The elite senior athlete: Staying fit after age 50

Vonda J. Wright, MD, answers 4 Questions about the special needs of active older athletes.

Whether athletes or not, we all age. While over the years I have met many of you at a higher level of conditioning than myself, I personally have enjoyed being physically active during each decade of my life.

Fitness and our health are a gift we can enhance. If we are going to live longer, we can improve those additional years. It pleases me to see new investigators studying quality of life projects. This month I have turned to one of these investigators, Vonda J. Wright, MD, to share some of her recent work and insights.

Douglas W. Jackson, MD
Chief Medical Editor

Douglas W. Jackson, MD: In your recent publication in the American Journal of Sports Medicine, you studied elite senior athletes. Who are they and why should we be interested in them?

Vonda J. Wright, MD: Senior and masters athletes are a group of vital, active and thriving amateur athletes over the age of 40 years who continue to compete in high-level sports. They are amazing examples of our bodys’ abilities as we age if we continue to challenge ourselves and not accept the notion that aging is an inevitable decline from vitality to frailty.

Most of them are normal people with normal jobs and not professional athletes or specimens of super genetic athletic predisposition. Demographically, the group captured in my study was in their late 50s and 60s, well-educated, middle class, retired but not for health reasons, and noted a life-long history of exercise. They are a great example of the fact that only 30% of how we age is determined by genetics while the remaining 70% is determined by the lifestyle choices we make including activity.

I study them for several reasons. First, they are perhaps the best examples of what our musculoskeletal systems are capable of as we age without the confounding variable of disuse playing a role. Most of the studies in the medical literature are carried out on people who are sedentary as they age. Therefore, we know what happens to us if we are inactive with aging but have less of an idea what aging would be like if we were all chronically active instead of being couch potatoes.

Second, despite the fact that the over 50 years crowd is the largest and fastest growing segment of the population and recognizing the need to get and stay active with aging, few studies, especially in orthopedics, have focused on this group.

As a profession, we are masters at helping people stay mobile. We need to find ways to help masters athletes and adult onset exercisers (AOE) maintain their mobility through activity modification or creative surgeries and not just tell them to stop running, cycling, or playing tennis, etc. when they have aches and pains.

Many people think that after age 50 years it is time to hang it up or that slowing down is mandatory. Slowing down happens, but much more slowly than people think. To put it into perspective: The 50-year-old male winner of the 2001 Senior Olympic mile race won in 4:34.

The approach we take in our PRIMA (Performance and Research Initiative for Masters Athletes) at the University of Pittsburgh Medical Center’s Center for Sports Medicine is to help the athletes and AOE’s to stay active and get them to the next level without injury.

Jackson: What were the findings of your study and how do they relate to the general population?

Wright: In the study, we evaluated the age-related performance declines in athletes participating in the National Senior Games. The finish times for the top eight finishers in every race, from 100 m to 10,000 m, for every age group were analyzed. We found that from age 50 years to 75 years there was a small decline in physical performance per year. Both men and women declined less than 2%. At ages 75 years and older, however, the performance declined rapidly at almost 8% per year. Is this biology finally taking over? Do the cumulative effects of VO₂ (maximal oxygen uptake) loss, loss of exercise efficiency and muscle/tendon shortening become greater than the capability to train past them?

Vonda J. Wright

The answer is yes. At 75 years old, performance times decline significantly, but let us put this in perspective. The winner of the 70- to 75-year-old mile race for men in the 2001 Senior Olympics won in around 7 minutes. While this is significantly slower than the 50 year-old winner it is still faster than most 30-year-old sedentary people can run a mile.

The implications of this study for the general population give us a time line for getting the 70% of people who do not do 30 minutes of exercise a day off the couch.

Sedentary lifestyle is attributed to high personal morbidity and chronic illness as well as high societal morbidity as we will have to pay to take care of a large segment of the baby boomer population who do not remain active as they age. If the oldest boomer is now 62 years and we know that even the “best of the best” senior athletes begin to significantly slow around age 75 then we only have 13 years to help people age more actively.

Sometimes it seems strange for an orthopedic surgeon and researcher to be so interested in active aging, but the fact that our profession is the gatekeeper of activity and we are focused on helping people maintain mobility throughout their lifespan, it becomes more than just maintaining mobility for sports but maintaining mobility to save lives. More than 35 chronic diseases are directly impacted by 30 minutes of activity a day. By helping people get or remain mobile for as long as possible, we are not only maintaining mobility but saving lives.

Jackson: What can our readers take from this information that may be helpful in patient care or in their own lives?

Wright: When I speak to groups, the media or my patients, I tell them that there is no expiration date on getting or staying fit and no matter what shape you are in, your body will respond to the physical challenge put before it.

I hope our research will help change the paradigm of aging in this country. Don’t tell your patients to just “grow up and act your age.” Help them modify their sport. If they are active and want to remain so, consider doing the surgery you would traditionally have reserved for people in their 30s. Do not let age alone determine what you do. Factor in activity level.

Jackson: Do you see “physiologic” levels of hormone replacement and/or other supplements as a means to prolong the time before we see age-related performance decreases?

Wright: This is a hot topic and I currently do not recommend physiologic hormone replacement for my elite masters athletes and certainly not for the more recreational masters athletes I treat. Most of the time we find there is still a lot of room in their training regimen for improvements and that they are still trying to do the same work out they did when they were in high school and therefore get hurt often. We first focus on assessing their individual strengths and weakness and then build a training program to meet their goals while minimizing injury. This has been very successful for us.

The supplement I do recommend is Omega 3, 6, and 9 fish oils for decreasing inflammation. It is great for both joint and heart health.

For more information:

• Vonda J. Wright, MD, is an assistant professor of orthopedic surgery at the University of Pittsburgh and director of PRIMA (Performance and Research Initiative for Masters Athletes). She can be reached at 3200 S Water St., Pittsburgh, PA 15203; 412-432-3651; e-mail: wrigvj@upmc.edu.

Reference:

• Wright VJ, Perricelli BC. Age-related rates of decline in performance among elite senior athletes. Am J Sports Med. 2008;36(3):441-442.