The role of physical activity in the elderly as primary prevention

Abstract

Aerobic fitness in the older population is related to health status [5], all-cause mortality [9], and functional capacity [5, 9, 13, 14]. Stathokostas et al. [16] described longitudinal (10 years) decline in aerobic fitness-maximal oxygen uptake and submaximal aerobic power (ventilatory threshold) in a relatively large sample of men and women, aged 55–85 years, living independently in the community [16]. Ten years after initial testing, 62 subjects (34 men, mean age 73.5±6.4 years; 28 women, 72.1±5.3 years) achieved maximal oxygen uptake. The men showed a rate of decline of −0.43 ml·kg·min·year, and the decline in maximal oxygen uptake was consequent to a lowered maximal heart rate with no change in the maximum oxygen pulse. The women showed a slower rate of decline of maximal oxygen uptake of −0.19 ml·kg·min·year, again with a lowered maximal heart rate and unchanged oxygen pulse. Evidence for the role of the muscles themselves in the reduction of maximal oxygen uptake is muscle atrophy [15] and the reduction in oxidative properties with age [7]. Recent in vivo measurements of whole muscle by magnetic resonance indicate a significant age-related decline in oxidative properties per muscle volume [3]. These in vivo whole muscle determinations point to a significant loss of muscle oxidative capacity that, combined with the observed reduction in muscle mass, may account for the reduction in maximal oxygen uptake with age. Physical activity is one of the most important and effective ways to prevent and treat certain health problems in older adults. During physical activity, the body is using energy to move muscles. Exercise is a type of physical activity that is designed to improve fitness. The importance of physical activity as a tool to reduce the risk of various chronic degeneration diseases in the elderly has been conclusively established in recent years. In 1992, the American Heart Association stated that regular aerobic physical activity plays a primary role in the prevention of cardiovascular disease [4]. However, as early as in the 1950s, the connection between a sedentary lifestyle and the onset of coronary artery disease with time was noted [10]. While addressing two different occupation populations, which differ mainly by their physical activity required at work, Morris and Heady [10, 11] demonstrated that the physically active population had less incidence of coronary artery disease compared to the sedentary population. In agreement with the above findings [10, 11], two decades later, Paffenbarger et al. [12] illustrated the same phenomenon. In a 22-year follow-up of 3,686 San Francisco longshoremen, a cohort analysis assessed job activity (via energy expenditure) and risk factors for heart disease, morbidity, and mortality. The risk factors include cigarette smoking, blood pressure, blood cholesterol level, obesity, and glucose metabolism in relation to fatal heart attack. The study demonstrated an inverse relationship between energy expenditure and fatal heart attack, which was most evident in younger and middle-aged cohorts compared to aged subjects. Furthermore, the role of energy expenditure was still manifested when viewed against the influence of the other risk factors [8]. Along with the increased evidence associating lower level of physical activity with higher risk of death from heart disease [6, 18], data from longitudinal studies have emerged indicating the influence of physical activity on longevity and mortality from other chronic disease such as cancer, diabetes, hypertension, and osteoporosis [17]. In addition, regular physical exercise is the best antidote to many of the effects Eur Rev Aging Phys Act (2007) 4:59–60 DOI 10.1007/s11556-007-0024-z