Aging is associated with a cascade of morphologic and physiologic changes that naturally predispose older adults to progressive weakening, functional decline, morbidity, disability, poor quality of life, and increased mortality. Physical activity moderates such insidious aging patterns and is a vital preventive and therapeutic strategy to optimize health throughout the aging process. Regular exercise provides many physiologic benefits, reduces risk of disease outcomes, and triggers important psychological gains. Advanced age presents distinctive obstacles to maintaining a physically active lifestyle. Individualized exercise strategies and regimens make it possible, however, for every elderly adult to benefit from physical activity.