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Statins increase the creatine kinase release from skeletal muscle, a sign of muscle injury. This chapter discusses studies that examined the effect of statins on: (1) skeletal muscle strength, (2) aerobic exercise performance, (3) skeletal muscle and cardiac biomarkers during exercise, (4) training for athletic competition, and (5) physical activity adherence. The majority of evidence does not demonstrate a deleterious effect of statin therapy on exercise performance or training, although the populations that appear to be at greatest risk of exercise-induced statin-associated muscle symptoms (SAMS) include older adults and athletes, especially those participating in prolonged or intense forms of exercise.

Exercise provides numerous physiological and psychological benefits for healthy older adults. However, most older adults in the United States are physically inactive. This chapter first summarizes the evidence demonstrating the resultant health benefits from exercise based on both epidemiological and interventional research. Second, this chapter introduces the concept of exercise prescription, presents the physical activity guidelines for older adults from various professional committees and organizations, and discusses special considerations when prescribing exercise for older adults. Last, this chapter highlights several of the behavioral theories that can be used to increase physical activity and reduce sedentary behavior among older adults.