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AGE AND SEX
Department of Physiology
Faculty of Medicine
Universitas Sumatera Utara
Exercise for Older Adults
Older individuals are a special challenge from
the standpoint of exercise prescription due to
the usual presence of chronic disease and
physical activity limitations.
However participation in physical activity and
exercise will go a long way in preventing the
progress of disease and in extending the
years of independent living.
Age-related decreases in aerobic capacity result
partly from decreased activity.
Much of the decline in endurance performance
associated with aging can be attributed to
decrements in central and peripheral circulation.
When evaluating decreases in VO2max with aging
in men and women, comparison per unit of body
weight might not be accurate because we tend to
gain weight as we age, which falsely lowers the
VO2max per unit of body weight, and because
these values do not account for a person’s initial
Instead, comparison should be based on the
percentage change in VO2max in liters per minute,
which excludes the influence of the change in body
weight with aging.
Studies of older athletes and less-active people of
the same age group indicate that the decrease in
VO2max is not strictly a function of age. Athletes
who continue to train have significantly smaller
decreases in VO2max as they age.
Both vital capacity and forced expiratory volume
decrease linearly with age. Residual volume
increases, and total lung capacity remains
unchanged. This increases the RV : TLC ratio,
meaning that less air can be exchanged with each
Maximal expiratory ventilation also decreases with
Pulmonary changes that accompany age are
primarily caused by a loss of elasticity in the lung
tissue and the chest wall. However, older people
have only slightly decreased pulmonary ventilation
capacity. For them, the primary limiter of VO2max
appears to be decreased oxygen transport to the
muscles. Furthermore, maximal a-vO2 diff
decreases, indicating that less oxygen is extracted
by their muscles.
Maximum heart rate decreases slightly less than 1
beat/min per year as we age. The average HR
max for a certain age can be estimated by
following equation : HR max = 220 – age.
Maximal stroke volume and cardiac output also
appear to decrease with age. Stroke volume can
be well maintained in older athletes who have
continued to train, but it will still be less than in
Peripheral blood flow also decreases with age; in
trained older athletes, however, this is offset by an
increased sub maximal a-vO2 diff.
It is unclear how much of the decrease in
cardiovascular function with aging is due to
physical aging alone and how much is due to
deconditioning because of decreased activity.
However, many studies indicate that these changes
are minimized in older athletes who continue to
train, which seems to indicate that inactivity might
play a larger role than physical aging.
Maximal strength decreases steadily with
Age-related losses of strength result primarily
from a substantial loss of muscle mass.
In general, normally active people experience a
shift toward a higher percentage of ST muscle
fibers as they age, possibly due to a reduction in FT
The total number of muscle fibers and fiber
crossectional area decrease with age, but training
appears to lessen the change in fiber area.
► Aging also appears to slow the nervous system’s ability to
detect a stimulus and to process the information to produce
► Training cannot arrest the process of biological aging, but it
can lessen the impact of aging on performance.
► Aging reduces our ability to adapt to exercise in the heat.
This is largely because sweating capacity decreases as we
► With age, body fat content increases, while at the same time
fat-free mass decreases. Much of these changes can be
attributed to the reduction in general activity levels that
occurs with aging .
► The amount of relative body fat increases as we age,
primarily because of increased dietary intake, decreased
physical activity, and a reduced ability to mobilized fat.
► Beyond age 30, fat-free mass decreases, primarily because
of decreased muscle mass and decreased bone mass, both
resulting at least partly from decreased activity.
Exercise for Adolescent
Prepubescent children can improve their strength
with resistance training. These strength gains are
due largely to neurological factors, with little or no
change in the size of the muscle.
The risk of injury from resistance training in young
athletes is relatively low, and the programs they
should follow are much like those for adult.
► Strength gains achieved from resistance training in
preadolescents result primarily from improved motor skill
coordination, increased motor unit activation, and other
neurological adaptations. Unlike adults, preadolescent who
resistance-train experience little change in muscle size.
► Aerobic training in preadolescents does not alter VO2max
as much as would be expected for the training stimulus,
possibly because VO2max depends on heart size. But
endurance performance does not improve with aerobic
► A child anaerobic capacity increases with anaerobic
A general comparison of male and female
structure and function
For the same amount of muscles, no
differences in strength between the
♀ posses smaller muscle fiber cross-
sectional areas than ♂
less muscle mass.
For the same rate of work, trained ♀ generally
have cardiac outputs similar to those of
comparability trained ♂, but this is achieved
through higher heart rates & lower stroke
Women's smaller body size
smaller left ventricle
& lower blood volume
lower stroke volume.
Extra body fat
Lower O2 content
in arterial blood
Lower VO2max values
expressed in ml per Kg per
Resistance training major increase in strength
(20% - 40%), similar to ♂.
In ♀ these gains are due more to neural factors,
because increase in muscle mass is generally
Aerobic training major increase in endurance
capacity ( VO2max increases of 10 – 40%)
Special concerns for male and
female who exercise
For females who trained too hard
Amenorrhea causes reduction in
circulating estrogen → increase bone
mineral loss → osteoporosis
Excessive exercise in males can result in
significant reductions in serum
testosterone → decreased sperm count