Increasing functional impairment is not a given, but can be the result of an accumulation of limited physical activity throughout our lives. Lack of muscle strength, poor balance, and coordination are all factors that can be trained. These often contribute to some of the challenges faced by older people, including: falls, cardiovascular disease, type 2 diabetes, joint stiffness, and musculoskeletal pain. Getting the message through to our patients that physical activity can be a powerful tool to help protect against the health impact of ageing is vital at any stage of life. However, it is important that we try to engage patients early, so as to make a real difference later down the line. Queries can arise around a patient’s ability to complete exercise. Their risk of injury and the impact medications may have on them. Understanding the physiology behind ageing can assist us in tailoring physical activity advice for the older population.
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References
1.
Al-MrabehA. (2020)
Pathogenesis and remission of type 2 diabetes: What has the twin cycle hypothesis taught us?Cardiovascular Endocrinology & Metabolism9(4): 32–142. DOI: 10.1097/XCE.0000000000000201.
2.
BarrettSBeggSO’HalloranP, et al. (2018)
Integrated motivational interviewing and cognitive behaviour therapy for lifestyle mediators of overweight and obesity in community-dwelling adults: A systematic review and meta-analyses. BMC Public Health18: 1160. DOI: 10.1186/s12889-018-6062-9.
3.
BiswasBBhattacharyyaADasguptaA, et al. (2017)
Urinary incontinence, its risk factors, and quality of life: A study among women aged 50 years and above in a rural health facility of West Bengal. Journal of Mid-life Health8(3): 130–136. DOI: 10.4103/jmh.JMH_62_17.
Bruno C, Collier A, Holyday M, et al. (2021) Interventions to Improve Hydration in Older Adults: A Systematic Review and Meta-Analysis. Nutrients 13(10): 3640. DOI: 10.3390/nu13103640.
6.
CaleyachettyRBarberTMMohammedNI, et al. (2021)
Ethnicity-specific BMI cutoffs for obesity based on type 2 diabetes risk in England: A population-based cohort. The Lancet Diabetes & Endocrinology9(7): 419–426. DOI: 10.1016/S2213-8587(21)00088-7.
7.
CherkasLFHunkinJLKatoBS, et al. (2008)
The association between physical activity in leisure time and leukocyte telomere length. Archives of Internal Medicine168(2):154–158. DOI: 10.1001/archinternmed.2007.39.
8.
Dąbrowska-GalasMDąbrowskaJPtaszkowskiK, et al. (2019)
High physical activity level may reduce menopausal symptoms. Medicina (Kaunas)55(8): 466. DOI: 10.3390/medicina55080466.
9.
DaleA Schoeller (1989)
Changes in total body water with age. The American Journal of Clinical Nutrition50(5): 176–1181. DOI: 10.1093/ajcn/50.5.1176.
10.
De MagalhãesJPPassosJF (2018)
Stress cell senescence and organismal ageing. Mechanisms of Ageing and Development170: 2–9. DOI: 10.1016/j.mad.2017.07.001.
11.
De OliveiraEPBuriniRC (2009)
The impact of physical exercise on the gastrointestinal tract. Current Opinion in Clinical Nutrition and Metabolic Care12(5): 533–538. DOI: 10.1097/MCO.0b013e32832e6776.
DuggalNAPollockRDLazarusNR, et al. (2018)
Major features of immunesenescence, including reduced thymic output, are ameliorated by high levels of physical activity in adulthood. Aging Cell17(2): e12750. DOI: 10.1111/acel.12750.
14.
EkelundUTarpJSteene-JohannessenJ, et al. (2019)
Dose-response associations between accelerometry measured physical activity and sedentary time and all-cause mortality: Systematic review and harmonised meta-analysis. British Medical Journal366: l4570. DOI: 10.1136/bmj.l4570.
15.
FlintBTadiP (2023) Physiology, Aging. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556106/.
16.
