Lifting weights boosts cardio fitness after 60, not just aerobic training

Cardiorespiratory fitness, the capacity of the heart and lungs to deliver oxygen during effort, declines steadily with age and tracks closely with independence and long-term health. Guidance for older adults has typically leaned on aerobic activity such as walking or cycling, leaving open whether strength work can move the same needle. Trials in older people have tested many formats, but individually they are often small and hard to compare. This review set out to establish whether aerobic, resistance and combined training each improve fitness in healthy people aged 60 and over, and by how much.

The authors searched six databases up to July 2024 for randomised controlled trials comparing structured exercise with control conditions in healthy adults aged 60 and over. Fifty-one trials met the criteria, covering 3152 participants in total. The outcomes were maximal or peak oxygen uptake, the standard laboratory measure of cardiorespiratory fitness, and the six-minute walk distance, a practical measure of walking capacity. Results were pooled across trials, and subgroup analyses split the evidence by training type, by programme length up to or beyond 24 weeks, and by sex.

Exercise improved maximal oxygen uptake against control, a moderate pooled effect with a standardised mean difference of 0.51. Six-minute walk distance improved by an average of 36.18 m. The benefits were consistent whether the training was aerobic, resistance or a combination of the two, which is the notable part: strength work alone was enough to lift cardiorespiratory fitness. Improvements appeared in both medium-term programmes of 24 weeks or less and in longer ones, and in men and women alike.

The result extends what was already well established for aerobic training in older adults and strengthens the case for resistance training as more than a muscle-building tool. It fits a broader picture in which any structured, progressive activity challenges the cardiovascular system enough to improve it at this age. The authors note that the trials used varied protocols, and they call for standardised interventions and longer follow-up to clarify how durable the gains are and to inform clinical guidelines. How the different training styles compare head to head at matched effort remains an open question.

For anyone past 60, or planning ahead, this is evidence that the choice between the weights room and the bike matters less than the decision to train at all. A preference for resistance work does not appear to leave heart and lung fitness behind, and combining styles works too. Since both men and women improved, and both shorter and longer programmes delivered gains, there are many workable entry points. This is information rather than a prescription, but the direction of the evidence is unusually consistent.