If older adults can manage only one type of exercise, could resistance training offer the broadest health benefits?

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This paper presents an argument-based discussion of exercise adaptations in older adults. The authors state that optimal health benefits come from meeting both aerobic and muscle-strengthening guidelines, yet most older adults do not exercise, and most of those who do perform only one type of exercise. They suggest that emphasizing a single exercise strategy that maximizes health benefits may be a pragmatic solution.

Accelerating losses of muscle mass and strength are hallmarks of aging and, without intervention, eventually lead to physical disability and loss of independence. Older adults are also at risk of developing several chronic diseases. Activities that maintain or increase muscle mass and strength while decreasing chronic disease risk are therefore essential for healthy aging.

The authors describe a widely held belief that adaptations to aerobic and resistance exercise are independent, so both types are needed for optimal health. They challenge this belief and discuss crossover adaptations from both aerobic and resistance exercise.

Aerobic exercise can increase muscle mass and strength, but not consistently; these effects may be limited to activities that overload a particular muscle group, such as stationary bicycling. In contrast, resistance exercise is effective at maintaining muscle health with increasing age and also has significant effects on cardiovascular disease (CVD) risk factors, type 2 diabetes (T2D), cancer, and mortality.

The authors propose that resistance exercise is the most effective standalone exercise strategy for improving overall health in older adults and should receive greater emphasis in future guidelines.