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Role of Lifestyle and Aging on the Longitudinal Change in Cardiorespiratory Fitness
Open accessAbstract
BACKGROUND: Cardiorespiratory fitness (CRF) in adults decreases with age and is influenced by lifestyle. Low CRF is associated with risk of diseases and the ability of older persons to function independently. We defined the longitudinal rate of CRF decline with aging and the association of aging and lifestyle with CRF. METHODS: We studied a cohort of 3429 women and 16 889 men, aged 20 to 96 years, from the Aerobics Center Longitudinal Study who completed 2 to 33 health examinations from 1974 to 2006. The lifestyle variables were body mass index, self-reported aerobic exercise, and smoking behavior. Cardiorespiratory fitness was measured by a maximal Balke treadmill exercise test. RESULTS: Linear mixed models regression analysis stratified by sex showed that the decline in CRF with age was not linear. After 45 years of age, CRF declined at an accelerated rate. For each unit of increase in body mass index, the CRF of women declined 0.20 metabolic equivalents (METs) (95% confidence interval, -0.21 to -0.19); that of men, 0.32 METs (-0.33 to -0.20). Current smokers of both sexes also had lower CRF (-0.29 METs [95% confidence interval, -0.40 to -0.19] for women and -0.41 METS [-0.44 to -0.38] for men). Cardiorespiratory fitness was positively associated with self-reported physical activity. CONCLUSIONS: Cardiorespiratory fitness in men and women declines at a nonlinear rate that accelerates after 45 years of age. Maintaining a low BMI, being physically active, and not smoking are associated with higher CRF across the adult life span.
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“Based on longitudinal35 36 and cross sectional studies,37 we expected an age dependent decline in peak oxygen uptake of at least 3.5 mL/kg/min over the five year period.”
From Effect of exercise training for five years on all cause mortality in older adults—the Generation 100 study: randomised controlled trial (2020) · cites this paper as [36]
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“Consistent with the natural age-related decline in cardiorespiratory fitness (Jackson et al. 2009) and a general reduction in physical activity levels with advancing age (Hallal et al. 2012), cardiorespiratory fitness in older adults was lower than young.”
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“…, 2023, Vol. 78, No. 11 1825 fitness (CRF) and muscular strength are two indicators of physical health that typically decline with normal aging (Jackson et al., 2009; Sternäng et al., 2015) and have been linked to many different indicators of brain health (Dercon et al., 2021; Duchowny et al.,…”
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“However, of concern, studies report that CRF declines with age.(8,9) The onset of this age-related decline occurs near 40 years and”
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“Similar to other studies [38], when examining PA behaviour with age this was only found to predict PA behaviour in the multilevel model.”
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Cardiovascular and Pulmonary Systems Changes
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Vogel, T., Lang, P. O., Schmitt, E., Kaltenbach, G., & Gény, B. (2013) · Les cahiers de l année gérontologique · doi:10.1007/s12612-013-0360-8 · Cited by 1
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BackgroundDoes the Framingham Risk Score Predict Risk in Women as Well as It Does in Men?
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Santana, E. J., Christle, J. W., Cauwenberghs, N., Peterman, J. E., Busque, V., Gomes, B., Bagherzadeh, S. P., Moneghetti, K. J., Kuznetsova, T., Wheeler, M. T., et al. (2024) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2024.01.022 · Cited by 1
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“However, the CCLS is one of the few cohorts in the United States with even one time point of CRF; multiple time points allow for novel longitudinal analysis of CRF changes over time in relation to changes in exposures.”
InfluentialSchulte, S., Ittermann, T., Groß, S., Ewert, R., Markus, M. R. P., Wiese, M. L., Kaczmarek, S., Friedrich, N., Dörr, M., & Bahls, M. (2025) · Scientific Reports · doi:10.1038/s41598-025-93828-2 · Cited by 1
“However, in the Aerobics Center Longitudinal Study maintaining a low BMI was related to higher VO 2 peak in 3,429 women and 16,889 men 32 .”
