Understanding heterogeneity of responses to, and optimizing clinical efficacy of, exercise training in older adults: NIH NIA Workshop summary

Melissa L. Erickson, Jacob M. Allen, Daniel P. Beavers, Linda M. Collins, Karina W. Davidson, Kirk I. Erickson, Karyn A. Esser, Matthijs K.C. Hesselink, Kerrie L. Moreau, Eric B. Laber, Charlotte A. Peterson, Courtney M. Peterson, Jane E. Reusch, John P. Thyfault, Shawn D. Youngstedt, Juleen R. Zierath, Bret H. Goodpaster, Nathan K. LeBrasseur, Thomas W. Buford, Lauren M. Sparks

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Exercise is a cornerstone of preventive medicine and a promising strategy to intervene on the biology of aging. Variation in the response to exercise is a widely accepted concept that dates back to the 1980s with classic genetic studies identifying sequence variations as modifiers of the VO2max response to training. Since that time, the literature of exercise response variance has been populated with retrospective analyses of existing datasets that are limited by a lack of statistical power from technical error of the measurements and small sample sizes, as well as diffuse outcomes, very few of which have included older adults. Prospective studies that are appropriately designed to interrogate exercise response variation in key outcomes identified a priori and inclusive of individuals over the age of 70 are long overdue. Understanding the underlying intrinsic (e.g., genetics and epigenetics) and extrinsic (e.g., medication use, diet, chronic disease) factors that determine robust versus poor responses to various exercise factors will be used to improve exercise prescription to target the pillars of aging and optimize the clinical efficacy of exercise training in older adults. This review summarizes the proceedings of the NIA-sponsored workshop entitled, “Understanding Heterogeneity of Responses to, and Optimizing Clinical Efficacy of, Exercise Training in Older Adults” and highlights the importance and current state of exercise response variation research, particularly in older adults, prevailing challenges, and future directions.

Original languageEnglish
Pages (from-to)569-589
Number of pages21
Issue number1
StatePublished - Feb 2023

Bibliographical note

Publisher Copyright:
© 2022, This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.


  • Aging
  • Clinical efficacy
  • Exercise
  • Response variation

ASJC Scopus subject areas

  • Aging
  • Veterinary (miscellaneous)
  • Complementary and alternative medicine
  • Geriatrics and Gerontology
  • Cardiology and Cardiovascular Medicine


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