Aerobic physical activity, cardiorespiratory fitness, and non-communicable diseases risk in older adults: a systematic review
1
Division of Epidemiology and Biostatistics, University of Cape Town, Cape Town, South Africa
2
Department of Global Public Health and Bioethics, University Medical Center Utrecht, Utrecht, Netherlands
3
Research Centre for Health through Physical Activity, Lifestyle and Sport (HPALS), University of Cape Town, Cape Town, South Africa
4
School of Health & Medical Sciences, University of Southern Queensland, Toowoomba, Australia
5
Human Kinetics and Ergonomics, Rhodes University, Makhanda, South Africa
6
Consulting Actuary, Chicago, United States
7
Vitality Group, Chicago, United States
8
Public Health Sciences, Loyola University, Chicago, United States
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Non-communicable diseases (NCDs) account for an estimated 80% of the healthcare burden among older adults. Aerobic physical activity (PA) contributes to functional mobility, increased bone and muscle strength, prevention of illness and quality of life; however, PA is not yet a fully realised aspect of geriatric care. Moreover, the optimal intensity, duration, and type of aerobic PA among older adults remains unknown. Amid ongoing global change and demographic ageing, beset by evolving health demands and challenges, there is a growing need for innovative and sustainable PA approaches to promoting healthy ageing among older populations. The aim of this study was to evaluate recent evidence relating to the association between aerobic PA and cardiorespiratory fitness (CRF) and all-cause mortality and NCD outcomes among older adults aged 65 years and older.
METHODS:
Following PRISMA guidelines, we performed a systematic search of the Scopus, Cochrane Library, PubMed and Web of Science databases, published between 2016 and February 2024.
RESULTS:
The 94 included studies (reported in 104 individual manuscripts) included 46 cross-sectional, 24 longitudinal, 7 cross-sectional/longitudinal, 1 intervention/cross-sectional, and 16 interventions studies. PA and CRF were consistently associated with reduced all-cause mortality in longitudinal studies. Most included studies reported significant inverse associations between measures of PA and cardiovascular disease (CVD) risk and measures of dysglycaemia. Obesity/adiposity, blood pressure, lipids, and metabolic syndrome (MetS) were not consistently associated with aerobic PA. Aerobic PA interventions generally improved depression outcomes, though longitudinal studies showed inconclusive results. Observational evidence suggests an association between PA and frailty, but less consistently with falls.
CONCLUSIONS:
This review suggests a beneficial association between aerobic PA and mortality, CVD, dysglycaemia, and frailty, with less consistent evidence for associations with obesity, dyslipidaemia, hypertension, MetS, depression, and falls. Further high-quality longitudinal studies are needed to determine the optimal aerobic PA measures for NCD mitigation.
Non-communicable diseases (NCDs) account for an estimated 80% of the healthcare burden among older adults. Aerobic physical activity (PA) contributes to functional mobility, increased bone and muscle strength, prevention of illness and quality of life; however, PA is not yet a fully realised aspect of geriatric care. Moreover, the optimal intensity, duration, and type of aerobic PA among older adults remains unknown. Amid ongoing global change and demographic ageing, beset by evolving health demands and challenges, there is a growing need for innovative and sustainable PA approaches to promoting healthy ageing among older populations. The aim of this study was to evaluate recent evidence relating to the association between aerobic PA and cardiorespiratory fitness (CRF) and all-cause mortality and NCD outcomes among older adults aged 65 years and older.
METHODS:
Following PRISMA guidelines, we performed a systematic search of the Scopus, Cochrane Library, PubMed and Web of Science databases, published between 2016 and February 2024.
RESULTS:
The 94 included studies (reported in 104 individual manuscripts) included 46 cross-sectional, 24 longitudinal, 7 cross-sectional/longitudinal, 1 intervention/cross-sectional, and 16 interventions studies. PA and CRF were consistently associated with reduced all-cause mortality in longitudinal studies. Most included studies reported significant inverse associations between measures of PA and cardiovascular disease (CVD) risk and measures of dysglycaemia. Obesity/adiposity, blood pressure, lipids, and metabolic syndrome (MetS) were not consistently associated with aerobic PA. Aerobic PA interventions generally improved depression outcomes, though longitudinal studies showed inconclusive results. Observational evidence suggests an association between PA and frailty, but less consistently with falls.
CONCLUSIONS:
This review suggests a beneficial association between aerobic PA and mortality, CVD, dysglycaemia, and frailty, with less consistent evidence for associations with obesity, dyslipidaemia, hypertension, MetS, depression, and falls. Further high-quality longitudinal studies are needed to determine the optimal aerobic PA measures for NCD mitigation.
| eISSN: | 2654-1459 |
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