Ageing and physical activity: evidence to develop exercise recommendations for older adults.

TLDR

Epidemiological evidence shows that physical activity reduces age‑related morbidity and mortality, and that achieving improvements in cardiorespiratory fitness, strength, power, and balance—requiring moderately vigorous intensity—helps counter age‑related declines that impair daily functioning. The study proposes exercise prescriptions for adults 65+ that emphasize moderately vigorous cardiorespiratory activity, strength or power training, balance‑mobility practice, and flexibility to maintain functional capacity, independence, and delay morbidity and mortality. Cross‑sectional and longitudinal evidence links cardiorespiratory fitness, strength, power, and balance‑mobility to functional capacity, independence, and fall prevention, while exercise interventions demonstrate that older adults can physiologically adapt and improve these capacities.

Abstract

An abundance of epidemiological research confirms the benefits of physical activity in reducing risk of various age-related morbidities and all-cause mortality. Analysis of the literature focusing on key exercise variables (e.g., intensity, type, and volume) suggests that the requisite beneficial amount of activity is that which engenders improved cardiorespiratory fitness, strength, power, and, indirectly, balance. Age-related declines in these components are such that physical limitations impinge on functional activities of daily living. However, an exercise programme can minimize declines, thus preventing older adults (age 65+ years) from crossing functional thresholds of inability. Cross-sectional and longitudinal data demonstrate that cardiorespiratory fitness is associated with functional capacity and independence; strength and, importantly, power are related to performance and activities of daily living; and balance-mobility in combination with power are important factors in preventing falls. Exercise interventions have documented that older adults can adapt physiologically to exercise training, with gains in functional capacities. The few studies that have explored minimal or optimal activity requirements suggest that a threshold (intensity) within the moderately vigorous domain is needed to achieve and preserve related health benefits. Thus, physical activity and (or) exercise prescriptions should emphasize activities of the specificity and type to improve components related to the maintenance of functional capacity and independence; these will also delay morbidity and mortality. An appropriate recommendation for older adults includes moderately vigorous cardiorespiratory activities (e.g., brisk walking), strength and (or) power training for maintenance of muscle mass and specific muscle-group performance, as well as "balance-mobility practice" and flexibility (stretching) exercise as needed.