GoodpasterBHParkSWHarrisTB, et al. (2006)
The loss of skeletal muscle strength mass and quality in older adults: The health aging and body composition study. The Journals of Gerontology. Series A Biological Sciences and Medical Sciences61(10):1059–1064. DOI: 10.1093/gerona/61.10.1059.
17.
GuliaKKKumarVM (2018)
Sleep disorders in the elderly: A growing challenge. Psychogeriatrics18(3): 155–165. DOI: 10.1111/psyg.12319.
18.
HenschenS (1899)
Skilanglauf und skiwettlauf: Eine medizinische sportstudie. Mitt Med Klin Upsala (Jena)2: 15–18.
19.
JuhaszovaMRabuelCZorovDB, et al. (2005)
Protection in the aged heart: Preventing the heart-break of old age?Cardiovascular Research66(2): 233–244. DOI: 10.1016/j.cardiores.2004.12.020.
20.
KitzmanDWBrubakerPHHerringtonDM, et al. (2013)
Effect of endurance exercise training on endothelial function and arterial stiffness in older patients with heart failure and preserved ejection fraction: A randomized controlled single-blind trial. Journal of the American College of Cardiology62(7): 584–592. DOI: 10.1016/j.jacc.2013.04.033.
21.
LeanMELeslieWSBarnesAC, et al. (2019)
Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial. The Lancet. Diabetes & Endocrinology7(5): 344–355. DOI: 10.1016/S2213-8587(19)30068-3.
OrangeSTJordanAROdellA, et al. (2022)
Acute aerobic exercise-conditioned serum reduces colon cancer cell proliferation in vitro through interleukin-6-induced regulation of DNA damage. International Journal of Cancer151(2): 265–274. DOI: 10.1002/ijc.33982.
28.
Rehfeld K, Lüders A, Hökelmann A, et al. (2018) Dance training is superior to repetitive physical exercise in inducing brain plasticity in the elderly. PLoS One 13(7): e0196636. DOI: 10.1371/journal.pone.0196636.
29.
ReidHRidoutAJTomazSAon behalf of the Physical Activity Risk Consensus group (2022)
Benefits outweigh the risks: A consensus statement on the risks of physical activity for people living with long-term conditions. British Journal of Sports Medicine56(8): 427–438. DOI: 10.1136/bjsports-2021-104281.
30.
SaffreyMJ (2014)
Aging of the mammalian gastrointestinal tract: A complex organ system. Age: The Official Journal of the American Aging Association36(3):1019–1032. DOI: 10.1007/s11357-013-9603-2.
31.
ShaltoutHAEggebeenJMarshAP, et al. (2017)
Effects of supervised exercise and dietary nitrate in older adults with controlled hypertension and/or heart failure with preserved ejection fraction. Nitric Oxide69: 78–90
32.
Verghese J, Lipton RB, Katz MJ, et al. (2003)
Leisure activities and the risk of dementia in the elderly. New England Journal Medicine348(25): 2508–2516. DOI: 10.1056/NEJMoa022252
33.
VolpiENazemiRFujitaS (2004)
Muscle tissue changes with aging. Current Opinion in Clinical Nutrition and Metabolic Care7(4): 405–410.
WeinbergADMinakerKLCobleYD, et al. (1995)
Dehydration—evaluation and management in older adults. JAMA274(19):1552–1556. doi: 10.1001/jama.274.19.1552.
37.
XuLWuYChenY, et al. (2021)
Is acute kidney injury age-dependent in older adults: An observational study in two centers from North China. BMC Geriatrics21(1): 7. DOI: 10.1186/s12877-020-01906-z.
38.
YangP YHoKHChenHC, et al. (2012)
Exercise training improves sleep quality in middle-aged and older adults with sleep problems: A systematic review. Journal of Physiotherapy58(3): 157–63. DOI: 10.1016/S1836-9553(12)70106-6.
39.
ZhongFWenXYangM, et al. (2021)
Effect of an 8-week exercise training on gut microbiota in physically inactive older women. International Journal of Sports Medicine42(7): 610–623. DOI: 10.1055/a-1301-7011.
