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Cardiovascular Health and The Over-65's

Updated: Nov 4, 2021

As sure as it is that time will pass, the physiological changes associated with ageing will inevitably affect us all. Whilst we cannot change the nature of ageing, and its effects, we might be able to slow down the ageing process, thus improving quality of life and reducing the risk of associated illnesses and injuries.

How can we achieve this? Lifestyle and dietary interventions have shown promising results, but only one intervention has consistently demonstrated the ability to attenuate functional decline amongst older adults: physical exercise (1).

Many physiological changes are associated with ageing. These changes cannot be avoided, but through regular exercise, the onset can be delayed and the effects minimised. Some of the effects which impact, and can be improved by, exercise include:

  • Sarcopenia - the progressive loss of skeletal muscle and strength. After age 30, the rate of muscle loss is approximately 3-5% per decade (2) (3).

  • Reduced cardiac output - the amount of blood pumped by the heart. The cardiac output of an 80-year-old is about half that of a 20-year-old (4).

  • Reduced lung volume - vital lung capacity reduces by 22-26ml per year after age 20 (5).

  • Joint degradation - loss of elasticity in tendons, shortening of ligaments and a reduction of synovial fluids can lead to joint degradation and pain (6).

  • Neurological decline - reduced cognitive function and altered memory recall (7).

These changes have an array of implications in terms of health and fitness. On one hand, the changes mean that exercise becomes harder and exercise performance is decreased. This could lead to a decrease in motivation and, ultimately, discontinuation of an exercise regime. On the other hand, these changes underline the importance of following an exercise programme and maintaining activity levels into older age.


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With that in mind, we now need to explore exactly what type of exercise we should be doing, and how often. The NHS guidelines for exercise for the over-65s are (link):

Of the four points made above, the guidelines regarding strength training and intense activity are of particular importance and require additional discussion. Flexibility and mobility training is not mentioned above but, considering the positive effects on balance, coordination and relaxation, should be included (8).

Cardiovascular exercise aims to improve the efficiency of the heart and lungs. These changes come about as the heart becomes stronger, blood vessel networks open up lowering blood pressure and lung capacity can increase. All of these changes are beneficial for