{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T22:55:44Z","timestamp":1790549744349,"version":"4.1.0"},"reference-count":62,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Aging Biology Foundation EU"},{"DOI":"10.13039\/501100000355","name":"Bupa Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000355","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["GeroScience"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    This study examined the impact of nine years of continued cycling exercise on physiological function in older exercisers, viewed as a model of inherent biological aging free from the negative effects of inactivity. A range of cardiorespiratory indices were measured, with peak oxygen consumption (V\u0307O\n                    <jats:sub>2peak<\/jats:sub>\n                    ) as the primary outcome. Of an original 125 cyclists first assessed in 2012\u20132013, 82 (53 males, 29 females) returned 9\u00a0years later (aged 64\u201386\u00a0years at follow up). V\u0307O\n                    <jats:sub>2peak<\/jats:sub>\n                    declined by 19.7% (44.1 to 35.4\u00a0ml\u00b7kg\u207b\n                    <jats:sup>1<\/jats:sup>\n                    \u00b7min\u207b\n                    <jats:sup>1<\/jats:sup>\n                    ,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.0001). Body mass remained stable, but lean tissue mass decreased (\u22128.1%,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.0001) and body fat percentage increased from 23.8% to 29.2% (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.0001). Resting blood pressure and metabolic indices remained within normal ranges, while lung function declined. Changes were similar between males and females. Based on returning health status, participants were classified as: optimal agers (OA; no disease,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200935), successful agers (SA;\u2009\u2264\u20092 well-controlled diseases,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200924), or those with compromised health (CH; poorly controlled disease, mainly cardiovascular,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200923). V\u0307O\n                    <jats:sub>2peak<\/jats:sub>\n                    declined more in CH than OA (24.2% vs 17.3%,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.05), but overall, 98.7% of those who completed the test were at or above the 90th percentile for V\u0307O\n                    <jats:sub>2peak<\/jats:sub>\n                    based on reference populations. Almost all indices showed no difference between health groups over 9\u00a0years. Whilst acknowledging potential survivor bias, these longitudinal data support the concept that even with emerging disease, exercise confers good physiological function in a body that is declining with age.\n                  <\/jats:p>","DOI":"10.1007\/s11357-026-02483-6","type":"journal-article","created":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T22:03:37Z","timestamp":1790546617000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A 9-year longitudinal investigation into physiological aging in highly active older adults"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7517-2566","authenticated-orcid":false,"given":"Amir S.","family":"Fathi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1021-8834","authenticated-orcid":false,"given":"Thomas","family":"Francis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5028-3053","authenticated-orcid":false,"given":"Eloise","family":"Milbourn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8078-1316","authenticated-orcid":false,"given":"Esme","family":"Newton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3079-8758","authenticated-orcid":false,"given":"Leah","family":"Siegel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6460-971X","authenticated-orcid":false,"given":"Suzanne","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4459-4632","authenticated-orcid":false,"given":"Niharika