Decades of aerobic exercise may help older adults age with more resilience

edited by Gaby Clark, reviewed by Robert Egan

Doctors have long recommended investing in physical health for its potential long-term benefits, especially as we age. Over 30 years, regular exercise might help preserve our functional ability.

A recent study published in GeroScience explored what happens to the body after decades of regular aerobic exercise. Researchers looked at whether activities like running, cycling and swimming can help older adults maintain their vitality capacity, or the body's physiological reserve.

The concept of vitality capacity came into focus after the United Nations declared 2021–2030 the Decade of Healthy Ageing in 2015, shifting attention toward a broader definition of healthy aging. Rather than simply tracking illness, the focus turned to preserving functional ability, or an older person's capacity to do the things they value. Vitality capacity is often assessed using biomarkers across three key areas: immune and stress response, energy and metabolism, and neuromuscular function.

In their study, the researchers compared adults who had done structured aerobic exercise at least three times a week for the past 30 years with adults who had led mostly sedentary lives. They found that maintaining an aerobic exercise routine was associated with higher vitality capacity in older adults, particularly in immune and stress response. Active adults had better blood oxygen levels at rest and higher heart rate variability, both strong indicators of the ability of the heart and nervous system to adapt to the body's changing demands.

Aging and aerobic exercise

Decades of research make one thing clear: Older adults who stay physically active age better. They tend to live longer, have longer telomeres—which are linked to cellular aging—and show healthier inflammation levels than those who aren't regularly active.

Among the different types of activity, aerobic exercise stands out. It has long been associated with a longer life and better heart, lung and metabolic health. What remained less clear was whether decades of running, cycling or swimming could also help preserve the body's overall vitality as we age. Few studies have directly examined the relationship between long-term aerobic exercise and total vitality capacity in humans. Many previous studies omitted immune and stress response, one of the three core domains outlined by the WHO.

To address that gap, researchers created a balanced scoring model that gave equal weight to all three domains using all 12 WHO-recommended biomarkers. They then conducted a cross-sectional comparison to examine how 30 years of regular aerobic exercise may relate to an individual's physiological reserve. The study included 39 healthy adults over 55 years old—19 active and 20 inactive participants from the Nice metropolitan area in France. To help isolate the relationship between exercise and vitality capacity, the researchers included only participants who were free from chronic illness or acute inflammation and were not taking regular medications.

Over three visits, researchers built a detailed picture of each participant's health and physical fitness. They documented 30 years of exercise habits, analyzed blood samples for metabolic markers, measured heart-related markers and used DXA scans to assess lean muscle percentage. Participants also performed endurance and muscle strength tests. Together, these measurements were used to calculate each participant's 12-biomarker vitality capacity score.

Does exercise help preserve our physiological reserve?

The active group came out ahead on overall vitality. After more than 30 years of regular aerobic exercise, these older adults had higher vitality capacity than their inactive peers, with a 0.2 z-score difference. Age still mattered, however: Vitality capacity declined as people got older, regardless of their level of physical activity.

The most significant difference appeared in immune and stress response, where the active group scored significantly higher. Yet when researchers looked at individual measures such as blood inflammation and self-reported immune health, the two groups looked much the same.

Neuromuscular function, including handgrip strength, leg strength and lung capacity, accounted for the largest differences in vitality capacity between individuals. At the group level, however, researchers observed no significant difference.

Overall, energy and metabolism scores were similar between the two groups, but active women had significantly more lean muscle and less body fat than inactive women.

The findings give us another reason to see exercise as an investment in healthier aging, not just a way to lose or control weight. The researchers noted that because the study was exploratory, this scoring model cannot establish whether aerobic exercise causes vitality capacity to be maintained over the years. Larger, more diverse studies are needed to test whether the vitality score works across different populations.