Functional ageing processes are characterized by a loss of performance capabilities regarding coordination, flexibility, strength, speed, and endurance. The effects of ageing processes on the cardiovascular system and skeletal muscle are the foci of attention. After age 30, the maximum aerobic dynamic performance capacity decreases by an average of 8% per decade. The causes are mainly a reduction in the maximum cardiac output and decreases in capillarization and in the skeletal muscle mass. An improvement in the maximum oxygen uptake by 18% and in the aerobic-anaerobic threshold by 22% was achieved in untrained men aged 55-70 years, in a 12-week-long bicycle ergometer-training programme. The strength of the skeletal muscle decreases particularly after 50-60 years of age. The main cause is the reduction in the number of motor units and muscle fibres. Further, modifications of the endothelial function and the development of sarcopenia are of particular importance in ageing processes. General aerobic dynamic training can improve the endothelial function in old age and thus help prevent cardiovascular diseases. Strength training is most appropriate for the prevention of sarcopenia.

Imaging techniques over the last 20 years have provided new findings on the influence and the significance of physical activity on the brain. We call this new interdisciplinary area 'Exercise Neuroscience.' Demands on coordination and aerobic dynamic endurance are suitable in counteracting age-related neuronal cellular loss, synapsis hypotrophy, and in improving neurogenesis and capillarization. Adjusted physical activity is thus capable of counteracting age-related changes and performance loss not only in the cardiovascular system but also in the brain.

Editor's Comment. I highly recommend this article for clinicians and other cardiovascular rehabilitation professionals. It is an excellent review piece that covers all the important material about aging, exercise, and cardiovascular disease. In addition, it breaks relatively new ground in addressing an area the authors call "Exercise Neuroscience." Although this has been a topic of discussion for some time (exercise and brain function), I have not seen a comparable review of this literature elsewhere. This article is information that all professionals who work with older adults should have at hand.-JLR