Jackson Fyfe, PhD
@jacksonfyfe
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I talk about exercise, ageing, and healthspan | Senior Lecturer in Exercise Science @DeakinIPAN | 15+ years in exercise research and education
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Exercise is about more than just fitness or aesthetics.
It’s what it means for our ability to stay independent for longer.
Here’s the cardiorespiratory fitness (VO2peak) needed for common daily activities.
Once our fitness drops below these thresholds, we can no longer
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Inactivity with hospitalisation is disastrous for physical function in older adults.
So much so that >30% of older adults leave hospital unable to do at least one activity of daily living they could do independently beforehand.
But it doesn’t take much activity to offset these
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1K
3 sets of repeated chair stands (5 or 10 reps per set), 3 times per week.
Sound feasible?
Over 8 weeks, this was enough to improve:
Muscle thickness: ⬆️8-9%
Muscle quality index: ⬆️40-45%
Relative sit-to-stand power: ⬆️29-38%
Resistance training doesn’t have to be fancy to be
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Exercise can reverse the trajectory of physical performance with ageing.
Here’s the difference a single year of exercise (mixed aerobic/strength/balance/flexibility) can make in older adults aged ~73:
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Physical inactivity and sedentary behavior increase the risk of metabolic and endocrine diseases.
Those who are physically inactive are:
1.75x more likely to develop cardiovascular disease
1.4x more likely to develop dementia
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Resistance training “works” in older adults.
But are the benefits less in the "oldest old" (85+)?
After 12 weeks of whole-body resistance training, older adults aged 85+ had similar gains in muscle size, strength, and functional performance to those aged 65-75 years.
It’s
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Muscle and brain health are closely linked.
New data suggests:
Males (aged ~67) who lost more muscle over a 4-year period had faster declines in cognitive function:
Older adults aged 65+ with sarcopenia had 2.4x greater risk of dementia:
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With fitness, it’s easy to get hung up on constant improvement.
But even maintaining fitness is a win - because we’re actively offsetting any losses that would otherwise occur.
And it doesn’t take much:
- 2 x aerobic training sessions per week (12-26 min per session) can
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“My job is physical, so I get enough activity.”
Work-related physical activity is not equal to leisure-time physical activity when it comes to cardiovascular health benefits.
The so-called “physical activity paradox”:
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How much resistance training is needed to reverse two decades’ worth of strength loss?
1 set of 6 repetitions
5 multi-joint exercises
12-15 minutes per session
Just 1-2 sessions per week
Over 12-19 weeks, strength gains (load progression per exercise):
Leg press: ⬆️38-59%
Pull
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Resistance training: a potent tool for enhancing muscle size and function.
And it doesn’t need to be fancy or extensive to be effective.
Our review of minimal-dose resistance training approaches in
@SportsMedicineJ
:
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We’re told to exercise because it’s “good for us”.
But are health benefits enough incentive for most people to exercise regularly?
Truth is, most health benefits associated with exercise are both time-delayed and intangible.
And both of these factors tend to devalue these
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Does lifelong exercise influence body composition?
Older endurance, sprint, and strength-trained athletes (aged 70-89) each had higher appendicular lean mass than healthy age-matched inactive controls.
But - lean mass was better preserved with lifelong strength training versus
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We know exercise can be impactful - particularly in the context of ageing.
Here’s the difference just 1 year of exercise can make for the physical function of older adults (aged 70+).
A decision to be more physically active can be a true “sliding doors” moment for physical
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Busting 3 common “muscle myths” with exercise training:
1/ Go big or go home
Many believe lifting heavy weights are mandatory for building muscle.
But - muscle growth is possible with a variety of loads and repetition ranges:
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A concept that’s completely shifted my views on exercise for healthy ageing:
"Strengthspan".
The importance of strength across ALL life stages.
Because although it’s never too late to improve our strength, it’s also important to set the foundations as early as possible.
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A lot of emphasis is placed on the “optimal” dose of exercise.
