Lifelong Endurance Exercise as a Countermeasure Against Age-Related V˙ O 2 max Decline: Physiological Overview and Insights from Masters Athletes

Pedro L. Valenzuela, Nicola A. Maffiuletti, Michael J. Joyner, Alejandro Lucia, Romuald Lepers

Research output: Contribution to journalReview articlepeer-review

17 Scopus citations


Maximum oxygen consumption (V˙ O 2 max) is not only an indicator of endurance performance, but also a strong predictor of cardiovascular disease and mortality. This physiological parameter is known to decrease with aging. In turn, physical exercise might attenuate the rate of aging-related decline in V˙ O 2 max, which in light of the global population aging is of major clinical relevance, especially at advanced ages. In this narrative review, we summarize the evidence available from masters athletes about the role of lifelong endurance exercise on aging-related V˙ O 2 max decline, with examples of the highest V˙ O 2 max values reported in the scientific literature for athletes across different ages (e.g., 35 ml·kg−1·min−1 in a centenarian cyclist). These data suggest that a linear decrease in V˙ O 2 max might be possible if physical exercise loads are kept consistently high through the entire life span, with V˙ O 2 max values remaining higher than those of the general population across all ages. We also summarize the main physiological changes that occur with inactive aging at different system levels—pulmonary and cardiovascular function, blood O2 carrying capacity, skeletal muscle capillary density and oxidative capacity—and negatively influence V˙ O 2 max, and review how lifelong exercise can attenuate or even prevent most—but apparently not all (e.g., maximum heart rate decline)—of them. In summary, although aging seems to be invariably associated with a progressive decline in V˙ O 2 max, maintaining high levels of physical exercise along the life span slows the multi-systemic deterioration that is commonly observed in inactive individuals, thereby attenuating age-related V˙ O 2 max decline.

Original languageEnglish (US)
Pages (from-to)703-716
Number of pages14
JournalSports Medicine
Issue number4
StatePublished - Apr 1 2020

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation


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