Ageing and activity: their effects on the functional reserve capacities of the heart and vascular smooth and skeletal muscles.

During perinatal life striated muscles grow through the acquisition of more contractile cells (myocytes or fibres) followed by their postnatal enlargement (i.e. hypertrophy). In the ageing adult these events are reversed, with a progressive loss of myocytes that cannot be fully compensated despite the presence of cell renewal systems or reactive myocyte hypertrophy. Hence the functional reserve capacities of the heart and skeletal muscles decline with age. This is probably a consequence of physiological ageing and diminished levels of physical activity. As a result daily tasks once taken for granted become progressively more difficult, and eventually impossible, to perform. For example, sufficient coordinated absolute muscle force is required for an individual to rise from a chair or climb stairs, and the reserve capacity of the heart is a major determinant of an individual's ability to remain active and cope with daily stresses and illnesses. Long-term participation in endurance-based activities helps to preserve cardiac reserve, and has both direct and indirect beneficial effects on vascular smooth muscle and health preservation within the cardiovascular system. In contrast, this type of activity does little to protect skeletal muscles against the age-related losses of fast-twitch fibres, small motor units, overall muscle mass and power output. While resistance exercise promotes fibre hypertrophy in skeletal muscles, and to a lesser extent in myocytes of the heart, the explosive power of muscles still declines with age. Hence, while physical activity is important in attenuating age-related changes in muscle function and its reserve capacity, it delays rather than prevents the deleterious effects of ageing per se. Despite this, in a culture where inactivity has become an accepted part of life we still need to explore in greater detail the benefits of habitual physical activity, and use this information as a community-based educational tool to help prevent or delay cardiovascular disease, obesity, arthritis and the frailty associated with old age.