Chasing “optimal” isn’t necessarily a bad thing. But, this just isn’t feasible for most. And too often, the alternative to is no activity at all.
With ageing, a key goal is achieving the minimum exercise dose needed
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Strength loss with ageing is muscle group-specific.
Loss of strength is greatest in:
- Lower-body vs. upper-body muscles
- Stabilisers vs. prime movers
(e.g., hip abductors/adductors vs. knee extensors)
Targeting strength
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After 1 year of either home- or gym-based resistance training, only 41% of older adults (>65 yr) managed to keep training over the next 6 months.
But of those who continued, 1 or more session per week was enough to offset losses of muscle mass compared to stopping completely.
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How strong are the strongest older adults?
That’s one takeaway from this analysis of 809,986 powerlifting competition entries.
The strongest (90th percentile) powerlifters aged 80+ had relative strength levels (as multiples of bodyweight) of:
Squat: 1.01x BW (females), 1.72x
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New data showing just eight weeks of supervised resistance training induced large and clinically-meaningful reductions in depressive symptoms in young adults.
According to the authors, these findings support resistance exercise as a promising treatment for mild or subclinical
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Cardiorespiratory fitness: a powerful predictor of morbidity and mortality.
New data combining >20.9 million observations from 199 cohort studies found:
- Higher (compared to lower) aerobic fitness reduced the risk of all-cause mortality by 41-53%
- Each 1-MET (3.5 mL/kg/min)
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Can prehabilitation improve outcomes after surgery in older adults?
This meta-analysis of 16 studies found combined exercise, nutritional, and psychological prehabilitation (before abdominal surgery):
- Reduced the risk of severe complications (by 44%)
- Decreased length of
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Muscle and bone are closely linked.
Age-related loss of muscle (sarcopenia) and bone (osteoporosis) are both independently related to loss of physical function and independence into older age.
Great review by
@csmithAEP
and colleagues showcasing the many links between muscle
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Resistance training ain’t just good for our (skeletal) muscles.
Updated guidelines from the American Heart Association summarise:
- The benefits of resistance training on cardiovascular risk factors
- The utility of resistance training for cardiovascular health in clinical
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Is cycling enough to stimulate muscle growth in older men?
➖20–45 min per session
➖60%–80% heart rate reserve
➖3–4 sessions per week
After 12 weeks, VO2max increased by +13%.
But changes in muscle size were variable.
Some got bigger:
➖ Vastii +7%, Sartorius +6%
Others
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Can traditional resistance training improve functional task performance in older adults?
Or is more “task-specific” training required?
Here, 6 weeks of traditional resistance training improved dynamic (5-RM) strength, but had limited carryover to functional task performance
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Resistance training ain't all about muscle health.
Just 12 weeks (2 sessions per week) of high-velocity resistance training improved executive function (including working memory, attention, and cognitive flexibility) in mobility-limited older adults.
Improvements in maximal
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Muscle mass is important.
But muscle function is arguably more important.
Particularly when it comes to maintaining our physical independence for longer.
This study found older adults who had low muscle function (assessed via sit-to-stand test) alone were at a much greater
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Muscle loss with ageing is accompanied by a loss of the faster and larger type II muscle fibres.
But can lifelong strength training offset these effects?
This new study found strength-trained masters athletes (aged 70+) had less muscle fibre atrophy - and fewer markers of type
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What’s the “best” type of resistance training?
“All combinations of load, sets, and weekly frequency improved strength, muscle mass, and physical function compared to the non-exercising control group”.
For most people, just getting started with resistance training (in a safe
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Exercise protects against age-related declines in physical performance.
A single year of exercise reverses the trajectory of physical function in older adults (aged ~73):
WITHOUT exercise:
- 6-minute walk test: ❌-18.7%
- Chair stands: ❌-24.5%
- Timed up-and-go: ❌-19.4%
WITH
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“Exercise interventions are associated with improved physical function in older adults in residential care, and should, therefore, be routinely promoted in long-term care facilities.”
