Five-year performance trends for older exercisers: a hierarchical model of endurance, strength, and flexibility

To examine 5-year trends in measures of physical performance, and the impact of disease upon performance, in three domains: cardiovascular fitness, musculo-skeletal strength, and flexibility among older adults participating in a medically supervised exercise program.

Longitudinal analyses of data obtained in an observational cohort study.

Department of Veterans Affairs Medical Center in Durham, North Carolina.

Seventy-three community-dwelling veterans between 64 and 90 years of age.

Voluntary participation in a medically supervised outpatient exercise program meeting 3 days per week for 90 minutes per session.

Changes over time in cardiovascular fitness, musculoskeletal strength, and flexibility.

Forty-nine percent of the original study participants remained in the program for a full 5 years. They had lower baseline rates of cardiorespiratory and musculoskeletal diseases than did the dropouts. Dropouts were significantly more impaired in baseline measures of cardiovascular fitness (P = .038) and strength (P = .007). Changes over time for cardiovascular fitness and strength were similar. Only linear (P < .05) and quadratic time (P < .001) were significant. Only linear time was significant for measures of flexibility (P < .05). Baseline cardiorespiratory disease, baseline musculoskeletal disease, and interaction terms were not significant. Overall, measures of physical performance demonstrated gradual improvement for 2 to 3 years, followed by a gradual decline in performance irrespective of baseline disease status.

Older adults who exercise regularly, including those with multiple chronic diseases, can achieve significant gains in measures of physical performance, and these gains can be sustained for 2 to 3 years.