A.","family":"Duggal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1030-6786","authenticated-orcid":false,"given":"Janet M.","family":"Lord","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3519-5034","authenticated-orcid":false,"given":"Norman R.","family":"Lazarus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3184-8253","authenticated-orcid":false,"given":"Ross D.","family":"Pollock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8203-0769","authenticated-orcid":false,"given":"Stephen D. R.","family":"Harridge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"issue":"2","key":"2483_CR1","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/j.cell.2022.11.001","volume":"186","author":"C L\u00f3pez-Ot\u00edn","year":"2023","unstructured":"L\u00f3pez-Ot\u00edn C, Blasco MA, Partridge L, et al. Hallmarks of aging: an expanding universe. Cell. 2023;186(2):243\u201378. https:\/\/doi.org\/10.1016\/j.cell.2022.11.001.","journal-title":"Cell"},{"issue":"1","key":"2483_CR2","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1113\/jphysiol.2007.141879","volume":"586","author":"H Tanaka","year":"2008","unstructured":"Tanaka H, Seals DR. Endurance exercise performance in Masters athletes: age-associated changes and underlying physiological mechanisms. J Physiol. 2008;586(1):55\u201363. https:\/\/doi.org\/10.1113\/jphysiol.2007.141879.","journal-title":"J Physiol"},{"issue":"8","key":"2483_CR3","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1093\/gerona\/glq016","volume":"65","author":"NR Lazarus","year":"2010","unstructured":"Lazarus NR, Harridge SD. Exercise, physiological function, and the selection of participants for aging research. J Gerontol A Biol Sci Med Sci. 2010;65(8):854\u20137. https:\/\/doi.org\/10.1093\/gerona\/glq016.","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"5","key":"2483_CR4","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1111\/sms.13616","volume":"30","author":"C Cunningham","year":"2020","unstructured":"Cunningham C, O\u2019Sullivan R, Caserotti P, Tully MA. Consequences of physical inactivity in older adults: a systematic review of reviews and meta-analyses. Scand J Med Sci Sports. 2020;30(5):816\u201327. https:\/\/doi.org\/10.1111\/sms.13616.","journal-title":"Scand J Med Sci Sports"},{"key":"2483_CR5","doi-asserted-by":"publisher","unstructured":"Booth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Compr Physiol. 2012;2:1143\u2013211. https:\/\/doi.org\/10.1002\/cphy.c110025.","DOI":"10.1002\/cphy.c110025"},{"key":"2483_CR6","unstructured":"Health Survey for England, 2021. https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/health-survey-for-england\/2021-part-2\/physical-activity. Accessed 14\u00a0July 2026."},{"issue":"4","key":"2483_CR7","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1249\/JSR.0000000000000168","volume":"14","author":"DE Lieberman","year":"2015","unstructured":"Lieberman DE. Is exercise really medicine? An evolutionary perspective. Curr Sports Med Rep. 2015;14(4):313\u20139. https:\/\/doi.org\/10.1249\/JSR.0000000000000168.","journal-title":"Curr Sports Med Rep."},{"issue":"5","key":"2483_CR8","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1056\/NEJM198501313120505","volume":"312","author":"SB Eaton","year":"1985","unstructured":"Eaton SB, Konner M. Paleolithic nutrition. A consideration of its nature and current implications. N Engl J Med. 1985;312(5):283\u20139. https:\/\/doi.org\/10.1056\/NEJM198501313120505.","journal-title":"N Engl J Med"},{"issue":"2","key":"2483_CR9","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1152\/physiol.00029.2016","volume":"32","author":"SDR Harridge","year":"2017","unstructured":"Harridge SDR, Lazarus NR. Physical activity, aging, and physiological function. Physiology. 