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By our 30’s, we’re losing about 1% of our aerobic fitness per year.
This accelerates to 2-3% per year by our 50’s.
So, what aerobic exercise intensities are “best” for offsetting these declines?
This review found moderate- and high-intensity aerobic exercise were similarly
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When it comes to muscle loss with ~50 years of ageing, not all muscle groups are affected equally:
Elbow extensors: ⬇️20%
Elbow flexors: ⬇️19%
Paraspinals: ⬇️24%
Psoas: ⬇️29%
Hip adductors: ⬇️13%
Hamstrings: ⬇️19%
Quadriceps: ⬇️27%
Dorsiflexors: ⬇️9%
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We’ve all been there.
Despite our best intentions to be physically active, we don’t take action.
But how prevalent is this “intention-behaviour gap”?
A new analysis in over 26,000 individuals found almost half (47.6%) of “intenders” were unable to follow through with their
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“Exercise snacks”: a promising alternative to structured exercise.
But does the evidence match the hype?
New scoping review of 32 studies found exercise snacks (with bouts ranging from 15 sec - 10 min) and other forms intermittent physical activity:
✅ Are feasible and safe in
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Sure, resistance training “works” in older adults.
But is this true even in the “oldest old“ (aged 85+)?
After 12 weeks of resistance training, older adults aged 85+ had similar gains in muscle size, strength, and functional performance to those aged up to 20 years younger
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Any amount of weight training reduces mortality risk.
A key conclusion of this new analysis of 216,000 American older adults followed between 2004-05 and 2019.
Compared with those who did none, any amount of weight training was associated with a:
- 6% lower risk of all-cause
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Want to build muscle, but don’t like lifting all the way to “failure”?
Good news: you don’t have to.
Stopping sets 1-2 reps before failure results in similar muscle growth to reaching failure over 8 weeks.
Our latest study led by
@MartinRefalo
and team.
@DeakinIPAN
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Another win for resistance exercise for combatting sarcopenia.
Resistance exercise trumps 6 interventions for improving strength, muscle mass, and physical function:
Aerobic exercise
Mixed exercise
Nutrition only
Resistance + nutrition
Mixed exercise + nutrition
Electrical
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How much physical activity is linked to better cardiometabolic health?
The largest study of its kind (in >12,000 people) found:
- 64 min/day walking
- 5 min/day stair climbing
- And any amount of running
Were all associated with more favourable cardiometabolic risk profiles.
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Resistance training with machines can be a simpler alternative to free weights.
But a common argument is machines aren’t “functional” enough.
So - does resistance training with machines improve functional capacity in older adults?
This new systematic review and meta-analysis
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Resistance training builds muscle - but do males respond differently to females?
Our new meta-analysis (in peer review) led by
@MartinRefalo
found:
- Males on average grow more muscle (in absolute terms)
- But relative changes in muscle size from baseline levels were similar
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Why does our physical performance decline as we age?
Spoiler alert: it’s more than just muscle loss.
Changes to mutiple systems contribute:
- Muscular
- Nervous
- Skeletal
And these systems are directly and indirectly influenced by various lifestyle, biological, and
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With ageing, it’s muscle power that suffers the most.
And much more so than strength or muscle mass.
Here’s the decline in these outcomes over just 3 years in older adults (aged ~77) with impaired mobility.
The good news is it’s never too late to reclaim these losses.
My take
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Holiday periods: a great time to switch to maintenance mode with exercise.
So how much training is required to maintain fitness?
This paper has some insights:
Aerobic training twice per week can maintain endurance (if exercise intensity/heart rate is maintained) for up to 15
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Muscle power: arguably our most important physical capacity with ageing.
To improve power with resistance training, we should attempt to move fast.
But does the load lifted matter?
A new meta-analysis suggests both lighter (≤49% 1-RM) and heavier (≥70% 1-RM) loads can
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Often we focus on the physical benefits of exercise.
