Fitness-Related Markers of Longevity: What Personal Trainers Need to Know

Longevity has become something of a buzzword in the fitness industry in recent years. While it traditionally referred to how long a person lives, it now has a broader meaning, encompassing both lifespan — the total number of years someone lives- and healthspan — the number of years lived in good health, free from major disease or disability.

This distinction is important because someone may live a long time but spend many years with poor mobility, chronic illness, or reduced independence.

Although the benefits of fitness for health and longevity have long been acknowledged, dating back to the earliest civilisations, modern science has now identified a range of fitness-related markers of longevity. These are physical abilities that reflect how well the body is ageing across multiple systems. This means that they can be used to predict how long someone is likely to live and how well they will function as they age.

In this article, we examine a range of fitness-related markers that can help personal trainers assess long-term health, function, and ageing for their clients.

Cardiorespiratory fitness (VO₂ max): The gold standard of longevity

As VO₂ max reflects the combined performance of the lungs, heart, blood vessels, muscles, and mitochondria, it comes as no surprise that it gives a good insight into how well the body is ageing.

Consequently, cardiorespiratory fitness has proven to be a powerful predictor of mortality and morbidity (1), with higher levels being associated with:

• Lower cardiovascular and metabolic disease risk
• Reduced cancer mortality
• Better cognitive ageing (1)

The relationship between cardiorespiratory fitness and mortality is dose-responsive. This means that people in the lowest VO₂ max category have the highest mortality risk, while those in the top fitness categories have the lowest risk, with benefits continuing even into the “elite” range.

One study showed that individuals with a VO₂ max in the elite range had an 80% lower mortality risk than those in the lowest group (2).

How fit do you need to be?

You don’t have to be an elite athlete to improve longevity. The evidence suggests that:

• Just being above the lowest 20% of VO₂ max for your age group is critical for reducing mortality risk (3).
• Reaching the middle or upper fitness categories (roughly the top 40–60% for age and sex) is associated with substantial longevity benefits (3).
• Higher is better: one study found a continuous reduction in mortality risk with increasing VO₂ max, with no plateau (2).

In practical terms, this means most clients should aim to achieve a VO₂ max that’s at least “average” for their age and sex. Ideally, they should aim for the “good” or “excellent” category, where the strongest longevity benefits appear.

It’s important to emphasise that even small improvements can provide some benefit, as every 1 MET (3.5 mL/kg/min) improvement in VO₂ max has been shown to reduce mortality by ~5–11% (3).

Get a grip: A simple window into systemic health

Grip strength has long been established as an effective measure of the strength of the muscles of the hand and forearm. It’s now increasingly being recognised as an important indicator of overall health and longevity.

One of the most compelling pieces of evidence comes from the Prospective Urban Rural Epidemiology (PURE) study (4), which followed more than 140,000 participants across 17
countries for four years.

The findings showed that lower grip strength:

• Was associated with higher all-cause mortality
• Predicted non-cardiovascular mortality, heart attack, and stroke
• Was a better predictor of cardiovascular and all-cause mortality than systolic blood pressure

How strong is strong enough?

Another large-scale analysis (5), involving over half a million adults, found that every 5 kg reduction in grip strength increased the risk of death from any cause. Individuals classified as having muscle weakness (below 26 kg for men and 16 kg for women) faced significantly higher risks across almost all major health outcomes.

In addition, older women with low grip strength have been shown to be 2.73 times more likely to fall than those with normal strength (6).

Grip strength’s predictive ability is due to how it reflects the combined function of the nervous system, muscle mass, motor unit recruitment, and metabolic efficiency. As these systems decline early in many chronic diseases, reductions in grip strength often appear long before clinical symptoms become apparent (5).

What your walking speed says about you

Walking, or gait, speed reflects the combined function of the nervous, cardiovascular, and muscular systems. When any of these decline with age, gait speed tends to reduce.

A study by Studenski et al., (7), involving the analysis of over 34,000 adults aged 65 and older showed:

• Usual gait speed is a strong, independent predictor of survival.
• Faster walkers had significantly higher life expectancy across all age and sex groups, even after adjusting for health status and comorbidities.
• A near-linear relationship exists between gait speed and mortality risk, with every 0.1 m/s (0.22 miles per hour) increase in usual walking speed reducing risk of death by approximately 12%.

As a general guide, older adults who walk at least 1.0 m/s (2.24 mph) have significantly better survival, independence, and long-term health. Speeds above 1.2 m/s (2.7 mph) are associated with the greatest longevity and lowest disability risk (7).

The importance of balance

The role of balance in the risk of falling in older people is well acknowledged. Less widely understood is the use of balance to predict mortality.