Wall, J. J. S., Matupi, L., Paul, M., Doleman, B., Lund, J. N., & Phillips, B. E. (2025) · JCSM Communications · doi:10.1002/rco2.70010 · Cited by 1
The FitTrack Index as fitness indicator: A pilot study
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Tracking of cardiorespiratory fitness in Japanese men
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“Bajos niveles de resistencia cardiorrespiratoria se ha identificado como un factor de riesgo en el desarrollo de hipertensión, diabetes, síndrome metabólico, cáncer y muerte por cualquier causa (1).”
BackgroundEFEK YOGA TERHADAP KOMPONEN BIOMOLEKULAR PADA PROSES CELL AGING
Wahyuni, N. (2020) · Sport and Fitness Journal · doi:10.24843/spj.2020.v08.i02.p03 · Cited by 1
Cech, D. J., & Martin, S. “. (2011) · Elsevier eBooks · doi:10.1016/b978-1-4160-4978-4.00015-6 · Cited by 1
Ortaglia, A., Stansbury, M. L., Wirth, M. D., Sui, X., & Bottai, M. (2022) · Mayo Clinic Proceedings Innovations Quality & Outcomes · doi:10.1016/j.mayocpiqo.2022.05.006 · Cited by 1
“This was unexpected, given the previous findings that CRF deteriorates at a greater rate in men than in women with each decade, particularly at the sixth decade and beyond.(6,7,32) It is likely that this was a result of differences in statistical methods applied among the studies.”
BackgroundMethodResultInfluentialSelf-citationPreventable Risk Factors for Beginning of Metabolic Syndrome and Comorbidities among Women
Tyagi, R. (2021) · Anthropology and Ethnology Open Access Journal · doi:10.23880/aeoaj-16000154
Liu, W.-J., Dhuromsingh, M., He, X., Xie, Y., Liu, X., Wang, H., & Zeng, H. (2022) · Current Medical Science · doi:10.1007/s11596-022-2656-7 · Cited by 1
Mobile Gamers versus Non-gamer students’ endurance levels via Beep and 3-minute step test
Lobo, J., & Bernardo, B. D. M. (2023) · Pedagogy of Physical Culture and Sports · doi:10.15561/26649837.2023.0107 · Cited by 1
Zhu, N. (2013) · University of Minnesota Digital Conservancy (University of Minnesota) · Cited by 1
Physical Activity, Exercise, and Aging
Gorman, G. S., Wood, J., & Trenell, M. I. (2014) · Well Being · doi:10.1002/9781118539415.wbwell084 · Cited by 1
Ferreira, M. J., Esposti, R. D., Jarrete, A. P., Sponton, C. H., & Zanesco, A. (2019) · Preprints.org · doi:10.20944/preprints201912.0168.v1 · Cited by 1
“through the VO2 peak, compared with men, corroborating with previous studies (Fleg et al., 2005; Jackson et al., 2009; Wang et al., 2010).”
ResultAerobic Exercise Training and Healthy Aging
Fleg, J. L. (2019) · Springer eBooks · doi:10.1007/978-3-319-69892-2_605-1 · Cited by 1
Spielmann, G. (2026) · Edinburgh Napier Research Repository (Edinburgh Napier University) · doi:10.17869/enu.192070
2B.5. Exercise for the elderly
Byfield, D. C. (2010) · Clinical Chiropractic · doi:10.1016/j.clch.2010.02.057
Endodontie bei älteren Patienten
Hülsmann, M., & Bürklein, S. (2012) · wissen kompakt · doi:10.1007/s11838-011-0139-y
Ko, G. (2013) · QSpace (Queen's University Library)
Conover, M. B. (2015)
Bartolomeu, R. F. (2013) · Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT)
Development of O2max Estimation and Validity Based on Body Index Variables for Adults
Jeon, Y.-J., Im, J. H., & Lee, B. (2014) · The Official Journal of the Korean Academy of Kinesiology · doi:10.15758/jkak.2014.16.1.31
The Effect of Physical Training Cessation on Cognitive and Mobility Performance of Older Adults
Rodrigues, L. (2017) · Spectrum Research Repository (Concordia University)
Spengler, C. M., Schultes, B., Wilms, B., Ernst, B., & Thurnheer, M. (2018) · Diabetologie und Stoffwechsel · doi:10.1055/s-0043-123506
“[37] Jackson AS, Sui X, Hébert JR et al.”
