood pressure was measured by a conventional mercury sphygmomanometer
after at least 10 min of rest under quiet, comfortable laboratory
conditions (16, 17).
Detailed information was obtained from each subject regarding her
training records. Endurance-trained women recorded their running
intensity, mileage, duration, frequency, and characteristics of
training (e.g., long slow distance, interval training) on a daily basis
continuously for 2 wk. The same questionnaire was used at the baseline
and follow-up periods. Additionally, to minimize the potential
influence of seasonal variations in training levels, the reevaluation
of the endurance-trained women was conducted at a similar time of the
year in their competitive season to that in the initial evaluation.
Physical activity levels of the sedentary subjects were estimated by
using the Stanford Physical Activity Questionnaire (15).
Statistics. Analysis of variance with repeated measures (group × time) was used to determine differences in the dependent variables in each group before and after the follow-up period. When indicated by a significant F value, a post hoc test using the Newman-Keuls method was performed to identify significant differences among mean values. Univariate correlation and regression analyses were used to determine associations between dependent variables. All data are reported as means ± SE. Statistical significance was set at P < 0.05.
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RESULTS |
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TOP
ABSTRACT
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
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Subject characteristics.
Table 1 presents mean values for
selected subject characteristics. At baseline, sedentary women had
significantly higher body mass, body mass index, body fat, hip
circumference, and waist-to-hip ratio compared with endurance-trained
women. Height and fat-free mass decreased and body mass index and body
fat percentage increased over the follow-up period in both groups
(P < 0.05); there were no significant differences in
these changes between the two groups. No significant changes were
observed in blood pressure and plasma cholesterol and lipid levels in
either group. Physical activity levels of the sedentary women did not
change (32 ± 1 kcal/day at baseline and 35 ± 1 at
follow-up; P = not significant).
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O2 max at baseline and during
follow-up.
At baseline, O2 max was
higher (P < 0.01) in endurance-trained compared with
sedentary women (Fig. 1). When expressed in absolute terms, the rate of decline in
O2 max over the follow-up period was
110% greater (P < 0.05) in endurance-trained (0.84 ± 0.15 ml · kg1 · min1 · yr1)
compared with sedentary (0.40 ± 0.12 ml · kg1 · min1 · yr1)
women. In contrast, the relative rate of decline in
O2 max over the same period was not
different between endurance-trained (1.8 ± 0.3% per year) and
sedentary (1.5 ± 0.4% per year) women (P = 0.59). Age-related declines in maximal heart rate and oxygen pulse also
were not different in the two groups (Table
2). In both groups, respiratory exchange
ratio and rating of perceived exertion at
O2 max were not different at baseline
and follow-up, suggesting similar voluntary maximal efforts at the two
testing points.
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Correlates of changes in O2 max
over the follow-up period.
In the pooled subject population, changes in
O2 max were related to corresponding
changes in maximal oxygen pulse (r = 0.42;
P < 0.01). Among sedentary women, changes in
O2 max were not related to any measure.
As illustrated in Fig. 2, among endurance-trained women, changes in
O2 max were positively related to
decreases in running mileage (r = 0.63) and more
modestly with running (weekly) frequency (r = 0.42)
(P < 0.01) but not with changes in running
intensity (r = 0.03; P = 0.93).
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Subgroup analysis: effects of training volume.
To gain further insight into the role of reductions in training
volume with age on the decline in
O2 max, we divided the
endurance-trained women into those who maintained or increased (n = 6) and those who reduced (n = 10)
their baseline training volume (Table 3).
The two subgroups did not differ significantly in baseline
levels of O2 max. The reduction in
O2 max over the follow-up period was
significantly greater in the subgroup of endurance-trained women who
reduced their training volume (1.04 ± 0.16 ml · kg1 · min1 · yr1)
compared with the other two groups but was not different
(P = 0.62) between the subgroup of endurance-trained
women who maintained/increased training volume (0.52 ± 0.20 ml · kg1 · min1 · yr1)
and the sedentary women (Fig. 3). Among
the sedentary women and endurance-trained women who
maintained/increased their training volume (i.e., groups that exhibited
similar rates of reduction in
O2 max with age), changes in
O2 max were not significantly related
to changes in any other variable.
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DISCUSSION |
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TOP
ABSTRACT
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
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For the last decade, our laboratory has been investigating the
modulatory influence of regular physical activity on age-related reductions in O2 max in women. As an
initial step, we used a meta-analytic approach to address this issue
(6) and found that, in marked contrast to the prevailing
view in men (7, 9, 11), the absolute rate of decline in
O2 max across age was greatest in the
most physically active and smallest in the least active women
(6). Because of the well-recognized limitations of
meta-analysis, we next performed a well-controlled laboratory-based
study (18) and obtained findings consistent with those of
our prior meta-analysis. However, to provide more definitive insight
into the relation between age-related changes in maximal aerobic
capacity and habitual exercise status, we conducted the present
longitudinal investigation.