2017;32(2):152\u201361. https:\/\/doi.org\/10.1152\/physiol.00029.2016.","journal-title":"Physiology"},{"issue":"3","key":"2483_CR10","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1113\/jphysiol.2014.282863","volume":"593","author":"RD Pollock","year":"2015","unstructured":"Pollock RD, Carter S, Velloso CP, et al. An investigation into the relationship between age and physiological function in highly active older adults. J Physiol. 2015;593(3):657\u201380. https:\/\/doi.org\/10.1113\/jphysiol.2014.282863.","journal-title":"J Physiol"},{"issue":"9","key":"2483_CR11","doi-asserted-by":"publisher","first-page":"2941","DOI":"10.1113\/JP272443","volume":"595","author":"NR Lazarus","year":"2017","unstructured":"Lazarus NR, Harridge SDR. Declining performance of master athletes: silhouettes of the trajectory of healthy human ageing? J Physiol. 2017;595(9):2941\u20138. https:\/\/doi.org\/10.1113\/JP272443.","journal-title":"J Physiol"},{"key":"2483_CR12","doi-asserted-by":"publisher","unstructured":"Blair SN, Kohl HW 3rd, Paffenbarger RS Jr., et al. Physical fitness and all-cause mortality. A prospective study of healthy men and women. JAMA. 1989;262(17):2395\u2013401. https:\/\/doi.org\/10.1001\/jama.262.17.2395.","DOI":"10.1001\/jama.262.17.2395"},{"issue":"11","key":"2483_CR13","doi-asserted-by":"publisher","first-page":"1533","DOI":"10.1016\/j.mayocp.2015.08.005","volume":"90","author":"C Bouchard","year":"2015","unstructured":"Bouchard C, Blair SN, Katzmarzyk PT. Less sitting, more physical activity, or higher fitness? Mayo Clin Proc. 2015;90(11):1533\u201340. https:\/\/doi.org\/10.1016\/j.mayocp.2015.08.005.","journal-title":"Mayo Clin Proc"},{"issue":"1","key":"2483_CR14","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1038\/s43587-025-01046-2","volume":"6","author":"F Ambrosio","year":"2026","unstructured":"Ambrosio F, Artyomov MN, Austad SN, et al. Past, present and future perspectives on the science of aging. Nat Aging. 2026;6(1):6\u201322. https:\/\/doi.org\/10.1038\/s43587-025-01046-2.","journal-title":"Nat Aging"},{"key":"2483_CR15","doi-asserted-by":"publisher","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP; STROBE Initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007;335(7624):806\u20138. https:\/\/doi.org\/10.1136\/bmj.39335.541782.AD.","DOI":"10.1136\/bmj.39335.541782.AD"},{"issue":"3","key":"2483_CR16","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1093\/ageing\/23.3.185","volume":"23","author":"CA Greig","year":"1994","unstructured":"Greig CA, Young A, Skelton DA, et al. Exercise studies with elderly volunteers. Age Ageing. 1994;23(3):185\u20139. https:\/\/doi.org\/10.1093\/ageing\/23.3.185.","journal-title":"Age Ageing"},{"issue":"s2","key":"2483_CR17","doi-asserted-by":"publisher","first-page":"S2","DOI":"10.1123\/IJSPP.2016-0403","volume":"12","author":"I Mujika","year":"2017","unstructured":"Mujika I. Quantification of training and competition loads in endurance sports: methods and applications. Int J Sports Physiol Perform. 2017;12(s2):S2\u20139. https:\/\/doi.org\/10.1123\/ijspp.2016-0403.","journal-title":"Int J Sports Physiol Perform"},{"issue":"2","key":"2483_CR18","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1164\/rccm.167.2.211","volume":"167","author":"ATS\/ACCP statement on cardiopulmonary exercise testing","year":"2003","unstructured":"ATS\/ACCP statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med. 2003;167(2):211\u201377. https:\/\/doi.org\/10.1164\/rccm.167.2.211.","journal-title":"Am J Respir Crit Care Med"},{"key":"2483_CR19","unstructured":"ICD-11 International Classification of Diseases 11th Revision. The global standard for diagnostic health information. https:\/\/icd.who.int\/en\/.