CARDIOVASCULAR BENEFITS AND POTENTIAL HAZARDS OF PHYSICAL EXERCISE
IN ELDERLY PEOPLE*
dissertation presented on the 11stof December 2004 at the Agora
Center, Jyväskylä, Finland by permission of Faculty of Medicine
of the University of Kuopio.
The Finnish Centre for Interdisciplinary Gerontology, Department of Health
Sciences, University of Jyväskylä, Jyväskylä, Finland;
LIKES-Research Center for Sport and Health Sciences, Jyväskylä, Finland;
Department of Physical and Rehabilitation Medicine, Central Finland Central
Hospital, Jyväskylä, Finland;
Kuopio Research Institute of Exercise Medicine, Department of Physiology,
Faculty of Medicine, University of Kuopio, Kuopio, Finland
© Journal of Sports Science
and Medicine (2005) 4, Suppl.7, 1 - 51
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review is based on the following original publications, which will be referred
to in the text as Studies 1-4:
Kallinen, M., Suominen, H., Vuolteenaho, O. and Alen, M. (1998) Effort
tolerance in elderly women with different physical activity backgrounds.
Medicine and Science in Sports and Exercise 30, 170-176.
Kallinen, M., Kauppinen, M., Era, P. and Heikkinen, E. The predictive
value of exercise testing for survival among 75-year-old men and women.
Submitted for publication.
Kallinen M, Sipilä S, Alen M, Suominen H. (2002) Improving cardiovascular
fitness by strength or endurance training in elderly women. A population-based
randomized controlled trial. Age and Ageing 31, 247-254.
M, Era P, Heikkinen E. (2000) Cardiac adverse effects and acute exercise
in elderly subjects. Aging 12, 287-294.
and consistent beneficial effects with few adverse effects have
been found in relation to physical exercise in selected samples
of elderly subjects. However, thus far, it has not been confirmed
to what extent the effects of physical exercise among elderly people
are beneficial or even harmful in population-based studies. Additionally,
the role of exercise testing among elderly people remains unclear.
Firstly, the effects of prolonged physical training on cardiovascular
fitness in 66-85-year-old women were examined in a cross-sectional
study. Secondly, the predictive value of exercise-test status and
results, including exercise capacity for survival, were studied
in 75-year-old men and women. Thirdly, the effects of an endurance
and strength training programme were examined in women aged 76 to
78 years in a population-based randomized controlled trial. Finally,
the cardiac-adverse effects of acute exercise in the form of a cycle
ergometer test were clarified in 75-year-old men and women. In the
maximal exercise tests the mean peak oxygen uptake was respectively
26.2 and 18.7 ml·kg-1·min-1 among the physically
active and less active control women. High cycling power (Watts
per kg body weight) in the completed ergometer test was associated
with decreased risk for death (multivariate HR 0.20; CI 0.08 - 0.50).
The 18-week strength training resulted in a 9.4% increase in peak
oxygen uptake while the endurance training improved peak oxygen
uptake by 6.8%. A significant increase in cycling power in W/kg
was found in the strength and endurance training groups compared
to controls. Five cases of cardio- or cerebrovascular health problems
emerged in the exercise training groups. These health problems were
not directly related to physical exertion. In the final study 23
and 7% of the exercise tests in men and women, respectively, were
prematurely terminated because of cardiac arrhythmia or ST segment
depressions. Using various study designs and methods the effects
of physical training on cardiovascular fitness were found to be
beneficial among the four different samples of elderly people. High
exercise capacity was found to be strongly and independently associated
with decreased mortality among elderly men and women. Exercise testing
provides information on the risk of death that is incremental to
clinical data and traditional risk factors for death. Cardiovascular
monitoring during exercise testing is recommended as a safety precaution.
Cardio- or cerebrovascular health problems can occur during exercise
training programmes involving elderly people, although they may
not be directly related to physical exertion. The dose-response
relationships in relation to physical exercise among elderly people
remain in need of further clarification in population-based trials.
WORDS: Benefits and hazards of exercise, cardiovascular fitness,
older people, exercise testing, predictive value, arrhythmia, ST