T2DM, aging and OA are associated with several physical impairments and metabolic alterations that can be addressed by physical activity. Physical impairments common in this population include: excess body weight and consequent increased adiposity and joint loads; poor balance and increased fall risk; muscle dysfunction such as muscle weakness, muscle atrophy, and decreased lean muscle mass; pain and joint stiffness; all of these impairments limit daily activities and mobility. Metabolic alterations include hyperglycemia, excess adipose tissue with deregulated lipid metabolism, accumulation of advanced glycation end products (AGEs), and systemic inflammation.