Are maximal power and maximal aerobic capacity in older and very old adults dependent on their level of physical activity?

Key Points

1. Both maximal muscle power (Pmax) and maximal aerobic capacity (VO2max) experience significant age-related decline, especially after age 80.
2. VO2max is mainly influenced by cardiovascular capacity and benefits from aerobic exercise, while Pmax is more dependent on muscle force and responds best to resistance training.
3. Daily step count is associated with VO2max but not with Pmax

BACKGROUND AND OBJECTIVE

Maximal muscle power (Pmax) and aerobic capacity (VO2max) both decline significantly with age, a process that is especially pronounced after age 80 (1). While VO2max is mainly limited by the heart’s capacity and can be better preserved with chronic aerobic exercise, Pmax is more affected by losses in muscle force than velocity, and benefits most from resistance training (2). However, it is still unclear whether habitual physical activity in very old adults is sufficient to counteract declines in both Pmax and VO2max, as few studies have focused on this age group.

The objective of this study was to investigate the effects of age and PA level on Pmax and VO2max, especially in very old adults.

Maximal muscle power and aerobic capacity both decline significantly with age, a process that is especially pronounced after age 80.

Exercise prescription should match the patient’s goal - power exercises for improving lower extremity power, and aerobic activities for increasing VO₂ max.

METHODS

Design: Part of a larger examination that included three visits to provide a comprehensive assessment of physical abilities.

Participants: 39 younger men (mean age 22.1), 34 older men (mean age 71.7), and 23 very older men (mean age 85.8).

Assessment: Anthropometric assessments, VO2 max ramp test, force–velocity profile protocol, and physical activity. The threshold of 10,000 steps per day (SPD) was used to dichotomize participants into high-PA and low-PA groups.

Analysis: Linear regressions were used to determine the rates of decline of VO2max and Pmax with age.

RESULTS

• Compared to younger men, the results for Pmax illustrated a decrease by 40% for older men and 64% for very older men (p < .001).

• For VO₂max the decrease identified was 29% among older men and 51% among very older men (p < .001). VO2max, but not Pmax was greater in individuals with higher levels of physical activity versus lower levels of physical activity.

• Maximal force, the decline was 29% for older men and 52% for very older men (p < .01). While maximal velocity decreased by 17% for older men and 28% for very older men (all p < .01).

• In very older men, steps per day was related to VO₂max (r = 0.79; p < .001) and maximal force (r = 0.51; p < .05), and VO₂max was positively correlated with maximal force (r = 0.72; p < .01).

LIMITATIONS

A limitation of this study is that it only included healthy men, and unfortunately most older adults have some type of cardiac-related pathologies. Thus, the results have limited generalizability.

CLINICAL IMPLICATIONS

The primary study findings were:

1. Both Pmax and VO2max declined with age, with greater decline after age 80.

2. Age-related decline in Pmax is mainly attributed to reduced relative maximal force.

3. More active men showed higher VO2max but similar Pmax compared to less active men, regardless of age.

4. Both active and less active men had similar rates of decline in relative Pmax and VO2max, with sharper declines after age 80.

5. In younger and older men, VO2max was influenced by the intensity of the physical activity performed, while in very old men, both VO2max and maximal force were linked to volume of physical activity or steps per day.

These results can be attributed to specificity of the physical activity or exercise the participants performed. The study measured activity via step count, which is an aerobic activity, but did not focus on strength and power training. Thus, it is not surprising that VO2max was associated with physical activity levels, but maximum power was not.

Power can be increased among older adults utilizing power-specific exercises (3). For upper and lower extremity muscle power, a meta-analysis of 16 randomized controlled trials showed a significantly greater benefit of power training over strength training (standard mean difference: 0.99-1.00, p =0.001-0.003) (3). Thus, if the goal is to increase lower extremity power, then the patient should be prescribed lower extremity power exercises listed in Table 1 (3). If the goal is to increase VO2 max, the patient should be prescribed aerobic activities, including daily step count increase as examined in this study.

+STUDY REFERENCE

Luneau E, Rozand V, Millet G (2025) Are Maximal Power and Maximal Aerobic Capacity in Older and Very Old Adults Dependent on their Level of Physical Activity?. The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 80(7).

SUPPORTING REFERENCE

1. Li Z, Zhang Z, Ren Y, Wang Y, Fang J, Yue H, Ma S, Guan F. Aging and age‐related diseases: from mechanisms to therapeutic strategies. Biogerontology. 2021 Apr;22(2):165-87.
2. Silva AW, Santos WR, Santos WR. The benefits of physical exercise for healthy aging. RBPFEX-Revista Brasileira de Prescrição e Fisiologia do Exercício. 2024 Apr 24;18(115):267-72.
3. El Hadouchi M, Kiers H, de Vries R, Veenhof C, van Dieën J. Effectiveness of power training compared to strength training in older adults: a systematic review and meta-analysis. European Review of Aging and Physical Activity. 2022 Dec;19(1):18.