Testing the master athlete

Many sporting organisations define a master athlete as an individual older than 35 years of age, who either trains for or takes part in athletic competitions often specifically designed for older participants. Many of these athletes are experienced competitors who continue their athletic pursuits after their sports careers have ended, often transferring from another sport. Participation rates in the marathon show that master athletes now make up ~55% of the total field, growing to ~70% of the field in ultra-marathons. Data from the UK suggest that myocardial disease typically accounts for 40% of sudden cardiac death in all athletes, being more prevalent in older athletes. The predominant causes were idiopathic left ventricular hypertrophy and/or fibrosis and arrhythmogenic right ventricular cardiomyopathy. With an athlete’s increasing age, the main adaptation linked to exercise testing will be to adjust an exercise test protocol to accommodate reductions in physical capacity.