The key findings of this new study are as follows. First, in the
overall sample of the endurance-trained women in their 50s and 60s, the
absolute but not relative rate of decline in
O2 max with age was greater than that
in healthy sedentary women. Second, endurance-trained women who
maintained/increased their training volume demonstrated a rate of
decline in O2 max over a 7-yr period
that is not different from their sedentary peers. These longitudinal
data confirm our previous cross-sectional observations (6,
18) that the decrease in maximal aerobic capacity with advancing
age is greater in endurance-trained women in general compared with
their sedentary peers. However, the present results extend
importantly our previous findings by demonstrating that the greater
decline in O2 max in the overall sample
of endurance-trained subjects is due to reductions in training volume in some of the women. Thus, among healthy women aged 34-78 yr, the
endurance exercise-trained state is associated only with an accelerated
rate of decline in maximal aerobic capacity (compared with sedentary
women) when training volume decreases.
During the development of the present manuscript, the results of a
longitudinal analysis of age-related reductions in
O2 max in endurance-trained women aged
40-73 yr were published (8). They reported
age-related rates of decline in O2 max ranging from 0.4 to 0.9
ml · kg1 · min1 · yr1
in female masters athletes (8). These rates of decline in O2 max are similar to those we obtained
in our endurance-trained women and appear to be greater than the rates
previously reported in sedentary controls (2, 6), but no
sedentary control group was included.
Regarding "physiological" mechanisms, it has been
hypothesized that the decline in O2 max
with age in trained and untrained adults may be influenced by the
corresponding reduction in maximal heart rate (7).
However, consistent with our previous cross-sectional results (6,
18, 19), there was no obvious association between reductions in
maximal heart rate and habitual exercise status. These findings suggest
that other factors, including declines in maximal stroke volume,
skeletal muscle oxidative capacity, and/or pulmonary function (e.g.,
maintenance of arterial oxygen concentrations), may be responsible for
explaining group differences in the absolute rate of decline in
O2 max with age. Moreover, we wish to
emphasize that more than one mechanism may be responsible for
population-specific differences in the rate of decline in O2 max with age. The fact that the
rates of decline were similar in the sedentary controls and
endurance-trained women who maintained/increased training volume
suggests the possibility of a common mechanism (or mechanisms), perhaps
related to fundamental biological aging processes. On the other hand,
the greater rate of decline in O2 max
in the endurance-trained women who decreased their training volume is
consistent with the superimposition of one or more additional
mechanisms, perhaps linked to processes associated with deconditioning
per se. Definitive mechanistic insight into these issues will need to
be obtained from future longitudinal studies.
Our series of findings in women (6, 18) differ from the
results of our recent meta-analysis in men (22). In the
latter investigation, we found that both absolute and relative rates of
decline in O2 max with age were not
different between sedentary and endurance-trained men
(22). These gender-related differences are in agreement
with the previously mentioned cross-sectional study by Ogawa et al.
(12). Although they studied distinct groups of young and
older men and women, manual construction of a linear regression line
with the use of their mean data reveals that the absolute rate of
decline in O2 max was ~50% greater
in the endurance-trained compared with the sedentary women, whereas such differences were absent in men (12). It is not clear
why there appears to be a sex difference in the age-related reduction in O2 max between sedentary and
endurance-trained healthy adults. Based on the present study's
findings, it is plausible to hypothesize that some
endurance-trained women may experience a greater rate of decline in
training volume compared with their male counterparts. A
well-controlled laboratory-based study would be required to properly
test this hypothesis.
In conclusion, the results of the present longitudinal study
support our recent cross-sectional findings that, in the overall sample
of endurance-trained women, the absolute, but not relative, rate of
decline in O2 max with age was greater
in endurance-trained compared with healthy sedentary women. However,
our data also indicate that the greater age-associated rate of decline
in O2 max in the overall sample of
endurance-trained women appears to be due to those who reduced their
training (running) volume. Thus, among healthy women aged 34-78
yr, the endurance exercise-trained state only is associated with an
accelerated rate of decline in maximal aerobic capacity (compared with
sedentary women) when training volume decreases.
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ACKNOWLEDGEMENTS |
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We thank Susan Evans, Cyndi Long, and Edith Stevenson for technical assistance in the present study.
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FOOTNOTES |
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This study was supported by National Institute on Aging Grants AG-00847 and AG-13038, and the Basque Government.
Address for reprint requests and other correspondence: H. Tanaka, Dept. of Kinesiology and Health Education, Univ. of Texas at Austin, Austin, TX 78712 (E-mail: htanaka{at}mail.utexas.edu).
The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
First published January 11, 2002;10.1152/japplphysiol.01124.2001
Received 9 November 2001; accepted in final form 9 January 2002.
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REFERENCES |
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TOP
ABSTRACT
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
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,
change. Numbers in parentheses indicate baseline
P < 0.05 vs. sedentary subjects' baseline value.
