The effect of age on mechanisms of exercise tolerance: Reduced arteriovenous oxygen difference causes lower oxygen consumption in older people

Amy Fuller, Nduka Okwose, Jadine Scragg, Christopher Eggett, Peter Luke, Alykhan Bandali, Radmila Velicki, Laura Greaves, Guy MacGowan, Djordje G Jakovljevic
Experimental Gerontology 2021 April 7, : 111340

OBJECTIVE: To assess the effect of age on mechanisms of exercise tolerance.

METHODS: Prospective observational study recruited 71 healthy individuals divided into two groups according to their age i.e. younger (≤40 years of age, N = 43); and older (≥55 years of age, N = 28). All participants underwent maximal graded cardiopulmonary exercise stress testing using cycle ergometer with simultaneous non-invasive gas-exchange and central haemodynamic measurements. Using the Fick equation, arteriovenous O2 difference was calculated as the ratio between measured O2 consumption and cardiac output.

RESULTS: The mean age of younger and older participants was 26.0 ± 5.7 years, and 65.1 ± 6.6 years respectively. Peak O2 consumption was significantly lower in older compared to the younger age group (18.8 ± 5.2 vs 34.4 ± 9.8 ml/kg/min, p < 0.01). Peak exercise cardiac output and cardiac index were not significantly different between the younger and older age groups (22.7 ± 5.0 vs 22.1 ± 3.9 L/min, p = 0.59; and 12.4 ± 2.9 vs 11.8 ± 1.9 L/min/m2 , p = 0.29). Despite demonstrating significantly lower peak heart rate by 33 beats/min (129 ± 18.3 vs 162 ± 19.9, p < 0.01), older participants demonstrated significantly higher stroke volume and stroke volume index compared to the younger age group (173 ± 41.5 vs 142 ± 34.9 mL/min, p < 0.01; and 92.1 ± 18.1 vs 78.3 ± 19.5 mL/m2 , p < 0.01). Arteriovenous O2 difference was significantly lower in older compared to younger age group participants (9.01 ± 3.0 vs 15.8 ± 4.3 mlO2 /100 mL blood, p < 0.01).

CONCLUSION: Ability of skeletal muscles to extract delivered oxygen represented by reduced arteriovenous O2 difference at peak exercise appears to be the key determinant of exercise tolerance in healthy older individuals.

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