Older Americans, the most rapidly growing age group, are the least physically active1 and generate the highest healthcare expenditures.2 For example, older persons who were functionally dependent accounted for 46% of the healthcare expenditures, but only made up 20% of the older adult population.3 Additionally, they spent $5000 more per year than people who remained independent. Physical activity (PA) may play an important role in maintaining health and physical function while reducing the healthcare burden.4 Recommendations for PA began in 1975 with the American College of Sports Medicine’s (ACSM) guidelines for exercise testing and prescription. While little space was devoted to PA in older adults, likely due to the limited amount of research, today a wealth of literature is available touting its benefits. Throughout the past two decades many obstacles to adopting PA, a safe and effective modality for improving physical capacity in older adults, have been overcome. Many questions still remain; the one which we attempt to address in this brief review is whether PA can maintain physical function in older adults.

Physical activity has a myriad of effects that stem from physiological adaptations that may transfer to improvements in clinical outcomes such as reducing the risk of falls.5 The purpose of this article is to briefly review the current literature regarding whether PA can help maintain physical function in older adults and offer some suggestions for clinicians wanting to improve physical function with PA. As illustrated in fig 1, individuals who begin a regular PA programme early in life and maintain this over the years will likely have high physical performance throughout the lifespan, although a decline in physical function is inevitable. Potentially more clinically relevant is whether a PA programme can set a person on a different trajectory over time (see …