Sports Medicine · Nov 12, 2026
Maximal Aerobic Capacity and Aging in Female Masters Athletes: A Systematic Review and Meta-analysis
By Kipp S, Larson KF, Collantes Hoyos DB et al.
Background Maximal aerobic capacity (\(\dot{V}\)O2max) represents the highest rate at which the body can use oxygen during intense exercise and is a key determinant of endurance performance. Although age-related declines in \(\dot{V}\)O2max have been well documented in male individuals, less is known about this trajectory in female Masters athletes, defined as individuals aged 40 years or older who often engage in lifelong endurance training. Objective We performed a systematic review and meta-analysis to quantify cross-sectional age-related differences in directly measured \(\dot{V}\)O2max among female Masters endurance athletes. Methods PubMed and Web of Science were searched from database inception to 14 May, 2025 for studies reporting directly measured \(\dot{V}\)O2max in female Masters endurance athletes aged 40 years or older. Eligible exercise modalities included running, cycling, swimming, and large muscle-mass ergometry, with testing conducted under standard environmental conditions. Two reviewers independently screened studies, extracted data, and assessed risk of bias using a modified Joanna Briggs Institute checklist. Pooled mean \(\dot{V}\)O2max values were calculated for predefined age groups (40–49, 50–59, 60–69, and 70 years or older) using a random-effects meta-analysis. Meta-regression was used to estimate the relationship between age and \(\dot{V}\)O2max. Results Sixty-nine studies, including 1903 female Masters athletes, met the inclusion criteria. Pooled mean relative \(\dot{V}\)O2max was 45 mL·kg⁻¹·min⁻¹ (95% confidence interval [CI] 43.0–46.8) in athletes aged 40–49 years, 40 mL·kg⁻¹·min⁻¹ (95% CI 38.5–41.7) in those aged 50–59 years, 35 mL·kg⁻¹·min⁻¹ (95% CI 33.2–37.1) in those aged 60–69 years, and 30 mL·kg⁻¹·min⁻¹ (95% CI 27.2–31.8) in athletes aged 70 years or older. Meta-regression demonstrated that each additional year of age was associated with a 0.57 mL·kg⁻¹·min⁻¹ lower \(\dot{V}\)O2max (95% CI − 0.70 to − 0.44; P < 0.0001), equivalent to about 11.7% per decade. The association was consistent across testing modalities. Conclusions This systematic review and meta-analysis demonstrates a progressive age-related decrease in directly measured \(\dot{V}\)O2max among female Masters endurance athletes. Maximal aerobic capacity declines at an average rate of 0.57 mL·kg⁻¹·min⁻¹ per year after age 40 years, corresponding to approximately 11.7% per decade. This decline is evident across endurance sport disciplines and appears consistent with physiological changes associated with aging despite sustained endurance training. These findings provide female-specific reference values and a quantitative framework for future studies on aerobic capacity trajectories in female athletes. Clinical Trial Registration The protocol was registered on the Open Science Framework (OSF; https://doi.org/10.17605/OSF.IO/S2RXZ).