Which exercises are safest for strength training at an older age?
Tailored resistance training combined with balance exercises is the best-supported choice for safe strength training at an older age. Training three times a week demonstrably improves muscle strength, walking speed and fall risk.
Resistance training is the best-supported form of strength training for older adults. In people with sarcopenia (age-related muscle loss) it clearly improves muscle strength, and experts (92.5% consensus) recommend tailored resistance training as the first choice. Safety is not a major concern: in a 24-week programme involving 60- to 74-year-olds, adherence was 92% and no training-related complaints occurred.
Combining resistance training with balance exercises adds an extra benefit. Such a combined programme improves dynamic balance and leg strength more than resistance training alone, which is directly relevant for fall prevention. Home-based exercises with strength and balance components, at least three times a week for thirty minutes, reduced the proportion of people over 80 who fell from 44% to 25%. The total number of falls per person-year did not decrease by a meaningful amount, but the proportion of people who fell at all did.
Resistance training combined with aerobic training or balance training also improves walking speed by an average of 0.16 m/s, which is above the clinically meaningful threshold of 0.1 m/s. For quality of life, resistance training, possibly supplemented with nutrition or other forms of exercise, is most effective in older adults with sarcopenia.
Whole-body vibration training (standing on a vibrating platform) does not improve muscle strength or walking speed in any meaningful way. Notably, it did improve mobility in one specific movement test, but that finding stands alone and is not backed up by other results. This form of training therefore offers no alternative to regular resistance training.
In older adults living in care homes or supported housing, exercise programmes also work, including for people with dementia or severe limitations. No single type of exercise clearly outperformed the others in that setting; what matters most is simply that a person moves, at roughly 110 to 225 minutes per week.
This answer draws on several combined analyses of multiple studies and two individual studies in people. The researchers behind the quality-of-life analysis rated their evidence as moderate to high certainty for resistance training. For muscle strength and mobility the certainty is moderate, and there is sometimes considerable variation between studies. The experts who drew up the consensus recommendation agreed 92.5% that tailored resistance training should be first choice, but that reflects expert opinion, not a direct test in people. The study involving people over 80 who used home exercise videos is relatively small and partly measures different outcomes from the larger combined analyses.