\u00a0Accessed 14 July 2026."},{"key":"2483_CR20","doi-asserted-by":"publisher","unstructured":"Graham BL, Steenbruggen I, Barjaktarevic IZ, et al. Standardization of spirometry 2019 update. An official American Thoracic Society and European Respiratory Society technical statement. Am J Respir Crit Care Med. 2019;200(8):e70\u201388. https:\/\/doi.org\/10.1164\/rccm.201908-1590ST.","DOI":"10.1164\/rccm.201908-1590ST"},{"issue":"6","key":"2483_CR21","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.1183\/09031936.00080312","volume":"40","author":"PH Quanjer","year":"2012","unstructured":"Quanjer PH, Stanojevic S, Cole TJ, et al. Multi-ethnic reference values for spirometry for the 3\u201395 year age range: the global lung function 2012 equations: report of the Global Lung Function Initiative (GLI), ERS Task Force to establish improved Lung Function Reference Values. Eur Respir J. 2012;40(6):1324\u201343. https:\/\/doi.org\/10.1183\/09031936.00080312.","journal-title":"Eur Respir J."},{"issue":"11","key":"2483_CR22","doi-asserted-by":"publisher","first-page":"1841","DOI":"10.1097\/00005768-200111000-00007","volume":"33","author":"SE Gaskill","year":"2001","unstructured":"Gaskill SE, Ruby BC, Walker A, et al. Validity and reliability of combining three methods to determine ventilatory threshold. Med Sci Sports Exerc. 2001;33(11):1841\u20138. https:\/\/doi.org\/10.1097\/00005768-200111000-00007.","journal-title":"Med Sci Sports Exerc."},{"issue":"2","key":"2483_CR23","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1016\/j.mayocp.2021.08.020","volume":"97","author":"LA Kaminsky","year":"2022","unstructured":"Kaminsky LA, Arena R, Myers J, et al. Updated reference standards for cardiorespiratory fitness measured with cardiopulmonary exercise testing: data from the Fitness Registry and the Importance of Exercise National Database (FRIEND). Mayo Clin Proc. 2022;97(2):285\u201393. https:\/\/doi.org\/10.1016\/j.mayocp.2021.08.020.","journal-title":"Mayo Clin Proc"},{"issue":"5","key":"2483_CR24","doi-asserted-by":"publisher","first-page":"1320","DOI":"10.1152\/japplphysiol.00475.2006","volume":"101","author":"M Burnley","year":"2006","unstructured":"Burnley M, Doust JH, Jones AM. Time required for the restoration of normal heavy exercise V\u0307O2 kinetics following prior heavy exercise. J Appl Physiol. 2006;101(5):1320\u20137. https:\/\/doi.org\/10.1152\/japplphysiol.00475.2006.","journal-title":"J Appl Physiol"},{"issue":"2","key":"2483_CR25","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","volume":"28","author":"DJ Buysse","year":"1989","unstructured":"Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193\u2013213. https:\/\/doi.org\/10.1016\/0165-1781(89)90047-4.","journal-title":"Psychiatry Res"},{"issue":"3","key":"2483_CR26","doi-asserted-by":"publisher","DOI":"10.1136\/BMJOPEN-2013-004503","volume":"4","author":"AA Mulligan","year":"2014","unstructured":"Mulligan AA, Luben RN, Bhaniani A, et al. A new tool for converting food frequency questionnaire data into nutrient and food group values: FETA research methods and availability. BMJ Open. 2014;4(3):e004503. https:\/\/doi.org\/10.1136\/BMJOPEN-2013-004503.","journal-title":"BMJ Open"},{"issue":"3","key":"2483_CR27","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1097\/00005650-199603000-00003","volume":"34","author":"JE Ware","year":"1996","unstructured":"Ware JE, Kosinski M, Keller SD. A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220\u201333. https:\/\/doi.org\/10.1097\/00005650-199603000-00003.","journal-title":"Med Care"},{"issue":"6","key":"2483_CR28","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","volume":"67","author":"AS Zigmond","year":"1983","unstructured":"Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361\u201370. https:\/\/doi.org\/10.1111\/j.1600-0447.1983.tb09716.x.","journal-title":"Acta Psychiatr Scand."