Physical, Physiological, and Psychological Considerations of Aging
Aging Changes That Shape Training
This domain tests how normal aging affects movement capacity and how psychological factors change adherence. You are not treating disease; you are adapting exercise to age-related change.
Physical and physiological changes
- Sarcopenia reduces muscle mass and strength; type II fiber loss and motor-unit remodeling slow power production.
- Bone mineral density declines, especially after menopause; fragile vertebrae and hips change loading choices.
- Cartilage thins and tendons stiffen, reducing shock absorption and ROM.
- VO2max, maximal heart rate, and baroreflex sensitivity decline; orthostatic hypotension and thermoregulation problems become more likely.
- Vision, hearing, proprioception, and reaction time decline, raising fall risk.
- Cognitive slowing, depression, social isolation, and fear of falling affect participation.
Worked example
A 72-year-old with osteoporosis and fear of falling wants stronger legs. You avoid loaded spinal flexion/rotation, teach hip hinge and sit-to-stand with a chair, add heel raises and side steps, and progress balance from two-hand support to fingertip support. You explain that slow, controlled loading builds confidence-not that exercise is risk-free.
Traps
Treating all older adults as frail, using the same program as for younger clients, ignoring fear of falling, and assuming depression is “just aging.” Also avoid bed-rest logic; inactivity accelerates loss.