BACKGROUND: Aging is associated with loss in both muscle mass and the metabolic quality of skeletal muscle. A major part of these changes is associated with an age-related decrease in the level of physical activity and may be counteracted by endurance training (ET) and resistance training (RT). OBJECTIVE: Since both muscle strength and aerobic power decrease with age, we investigated what form of training might be best for improvements in physical performance in the elderly. In detail, we wanted to know whether systematic ET can augment muscle strength and/or whether systematic RT can augment the aerobic power of healthy elderly adults. METHODS: Forty-two volunteers (32 women, 10 men) were recruited for the study and randomized into three groups: 13 persons undertook a continuous 6-month ET program, 15 undertook a continuous 6-month RT program and 14 served as a control group. All persons performed a cycling test to measure aerobic power (VO2max) and maximum workload (Wmax) before and after the training period. Maximum strength was determined from one repetition maximum (1-RM). RESULTS: After 6 months of RT, maximum strength increased by an average of 15% for leg press (p < 0.01), 25% for bench press (p < 0.01) and 30% for bench pull (p < 0.001); ET showed no effect on maximum strength except for the 1-RM in bench pull. Aerobic power improved by 6% in the ET group and by 2.5% in the RT group, neither of which was significant. Maximum workload improved significantly by 31% in the ET group (p < 0.001) and by 6% in the RT group (p = 0.05). ET resulted in a significant 5.3% reduction of body fat (p < 0.05), whereas only RT increased lean body mass by 1.0 +/- 0.5 kg. CONCLUSION: RT leads to a genuine increase in lean body mass and muscle strength in healthy elderly adults and is therefore the best method for treatment of amyotrophia. ET appears to be the most efficacious training mode for maintaining and improving maximum aerobic power in the elderly and should be viewed as a complement to RT. The loading intensity to promote hypertrophy should approach 60 to 80% of 1-RM with an exercise volume ranging from 3 to 6 sets per muscle group per week of 10 to 15 repetitions per exercise. ET should be performed on two days per week controlled by a heart rate according to 60% of VO2max and an exercise volume ranging from 30 to 60 minutes per week.

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