},{"key":"2483_CR29","unstructured":"R Core Team. R: a language and environment for statistical computing. Published online 2023."},{"key":"2483_CR30","doi-asserted-by":"publisher","unstructured":"Sehl ME, Yates FE. Kinetics of human aging: I. Rates of senescence between ages 30 and 70 years in healthy people. J Gerontol A Biol Sci Med Sci. 2001;56:B198\u2013208.\u00a0https:\/\/doi.org\/10.1093\/gerona\/56.5.b198.","DOI":"10.1093\/gerona\/56.5.b198"},{"key":"2483_CR31","doi-asserted-by":"publisher","unstructured":"Ferrucci L, Gonz\u00e1lez-Freire M, Fabbri E, et al. Measuring biological aging in humans: a quest. Aging Cell. 2020;19:e13080.\u00a0https:\/\/doi.org\/10.1111\/acel.13080.","DOI":"10.1111\/acel.13080"},{"issue":"1","key":"2483_CR32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jnha.2024.100401","volume":"29","author":"M Izquierdo","year":"2025","unstructured":"Izquierdo M, de Souto Barreto P, Arai H, et al. Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR). J Nutr Health Aging. 2025;29(1):100401. https:\/\/doi.org\/10.1016\/j.jnha.2024.100401.","journal-title":"J Nutr Health Aging"},{"issue":"3","key":"2483_CR33","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1136\/bjsports-2013-092993","volume":"48","author":"M Hamer","year":"2014","unstructured":"Hamer M, Lavoie KL, Bacon SL. Taking up physical activity in later life and healthy ageing: the English longitudinal study of ageing. Br J Sports Med. 2014;48(3):239\u201343. https:\/\/doi.org\/10.1136\/bjsports-2013-092993.","journal-title":"Br J Sports Med."},{"issue":"8","key":"2483_CR34","doi-asserted-by":"publisher","first-page":"2001","DOI":"10.1113\/jphysiol.2014.282665","volume":"594","author":"DR Seals","year":"2016","unstructured":"Seals DR, Justice JN, LaRocca TJ. Physiological geroscience: targeting function to increase healthspan and achieve optimal longevity. J Physiol. 2016;594(8):2001\u201324. https:\/\/doi.org\/10.1113\/jphysiol.2014.282665.","journal-title":"J Physiol"},{"key":"2483_CR35","doi-asserted-by":"publisher","unstructured":"Wilson TM, Tanaka H. Meta-analysis of the age-associated decline in maximal aerobic capacity in men: relation to training status.\u00a0Am J Physiol Heart Circ Physiol. 2000;278:H829\u201334.\u00a0https:\/\/doi.org\/10.1152\/ajpheart.2000.278.3.H829.","DOI":"10.1152\/ajpheart.2000.278.3.H829"},{"issue":"9","key":"2483_CR36","doi-asserted-by":"publisher","first-page":"1196","DOI":"10.1001\/JAMAINTERNMED.2021.3836","volume":"181","author":"M Ried-Larsen","year":"2021","unstructured":"Ried-Larsen M, Rasmussen MG, Blond K, et al. Association of cycling with all-cause and cardiovascular disease mortality among persons with diabetes: the European Prospective Investigation Into Cancer and Nutrition (EPIC) study. JAMA Intern Med. 2021;181(9):1196\u2013205. https:\/\/doi.org\/10.1001\/JAMAINTERNMED.2021.3836.","journal-title":"JAMA Intern Med."},{"issue":"10","key":"2483_CR37","doi-asserted-by":"publisher","first-page":"1744","DOI":"10.1097\/00005768-200110000-00020","volume":"33","author":"SA Hawkins","year":"2001","unstructured":"Hawkins SA, Marcell TJ, Victoria Jaque S, Wiswell RA. A longitudinal assessment of change in VO2max and maximal heart rate in master athletes. Med Sci Sports Exerc. 