BackgroundΜπούρδας, Δ. Η. (2021) · ΥΣΠΛΗΓΞ Επιστημονικό Περιοδικό Φυσικής Αγωγής · doi:10.12681/hsjpe.26619
“Επιπλέον, και από τη στιγµή που γνωρίζουµε ότι µε τη γήρανση τα επίπεδα φυσικής κατάστασης µειώνονται (Fleg et al. 2005, Jackson et al. 2009) και η κατατοµή των λιπιδίων επιδεινώνεται (Park et al. 2015), όλοι οι εµπλεκόµενοι φορείς και οι σχετικοί ειδικοί θα πρέπει να συµβουλεύουν ασθενείς και µη…”
Bastone, A. D. C., Vasconcelos, K. S. D. S., Lacerda, A. C. R., Neves, C. D. C., Mendonça, V. A., Dias, J. M. D., & Dias, R. C. (2018) · Topics in Geriatric Rehabilitation · doi:10.1097/tgr.0000000000000200
Yusuf, M. (2019) · INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH · doi:10.36106/ijsr/5704908
“This was due to difference in the workload between the two tests when calculated by ACSM equation [22] for walking and running.”
MethodOkechukwu, C. E. (2020) · International Journal of Health & Allied Sciences · doi:10.4103/ijhas.ijhas_116_19
Aerobic Exercise Training and Healthy Aging
Fleg, J. L. (2021) · Springer eBooks · doi:10.1007/978-3-030-22009-9_605
The influence of active and passive smoking on the cardiorespiratory fitness of adults
de Borba, A. T., Jost, R. T., Gass, R., Nedel, F. B., Cardoso, D. M., Pohl, H. H., Reckziegel, M. B., Corbellini, V. A., & Paiva, D. N. (2014) · Multidisciplinary Respiratory Medicine · doi:10.4081/mrm.2014.400
Ernandini, E. (2023) · Hematology and Disorders · doi:10.58489/2836-3582/003
Szubert, J., Ziółkowski, W., Szymańska-Paszczuk, A., Wieczorek, W., & Szubert, M. (2019) · Wydawnictwo Uniwersytetu Łódzkiego eBooks · doi:10.18778/8142-303-8.09
Szubert, J., Ziółkowski, W., Szymańska-Paszczuk, A., Wieczorek, W., & Szubert, M. (2019) · Wydawnictwo Uniwersytetu Łódzkiego eBooks · doi:10.18778/8142-303-8.08
Mylius, C. (2024) · doi:10.33612/diss.893591302
Weiß, M., Mende, E., Schaller, N., Krusemark, H., Spanier, B., Zelger, O., Bischof, J., Haller, B., Halle, M., & Siegrist, M. (2024) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.14576
Metadata
- Authors
- Jackson, A. S., Sui, X., Hébert, J. R., Church, T. S., & Blair, S. N.
- Affiliations
- University of Houston (US)
- Pennington Biomedical Research Center (US)
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2009-10-26
- Volume
- 169
- Issue
- 19
- Pages
- 1781-7
- ISSN
- 0003-9926 (ISSN-L)
- PMC
- PMC3379873
- OpenAlex
- W2145173489
- Cited by
- 329
- References
- 37
- Citations by year
- 2026: 12 · 2025: 28 · 2024: 29 · 2023: 22 · 2022: 34 · 2021: 25 · 2020: 19 · 2019: 21 · 2018: 14 · 2017: 16 · 2016: 15 · 2015: 15 · 2014: 20 · 2013: 18 · 2012: 20
- FWCI
- 33.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Scholar Commons (University of South Carolina) (submittedVersion)
- Funders
- National Institute on Aging (R37AG006945, AG06945, R01AG006945)
- National Heart, Lung, and Blood Institute (HL62508, R01HL062508)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Performance
- Keywords
- cardiorespiratory fitness, aging, lifestyle factors, body mass index, physical activity, smoking, aerobic exercise, sex differences, Aerobics Center Longitudinal Study, treadmill exercise testing
- MeSH terms
- Adult, Age Factors, Aged, Aged, 80 and over, Aging, Exercise Test, Female, Humans, Life Style, Longitudinal Studies, Male, Middle Aged, Oxygen Consumption, Physical Fitness, Sex Factors, Smoking, Exercise, Body Mass Index, Linear Models
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