But the emotional benefits can be just as (if not more) powerful.
In this study, women reported the wellbeing benefits of gym-based resistance training to include:
- Social affiliation
- Feelings of “flow”
- Building
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More weight or more reps for building muscle and strength?
Early in a resistance training program, it doesn’t really matter.
Previously untrained young men and women had similar gains in muscle size and strength when lifting more weight or doing more reps (with the same weight)
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You don’t need to hit failure in the gym to build muscle.
And doing so probably won’t lead to further gains (versus training just shy of failure).
Some of the main conclusions from our meta-analysis led by
@MartinRefalo
as part of his (soon to be submitted) PhD.
A great body
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Interested in pragmatic and time-efficient strength training?
Here are 5 key papers:
1.
2.
3.
4.
5.
More info 👇
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Sedentary behaviour impacts a multitude of physiological systems.
“High volumes of sedentary behaviour can have adverse physiological impacts even in the presence of large volumes of aerobic and/or resistance exercise.”
This reinforces our need to "sit less, move more, and
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The benefits of strength training go well beyond the physical ones.
New meta-analysis of 21 randomised controlled trials in older adults found resistance training:
- Improves depression and anxiety symptoms
- Has benefits regardless of mental health status
- Further benefits
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Even small doses of resistance training can have big benefits.
Some updated evidence on minimal dose resistance training approaches, including:
“Weekend warrior”: a single weekly resistance training session
“Single-set resistance training”: one set of multiple exercises,
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With ageing:
The decline from our “peak” cognitive and physical function is inevitable.
But we can influence:
- The height of the peak
- The rate of decline after the peak
And ultimately delay:
The point where we cross the disability and dependence threshold.
@mackinprof
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Should you take your resistance training sets close to “failure”?
If you want to grow muscle, likely yes.
If you want to get stronger, likely not so much.
From my perspective, this is important because taking sets closer to failure takes more effort and can increase fatigue
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How much exercise can reduce the risk of cardiovascular events in adults (50+) with hypertension?
- As little as 1 session of vigorous physical activity per month
- Just 15 min moderate physical activity per day
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Ageing muscle + inactivity = not a good mix.
Just 6-10 days of inactivity during hospitalisation can reduce leg lean mass by >10%.
Here, multicomponent exercise (2 x 20 min sessions) improved measures of physical and cognitive function in older adults (mean age 87) when
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Aerobic versus resistance training: how do they stack up for health benefits?
Sure, there are some unique benefits to aerobic and resistance training.
But - the overall health benefits are more similar than once thought.
So, do both if you can.
But just getting started (and
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Another win for short but frequent exercise.
In older adults with mild cognitive impairment, 9-minute “exercise snacks” twice per day (over 28 days) was feasible, enjoyable, and showed promising effects on physical function.
Great work from
@MaxJWestern
and co.
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Lifting weights: the gift that keeps on giving?
In 369 participants aged 64-75, just 1 year of supervised heavy resistance training (HRT) was enough to maintain their leg strength 4 years later.
The same effect was not seen with moderate-intensity resistance training (MIT).
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We don’t need more evidence that exercise is beneficial.
We do need more work on how to translate this evidence into practice.
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Sarcopenia and type 2 diabetes share a bidirectional relationship.
Both resistance and aerobic exercise, with appropriate nutritional support, can benefit these conditions.
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Strength and physical function predict adverse outcomes with ageing.
New data from 1396 men and women (~69 years of age) followed over 14.5 years showed:
1) Men with low quadriceps strength (<0.39 kg/m2 scaled to BMI) at baseline were 3x more likely to die
2) Women with slower
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Are moderate resistance training intensities (loads) “enough” to improve components of sarcopenia in older adults?
Both moderate (~50-69% 1-RM) and moderate-vigorous (~70-84% 1-RM) resistance training improved muscle strength and markers of physical function (30-s chair stand
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When we start exercising, the biggest challenge is staying on track.