2001Oct;33(10):1744\u201350. https:\/\/doi.org\/10.1097\/00005768-200110000-00020.","journal-title":"Med Sci Sports Exerc"},{"key":"2483_CR38","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph191711050","volume":"19","author":"J Burtscher","year":"2022","unstructured":"Burtscher J, Strasser B, Burtscher M, Millet GP. The impact of training on the loss of cardiorespiratory fitness in aging masters endurance athletes. Int J Environ Res Public Health. 2022;19:11050. https:\/\/doi.org\/10.3390\/ijerph191711050.","journal-title":"Int J Environ Res Public Health"},{"key":"2483_CR39","doi-asserted-by":"publisher","DOI":"10.1016\/j.freeradbiomed.2025.11.043","author":"NR Lazarus","year":"2025","unstructured":"Lazarus NR, Harridge SDR. Exercise and functional integrity in non-disease and disease states during human ageing: the relevance of VO2max. Free Radic Biol Med. 2025. https:\/\/doi.org\/10.1016\/j.freeradbiomed.2025.11.043.","journal-title":"Free Radic Biol Med"},{"key":"2483_CR40","doi-asserted-by":"publisher","unstructured":"Betik AC, Hepple RT. Determinants of VO\u2082max decline with aging: an integrated perspective. Appl Physiol Nutr Metab. 2008;33(1):130\u201340.\u00a0https:\/\/doi.org\/10.1139\/H07-174.","DOI":"10.1139\/H07-174"},{"issue":"5","key":"2483_CR41","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1161\/CIRCULATIONAHA.105.545459","volume":"112","author":"JL Fleg","year":"2005","unstructured":"Fleg JL, Morrell CH, Bos AG, Brant LJ, Talbot LA, Wright JG, et al. Accelerated longitudinal decline of aerobic capacity in healthy older adults. Circulation. 2005;112(5):674\u201382. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.105.545459.","journal-title":"Circulation."},{"issue":"11","key":"2483_CR42","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1164\/rccm.2202033","volume":"166","author":"XG Sun","year":"2002","unstructured":"Sun XG, Hansen JE, Garatachea N, Storer TW, Wasserman K. Ventilatory efficiency during exercise in healthy subjects. Am J Respir Crit Care Med. 2002;166(11):1443\u20138. https:\/\/doi.org\/10.1164\/rccm.2202033.","journal-title":"Am J Respir Crit Care Med"},{"issue":"5","key":"2483_CR43","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1007\/s00421-006-0375-6","volume":"99","author":"K Sanada","year":"2007","unstructured":"Sanada K, Kuchiki T, Miyachi M, McGrath K, Higuchi M, Ebashi H. Effects of age on ventilatory threshold and peak oxygen uptake normalised for regional skeletal muscle mass in Japanese men and women aged 20\u201380 years. Eur J Appl Physiol. 2007;99(5):475\u201383. https:\/\/doi.org\/10.1007\/s00421-006-0375-6.","journal-title":"Eur J Appl Physiol."},{"key":"2483_CR44","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.1183\/13993003.00347-2016","volume":"48","author":"MA Roman","year":"2016","unstructured":"Roman MA, Rossiter HB, Casaburi R. Exercise, ageing and the lung. Eur Respir J. 2016;48:1471\u201386. https:\/\/doi.org\/10.1183\/13993003.00347-2016.","journal-title":"Eur Respir J."},{"issue":"3","key":"2483_CR45","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1139\/h96-015","volume":"21","author":"PD Chilibeck","year":"1996","unstructured":"Chilibeck PD, Paterson DH, Petrella RJ, Cunningham DA. The influence of age and cardiorespiratory fitness on kinetics of oxygen uptake. Can J Appl Physiol. 1996;21(3):185\u201396. https:\/\/doi.org\/10.1139\/h96-015.","journal-title":"Can J Appl Physiol."},{"key":"2483_CR46","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1007\/s11357-024-01245-6","volume":"47","author":"M Briand","year":"2025","unstructured":"Briand M, Raffin J, Gonzalez-Bautista E, et al. Body composition and aging: cross-sectional results from the INSPIRE study in people 20 to 93 years old. GeroScience. 2025;47:863\u201375. https:\/\/doi.org\/10.1007\/s11357-024-01245-6.","journal-title":"Geroscience"},{"key":"2483_CR47","doi-asserted-by":"publisher","unstructured":"Bauer J, Biolo G, Cederholm T, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc. 2013;14:542\u201359.