One study (8) followed 1,702 middle-aged and older adults for seven years, and found:

• Inability to maintain a 10-second one-leg stance was strongly associated with higher all-cause mortality.
• Adults aged 51–75 who could not stand on one leg for 10 seconds had a significantly higher risk of all-cause mortality over 7 years, with 17.5% of those who failed the 10-second test dying, compared with 4.6% of those who passed.
• The ability to hold the stance declined sharply with age, with failure rates rising from 4.7% (age 51–55) to 53.6% (age 71–75).
• Just adding the 10-second balance test has been shown to improve the accuracy of models that predict death, even after adjusting for age, sex, BMI, and comorbidities.

Findings such as these help to demonstrate the value of a simple 10-second balance test for providing useful information about an individual’s neuromuscular function, frailty, overall physiological ageing, and life expectancy.

Functional movement capacity

Functional movement assessment evaluates how well a person performs everyday movement patterns—such as squatting, stepping, reaching, or balancing.

This helps to identify limitations in mobility, strength, stability, or coordination, which may affect an individual’s ability to perform their activities of daily living safely and effectively.

Functional movement capacity is typically assessed with a mix of mobility, strength, balance, coordination, and movement quality tests.

One such test is the Sitting Rising Test (SRT). This is a simple assessment of an individual’s functional capacity, which measures how easily a person can sit down on the floor and stand back up again without using support.

It uses a 10-point scoring system:

• You start with 10 points and lose one point each time you use a hand, knee, forearm, or the side of your leg for support, or if you lose balance during the movement.
• A higher score means better strength, flexibility, balance, and coordination.
• Lower scores are strongly associated with higher all-cause mortality in middle-aged and older adults, with each one-point reduction in the 10-point score linked to a 21% increase in risk (9).

What this means for personal trainers

Life expectancy continues to rise, but unfortunately, these extra years are not always accompanied by good health. To close this gap, the focus must shift from lifespan toward longevity—helping clients stay physically and mentally capable and independent for as long as possible.

The longevity-related fitness markers discussed in this article highlight how well-placed personal trainers are to support this goal. These relatively simple assessments can provide valuable insight into a client’s long-term functional needs and abilities, which can be used to develop an appropriate programme of physical activity. They can also provide a useful method to monitor progress. Ultimately, our aim should not only be to add years to life, but life to years.

If you’re looking to develop your skills further or build on your ability to apply these assessments in practice, explore our personal training courses page.

References

1) Lang JJ, Prince SA, Merucci K, Cadenas Sanchez C, Chaput JP, Fraser BJ, et al. Cardiorespiratory fitness is a strong and consistent predictor of morbidity and mortality among adults: an overview of meta analyses. Br J Sports Med. 2024;58(10):560–568.

2) Mandsager K, Harb S, Cremer P, et al. Association of cardiorespiratory fitness with long term mortality among adults undergoing exercise treadmill testing. JAMA Netw Open. 2018;1(6):e183605. doi:10.1001/jamanetworkopen.2018.3605

3) Gonzales TI, Westgate K, Strain T, et al. Cardiorespiratory fitness assessment using risk stratified exercise testing and dose response relationships with disease outcomes. Sci Rep. 2021;11:14709. doi:10.1038/s41598 021 94768 3

4) 2.Leong DP, Teo KK, Rangarajan S, Lopez Jaramillo P, Avezum A, Orlandini A, et al. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet. 2015;386(9990):266 73.

5) 3.Celis Morales CA, Welsh P, Lyall DM, Steell L, Petermann F, Anderson J, et al. Associations of grip strength with cardiovascular, respiratory, and cancer outcomes and all cause mortality: prospective cohort study of half a million UK Biobank participants. BMJ. 2018;361:k1651.

6) 11. Neri SGR, Lima RM, Ribeiro HS, Vainshelboim B. Poor handgrip strength determined clinically is associated with falls in older women. J Frailty Sarcopenia Falls. 2021 Jun 1;6(2):43-49. doi: 10.22540/JFSF-06-043. PMID: 34131600; PMCID: PMC8173535.

7) Studenski S, Perera S, Patel K, Rosano C, Faulkner K, Inzitari M, et al. Gait speed and survival in older adults. JAMA. 2011;305(1):50–58.

8) Araújo CG, de Souza e Silva CG, Laukkanen JA, Singh MF, Kunutsor SK, Myers J, et al. Successful 10 second one legged stance performance predicts survival in middle aged and older individuals. Br J Sports Med. 2022;56(17):975–981.

9) Araújo CG, de Souza e Silva CG, Laukkanen JA. The sitting rising test: a predictor of mortality. Eur J Prev Cardiol. 2014;21(7):892–898.

Author

Paul Orridge

Paul Orridge BSc (Hons)

Paul Orridge is a graduate in the field of sport, exercise and health, and has over 30 years’ experience within the fitness industry. In this time, he has performed a variety of roles including personal training, lecturing and writing. Paul now works as a freelance technical author and subject matter expert within the fitness industry. His work is based on his practical experience gained working with a diverse range of people from very unfit, overweight individuals to highly conditioned athletes, and is underpinned by the latest research.