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April 23, 2026GeroScience0 citationsOpen Access

Decline in cardiorespiratory fitness and its association with vascular aging and subclinical atherosclerosis in healthy older adults: a 3-year longitudinal study

VGVincent GroesserJustus-Liebig-Universität GießenCWChristopher WeyhJustus-Liebig-Universität GießenTFTorsten FrechJustus-Liebig-Universität Gießen

Key Result

Participants who developed new subclinical atherosclerosis over 3 years experienced a significantly greater decline in cardiorespiratory fitness (-3.70 ml/min/kg) compared to plaque-free individuals.

Key Points

  • This study investigates the relationship between cardiorespiratory fitness and vascular aging in healthy older adults over three years.
  • Forty-nine older adults underwent vascular and echocardiographic assessments at baseline and three years later.
  • Participants were categorized based on carotid plaque status to assess changes in cardiovascular parameters and muscle strength.
  • Cardiorespiratory fitness was measured using spiroergometry to determine VO2 peak.
  • Cardiorespiratory fitness and muscle strength declined significantly over three years.
  • Participants with newly developed atherosclerosis experienced the most drastic decline in fitness levels.
  • Changes in fitness were linked to increases in blood pressure, suggesting a connection between fitness and vascular health.

Study Design

Type

Observational (n=49)

Multicenter

No

Structured PICO

Does a decline in cardiorespiratory fitness associate with vascular aging and subclinical atherosclerosis in healthy older adults over a 3-year period?

P
Population
49 healthy older adults (30 men, 19 women), mean age 63.8 ± 3.8 years, based in Germany. Key inclusion: free of acute or chronic disease and reported no regular medication use.
O
Outcome
3-year changes in vascular parameters (blood pressure, pulse wave velocity, augmentation index), echocardiographic parameters, cardiorespiratory fitness (VO2peak), and muscle strengthsurrogate

In healthy older adults, preservation of cardiorespiratory fitness over a 3-year period is associated with more favorable vascular aging profiles and a lower prevalence of newly developed subclinical atherosclerosis.

Main Result

p-value: p=0.012

Limitations

  • Cohort consisted of healthy, medication-free older adults with above-average fitness, limiting generalizability to broader populations
  • Physical activity was assessed by self-report using the IPAQ questionnaire, which may be subject to recall bias
  • Incomplete follow-up data preclude a clear separation of physiological aging effects from lifestyle-related influences

Abstract

Abstract Aging is associated with progressive deterioration of vascular function and cardiovascular risk. Cardiorespiratory fitness (CRF) is closely associated with cardiovascular health, yet longitudinal data in healthy older adults remain limited. This study examined 3-year changes in vascular and echocardiographic parameters in older adults and their associations with CRF and muscle strength. Forty-nine participants (mean age 63.8 ± 3.8 years) underwent vascular assessments (brachial/central blood pressure (BP), pulse wave velocity (PWV), augmentation index), echocardiography, CRF testing via spiroergometry to determine VO 2 peak, muscle strength testing, and carotid sonography at baseline and after 3 years. Participants were grouped by carotid plaque status: no atherosclerosis, existing atherosclerosis, or newly developed atherosclerosis. Over 3 years, CRF and muscle strength (grip strength, leg flexion) declined significantly (all p 90% of baseline VO 2 peak had significantly smaller BP increases. These results indicate that vascular aging progresses measurably within a few years in clinically healthy older adults and is associated with declines in CRF and muscle strength. Preservation of CRF is linked to more favorable vascular aging profiles and a lower prevalence of newly developed atherosclerosis. Graphical Abstract

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Cite This Study

Groesser et al. (2026) conducted an observational in Healthy older adults (n=49). Cardiorespiratory fitness (VO2peak) decline vs. Baseline vs 3-year follow-up was evaluated on Changes in vascular parameters and subclinical atherosclerosis (p=0.012). Participants who developed new subclinical atherosclerosis over 3 years experienced a significantly greater decline in cardiorespiratory fitness (-3.70 ml/min/kg) compared to plaque-free individuals.

synapsesocial.com/papers/69e9ba6b85696592c86ec93ehttps://doi.org/10.1007/s11357-026-02261-4
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