\u00a0https:\/\/doi.org\/10.1016\/j.jamda.2013.05.021.","DOI":"10.1016\/j.jamda.2013.05.021"},{"key":"2483_CR48","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.clnu.2018.05.024","volume":"38","author":"D Volkert","year":"2019","unstructured":"Volkert D, Beck AM, Cederholm T, et al. ESPEN guideline on clinical nutrition and hydration in geriatrics. Clin Nutr. 2019;38:10\u201347. https:\/\/doi.org\/10.1016\/j.clnu.2018.05.024.","journal-title":"Clin Nutr."},{"issue":"3","key":"2483_CR49","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1007\/s11357-012-9409-7","volume":"35","author":"H Degens","year":"2013","unstructured":"Degens H, Maden-Wilkinson TM, Ireland A, et al. Relationship between ventilatory function and age in master athletes and a sedentary reference population. Age (Dordr). 2013;35(3):1007\u201315. https:\/\/doi.org\/10.1007\/s11357-012-9409-7.","journal-title":"Age (Dordr)"},{"key":"2483_CR50","doi-asserted-by":"publisher","unstructured":"Johnson JL, Duick DS, Chui MA, Aldasouqi SA. Identifying prediabetes using fasting insulin levels. Endocr Pract. 2010;16(1):47\u201352.\u00a0https:\/\/doi.org\/10.4158\/EP09031.OR.","DOI":"10.4158\/EP09031.OR"},{"issue":"2","key":"2483_CR51","doi-asserted-by":"publisher","first-page":"152","DOI":"10.3390\/clockssleep5020014","volume":"5","author":"L Solis-Navarro","year":"2023","unstructured":"Solis-Navarro L, Masot O, Torres-Castro R, Otto-Y\u00e1\u00f1ez M, Fern\u00e1ndez-Jan\u00e9 C, Sol\u00e0-Madurell M, et al. Effects on sleep quality of physical exercise programs in older adults: a systematic review and meta-analysis. Clocks Sleep. 2023;5(2):152\u201366. https:\/\/doi.org\/10.3390\/clockssleep5020014.","journal-title":"Clocks Sleep"},{"issue":"6","key":"2483_CR52","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.1152\/japplphysiol.00798.2022","volume":"135","author":"G Carrick-Ranson","year":"1985","unstructured":"Carrick-Ranson G, Howden EJ, Brazile TL, et al. Effects of aging and endurance exercise training on cardiorespiratory fitness and cardiac structure and function in healthy midlife and older women. J Appl Physiol. 2023;135(6):1215\u201335. https:\/\/doi.org\/10.1152\/japplphysiol.00798.2022.","journal-title":"J Appl Physiol"},{"issue":"2","key":"2483_CR53","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1161\/CIRCRESAHA.125.325526","volume":"137","author":"MY Mi","year":"2025","unstructured":"Mi MY, Perry AS, Krishnan V, Nayor M. Epidemiology and cardiovascular benefits of physical activity and exercise. Circ Res. 2025;137(2):120\u201338. https:\/\/doi.org\/10.1161\/CIRCRESAHA.125.325526.","journal-title":"Circ Res."},{"issue":"21","key":"2483_CR54","doi-asserted-by":"publisher","first-page":"1874","DOI":"10.1093\/eurheartj\/ehad170","volume":"44","author":"PL Valenzuela","year":"2023","unstructured":"Valenzuela PL, Ruilope LM, Santos-Lozano A, Wilhelm M, Kr\u00e4nkel N, Fiuza-Luces C, et al. Exercise benefits in cardiovascular diseases: from mechanisms to clinical implementation. Eur Heart J. 2023;44(21):1874\u201389. https:\/\/doi.org\/10.1093\/eurheartj\/ehad170.","journal-title":"Eur Heart J"},{"issue":"14","key":"2483_CR55","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1136\/bjsports-2018-099099","volume":"53","author":"S Nordengen","year":"2019","unstructured":"Nordengen S, Andersen LB, Solbraa AK, Riiser A. Cycling is associated with a lower incidence of cardiovascular diseases and death: part 1 \u2013 systematic review of cohort studies with meta-analysis. Br J Sports Med. 2019;53(14):870\u20138. https:\/\/doi.org\/10.1136\/bjsports-2018-099099.","journal-title":"Br J Sports Med"},{"issue":"7","key":"2483_CR56","doi-asserted-by":"publisher","first-page":"1439","DOI":"10.1007\/S40279-021-01452-7","volume":"51","author":"Y Zhao","year":"2021","unstructured":"Zhao Y, Hu F, Feng Y, et al. Association of cycling with risk of all-cause and cardiovascular disease mortality: a systematic review and dose\u2013response meta-analysis of prospective cohort studies. Sports Med. 2021;51(7):1439\u201348. https:\/\/doi.org\/10.1007\/S40279-021-01452-7.","journal-title":"Sports Med."