A supervised 12-week intervention of time-matched aerobic vs resistance versus concurrent exercise training was employed to investigate mode- and time course-specific effects of exercise training in older adults. Community-dwelling men and women (n = 84; M/F, 45/39; 69.3 ± 3.5 years; 26.4 ± 3.8 kg m ) were randomly assigned (n = 21 each) to either non-exercise control (CON), aerobic exercise only (AER), resistance exercise only (RES), or concurrent aerobic and resistance exercise (CEX). Training groups trained three times per week, each performing 72 minutes of active exercise time per week. Body composition, physical and cognitive function, and markers of metabolic health were assessed before (PRE), and after 6 (MID) and 12 (POST) weeks of exercise training. Hand-grip strength, 1RM chest press, and arm LBM were improved by both RES and CEX, but not AER. Aerobic fitness increased in AER and RES, but not CEX. Cognitive function improved in all groups, but occurred earlier (ie, at MID) in AER. CEX improved gait speed and lower limb strength and reduced trunk fat compared to either AER or RES. Leg LBM was unchanged in any group. Temporal patterns were observed as early as 6 weeks of training (gait speed, upper and lower limb strength, aerobic fitness), whereas others were unchanged until 12 weeks (hand-grip strength, timed up-and-go, sit-to-stand). Compared to either aerobic or resistance exercise training alone, concurrent exercise training is as efficacious for improving a range of health-related parameters and is more efficacious for increasing gait speed and lower limb strength, and decreasing trunk fat in older adults.

BACKGROUND/OBJECTIVE Barriers and facilitators of exercise maintenance and residual effects of exercise training intervention on physical and cognitive function after the cessation of training are inadequately described in older adults. DESIGN AND SETTING One year after the cessation of a supervised exercise training intervention, a mixed methods approach employed a quantitative phase that assessed body composition and physical and cognitive function and a qualitative phase that explored determinants of exercise maintenance after participation in the intervention. PARTICIPANTS Community‐dwelling older Irish adults (aged >65 years) who had completed 12 weeks of supervised exercise training 1 year previously. MEASUREMENTS Fifty‐three participants (male/female ratio = 30:23; age = 70.8 ± 3.9 years) completed the follow‐up testing comprising body composition and physical and cognitive function. Semistructured interviews were conducted with 12 participants (male/female ratio = 6:6) using the Theoretical Domains Framework to inform the interview guide. RESULTS At 1 year follow‐up, body fat increased (mean = 4.3%; 95% confidence limit = 2.2% to 6.3%), while lean body mass (mean = −0.6%; 95% confidence limit = −1.2% to −0.1%), strength (leg press, mean = −5.6%; 95% confidence limit = −8.3% to −2.8%; chest press, mean = −11.0%; 95% confidence limit = −14.8% to −7.8%), and cognitive function (mean = −3.7%; 95% confidence limit = −5.7% to −1.8%) declined (all P < .05). Interviews revealed key facilitators (social aspects and beliefs about benefits of exercise) and barriers (affordability and general aversion to gyms) to exercise maintenance in this population. CONCLUSION Key barriers and facilitators to exercise maintenance were identified, which will inform the development of future behavior change interventions to support exercise participation and maintenance in older adults to mitigate adverse changes in body composition and physical and cognitive function with advancing age. J Am Geriatr Soc 68:163–169, 2019

Most studies in older adults have utilized powdered protein supplements or oral nutrition solutions as a source of additional dietary protein, but whole foods may provide a greater anabolic stimulus than protein isolated from food matrices. Therefore, the present study investigated a concurrent aerobic and resistance exercise training program in older adults, in the absence or presence of a high protein whole food-based dietary intervention, for effects on strength, physical function, and body composition. Community-dwelling older adults (n = 56; M/F, 28/28; age, 69.3 ± 4.0 years; BMI, 26.6 ± 3.7 kg m−2) participated in a 12-week intervention after randomization to either nutrition only (NUTR; n = 16), exercise only (EX, n = 19), or nutrition plus exercise (NUTR + EX, n = 21) groups. NUTR and NUTR + EX followed a dietary intervention targeting an increase in protein-rich meals at breakfast, lunch, and dinner. Exercise training in EX and NUTR + EX consisted of 24 min sessions of concurrent aerobic and resistance exercise performed three times per week. Daily protein intake increased in NUTR and NUTR + EX, but not EX. The increase in 1RM leg press strength was greater (Interaction effect, P = 0.012) in NUTR + EX [29.6 (18.1, 41.0) kg] than increases observed in NUTR [11.1 (−1.3, 23.6) kg] and EX [12.3 (0.9, 23.8) kg]. The increase in 1RM chest press strength was greater (interaction effect, P = 0.031) in NUTR + EX [6.3 (4.0, 8.6) kg] than the increase observed in NUTR [2.9 (0.3, 5.5) kg], but not EX [6.3 (3.9, 8.7) kg]. Hand-grip strength and sit-to-stand performance were each improved in all three groups, with no differences observed between groups (interaction effect, P = 0.382 and P = 0.671, respectively). An increase in percentage body fat was observed in NUTR, but not in EX or NUTR + EX (interaction effect, P = 0.018). No between-group differences were observed for change in lean body mass (interaction effect, P = 0.402). Concurrent aerobic and resistance exercise training improves strength and physical function in older adults, but combining this training with an increase in daily protein intake through whole foods may be advantageous to increase lower limb strength.

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Timmons, JF, Hone, M, Duffy, O, and Egan, B. When matched for relative leg strength at baseline, male and female older adults respond similarly to concurrent aerobic and resistance exercise training. J Strength Cond Res 36(10): 2927-2933, 2022-Comparisons between sexes of adaptive responses with concurrent aerobic and resistance exercise training are largely unexplored. A supervised 12-week intervention of concurrent exercise training was used to investigate sex-specific differences, if any, in the response to concurrent exercise training in older adults. Community-dwelling men (n 5 14; 68.0 6 1.8 years; 27.8 6 3.8 kg•m 22 ) and women (n 5 14; 68.9 6 3.8 years; 25.1 6 3.8 kg•m 22 ) were pair-matched for relative leg strength expressed as leg press 1 repetition maximum per kg of leg lean body mass (LBM; assessed by dualenergy X-ray absorptiometry). Subjects undertook 24 minutes of concurrent aerobic (12 minutes) and resistance (12 minutes) exercise training 3 times per week i.e., 72 minutes of active exercise time per week. Muscle strength, physical function, and body composition were assessed before (PRE) and after 12 weeks (POST) of exercise training. The increase in absolute leg press strength was larger in men (mean difference 6 SE, 25.3 6 11.8 kg; p 5 0.041, h 2 p 5 0.156), but when expressed as leg press strength relative to leg LBM, training-induced increases were not different between the sexes (mean difference 6 SE, 0.30 6 0.46 kg•kg 21 ; p 5 0.526, h 2 p 5 0.016). No other measure of muscle strength (hand-grip and chest press), physical function (gait speed, timed-up-and-go, sit-to-stand, and Chester step test), or body composition (LBM and fat mass) differed in response to exercise training for between-sex comparisons. When male and female older adults are pair matched for relative leg strength at baseline before commencing exercise training, sex-specific adaptive responses to concurrent aerobic and resistance exercise training are largely similar for muscle strength, physical function, and body composition.