So what can we learn from those who do - and don’t - keep going?
Interviews of 20 new runners - 10 who stopped and 10 who continued for 6-12 months - revealed:
- Having a meaningful “why” helped participants
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No time for a ‘full’ exercise session?
It’s fine to spread out your exercise throughout the day.
And in some cases it might even increase the benefits.
“Collectively our findings suggest that adults are likely to accrue similar health benefits from exercising in a single bout
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Resistance training: our best “tool” for preserving strength as we age.
But many barriers prevent older adults engaging in resistance training - particularly those with multiple long-term conditions and frailty.
A new study found many of these older adults:
- Know little about
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Many of us struggle to carve out time for exercise.
Here’s 5 papers on the benefits of "snacking” on bite-sized activity instead:
1.
2.
3.
4.
5.
👇
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The benefits of lifting weights go beyond bigger and stronger muscles.
Across 10 trials in 376 younger participants aged 11-26, resistance training had large positive effects on both depression and anxiety symptoms.
These benefits were seen after 12-20 weeks of training (2-3
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Muscle power: arguably our most critical physical capacity as we age.
With aging, power declines faster than strength and is more closely associated with physical function and adverse outcomes.
This meta-analysis found resistance training with fast velocities (or “power
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Resistance training + protein: a good combo for muscle.
But how much does protein increase the benefits of resistance training?
The answer is probably less than many think.
In healthy adults, increasing daily protein intake did further increase lower-body strength and lean
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Strength training can boost aerobic fitness in older adults.
Meta-analysis of 37 studies suggests short-term resistance training (24 weeks or less) improves:
- Cardiorespiratory fitness (VO2peak): +1.89 ml/kg/min
- Anaerobic threshold: +1.27 ml/kg/min
- 6-minute walk test:
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Changes in muscle over the lifespan aren’t “just ageing”.
Over 10 years, masters sprinters aged 40-85 had no changes in:
- Muscle fibre size (type I or type II)
- Fibre composition (amount of type I vs. type II fibres)
- Fibre grouping or shape (signs of motorneuron loss)
Yet
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With ageing, muscles don’t just get smaller.
Their very composition changes as well.
And this has big implications for our ability to perform daily tasks, independence, and quality of life.
But some older adults have shown it’s possible to turn the tables on muscle ageing:
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Do I need to leave 2-3 days between resistance training sessions?
Well, not necessarily.
Non-strength trained males who trained on 3 consecutive days per week had similar improvements in strength and body composition (after 12 weeks) to those leaving 48-72 hours between
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How does ageing and physical activity affect our mitochondria?
And how do these mitochondrial changes impact physical function (and sarcopenia) across the lifespan?
Great review from
@matt_lee1
@BlueSpotScience
and colleagues!
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Are you working to maximise your “strengthspan”?
It's important to expand strengthspan with resistance training across each life stage:
- Childhood: START strong
- Adulthood: BE strong
- Old age: STAY strong
“Strengthspan-centred actions will add life to years and not just
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No time to lift? A great paper from
@BradSchoenfeld
and co. outlines how to make strength training more time efficient:
So what are the key takeaways? A short 🧵:
(1/7)
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With exercise, more is not always better.
Take the effects of resistance training on physical function in older adults for example.
A new review of studies in frail and pre-frail older adults found:
- Just 2 sessions per week was enough to improve Short Physical Performance
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An easy way to save time in the gym?
Superset your exercises.
The same 6 exercises (4 sets of each) either done:
- 1 exercise at a time (2 min rest between sets)
OR
- With alternating supersets of 2 exercises with 2 min rest between supersets
The result over 8 weeks?
Same
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Training our muscles can keep our brain in shape as well.
How the “muscle-brain axis” is key to keeping us both physically and mentally healthy as we age:
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Exercise in Octogenarians: How Much Is Too Little?
🏃♀️As little as 75 min of moderate-intensity activity per week can improve VO2max by 7%.
