Age-related changes affect the ratio between two steroid hormones of the hypothalamic-pituitary-adrenal axis, cortisol and dehydroepiandrosterone (sulfate) (DHEAS). Physical activity (PA) may buffer the effects of chronic stress and counteract the aging decline of DHEAS. Therefore, a systematic review was conducted to understand how PA influences physiological markers of cortisol and/or DHEAS and whether there is a difference in observational associations or experimental effects in older adults aged 65 years and older. A narrative synthesis was performed on nine observational studies, and meta-analyses were performed on 22 randomized controlled trials. There was low-to moderate-quality evidence that regular PA beneficially reduces cortisol and increases DHEAS levels. Subgroup analyses showed no clinically important differences between men and women, different exercise modalities, or health states. The findings cautiously suggest that regular PA of older adults' own choice that they find enjoyable could be recommended to improve cortisol and/or DHEAS levels.

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