},{"issue":"3","key":"2483_CR57","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1016\/J.JACC.2015.11.034","volume":"67","author":"TMH Eijsvogels","year":"2016","unstructured":"Eijsvogels TMH, Molossi S, Lee DC, et al. Exercise at the extremes: the amount of exercise to reduce cardiovascular events. J Am Coll Cardiol. 2016;67(3):316\u201329. https:\/\/doi.org\/10.1016\/J.JACC.2015.11.034.","journal-title":"J Am Coll Cardiol"},{"issue":"5","key":"2483_CR58","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/J.JACC.2014.11.023","volume":"65","author":"P Schnohr","year":"2015","unstructured":"Schnohr P, O\u2019Keefe JH, Marott JL, et al. Dose of jogging and long-term mortality: the Copenhagen City Heart Study. J Am Coll Cardiol. 2015;65(5):411\u20139. https:\/\/doi.org\/10.1016\/J.JACC.2014.11.023.","journal-title":"J Am Coll Cardiol"},{"issue":"28","key":"2483_CR59","doi-asserted-by":"publisher","first-page":"2737","DOI":"10.1093\/EURHEARTJ\/EHAB095","volume":"42","author":"G Parry-Williams","year":"2021","unstructured":"Parry-Williams G, Gati S, Sharma S. The heart of the ageing endurance athlete: the role of chronic coronary stress. Eur Heart J. 2021;42(28):2737\u201344. https:\/\/doi.org\/10.1093\/EURHEARTJ\/EHAB095.","journal-title":"Eur Heart J."},{"issue":"5","key":"2483_CR60","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1001\/JAMACARDIO.2020.0054","volume":"5","author":"TW Churchill","year":"2020","unstructured":"Churchill TW, Groezinger E, Kim JH, et al. Association of ascending aortic dilatation and long-term endurance exercise among older masters-level athletes. JAMA Cardiol. 2020;5(5):522\u201331. https:\/\/doi.org\/10.1001\/JAMACARDIO.2020.0054.","journal-title":"JAMA Cardiol"},{"issue":"23","key":"2483_CR61","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1093\/EURHEARTJ\/EHV090","volume":"36","author":"S Sharma","year":"2015","unstructured":"Sharma S, Merghani A, Mont L. Exercise and the heart: the good, the bad, and the ugly. Eur Heart J. 2015;36(23):1445\u201353. https:\/\/doi.org\/10.1093\/EURHEARTJ\/EHV090.","journal-title":"Eur Heart J"},{"issue":"26","key":"2483_CR62","doi-asserted-by":"publisher","first-page":"2388","DOI":"10.1093\/EURHEARTJ\/EHAD152","volume":"44","author":"R De Bosscher","year":"2023","unstructured":"De Bosscher R, Dausin C, Claus P, et al. Lifelong endurance exercise and its relation with coronary atherosclerosis. Eur Heart J. 2023;44(26):2388\u201399. https:\/\/doi.org\/10.1093\/EURHEARTJ\/EHAD152.","journal-title":"Eur Heart J."}],"container-title":["GeroScience"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11357-026-02483-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11357-026-02483-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11357-026-02483-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T22:03:39Z","timestamp":1790546619000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11357-026-02483-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":62,"alternative-id":["2483"],"URL":"https:\/\/doi.org\/10.1007\/s11357-026-02483-6","relation":{},"ISSN":["2509-2723"],"issn-type":[{"value":"2509-2723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]},"assertion":[{"value":"30 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}