🏋️♂️A single weekly session of high-intensity resistance training can improve maximum strength by >35%.
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Sarcopenia and cardiovascular disease: a bidirectional relationship.
Muscle loss with ageing isn't all about loss of strength and physical function.
“Early recognition of sarcopenia is important because it can provide an opportunity for interventions to reverse or delay the
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Is brief but more frequent resistance training better for strength gain?
This new study says yes.
Strength gain was greater when the same amount of resistance training was spread over 4 sessions versus doing all in a single session.
Changes in muscle thickness and jump height
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Take the stairs to boost your VO2max?
Inactive adults who did 3 bouts of “all-out” stair climbing (6 flights in ~30-seconds) on 3 days per week improved their VO2max by 7% after 6 weeks.
Simple (and not easy), but effective.
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Walking speed is a strong predictor of overall health.
So much so it’s known as the “6th vital sign”.
And strength (grip strength) is one of the best predictors of slow walking speed.
New work from Jesse Zanker,
@DavidScottPhD
,
@DrBenKirk
,
@DrGustavoDuque
et al.
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Resistance exercise preserves muscle during inactivity.
Even when muscle is ‘primed’ with resistance exercise prior to a short-term disuse event.
Older adults who did a single bout of unilateral resistance exercise before 5 days of bed rest - akin to a typical inpatient
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Which hip-focused exercises elicit the highest gluteal muscle forces?
G maximus: Loaded (L) split squat, L single-leg RDL, L single-leg hip thrust
G medius: BW side plank, L single-leg squat, L single-leg RDL
G minimus: L single-leg RDL, BW side plank
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Big weights aren’t mandatory for bigger muscles.
A reminder that muscle growth is similar across a wide range of loads - both light and heavy.
But if the goal is to maximise strength, heavier loads are best.
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With muscle disuse, the “functional” aspects of fitness suffer the most.
These include VO2max and muscle strength.
This analysis of 47 studies found muscle strength declined 2.5 times more than muscle mass with disuse (mainly bed rest of between 5 to 84 days).
This suggests:
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2 bodyweight exercises
3 sets of 10-15 reps (either slow or fast)
3 times per week
All done at home with no equipment.
Simple, right?
Here’s the changes after 8 weeks (in males aged 65-88):
Muscle power: +12% (slow) to +24% (fast)
Muscle size (volume index): +16% (fast group
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Strength training confers unique health benefits.
Engaging in strength-promoting exercise was linked with:
- ⬇️ 23% reduction in all-cause mortality
- ⬇️ 31% reduction in cancer mortality
Meeting both aerobic and muscle strengthening guidelines further reduced mortality risk
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The best time to exercise?
Any time you can.
“The current state of research provides evidence neither for nor against a specific time of the day being more beneficial, but provides evidence for larger effects when there is congruency between training and testing times.”
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A gentle reminder that if you want to improve your resistance training performance:
Rest more between your sets.
Doing so allows more force to be produced and more volume to be completed.
And as a result, your strength and possibly your muscle mass may improve more than with
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Are “split” resistance training programs more effective than full-body routines?
- Split = specific muscle groups trained per session
- Full body - all/most muscle groups trained
Many believe they are - especially once a certain training status is attained.
But this new
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Physical activity reduces functional decline and adverse events in hospitalised older adults.
Just 25 minutes per day of slow walking or daily activities (e.g., sit-to-stands) may have benefits.
But as always, the key challenge is the implementation of such exercise/activity
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We often think of age-related muscle loss as a gradual process.
But in reality, muscle loss is periodically accelerated by short-term ‘disuse’ events (due to illness, injury, poor weather, etc.).
Even brief periods of inactivity can worsen physical function and metabolic
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If current physical inactivity levels remain unchanged by 2030, what are the impacts on global disease burden and direct healthcare costs?
The answer:
499.2 million new cases of preventable major non-communicable diseases globally, with direct healthcare costs of INT$520
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