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      Physical activity is medicine for older adults

      review-article
      Postgraduate Medical Journal
      BMJ Publishing Group
      PREVENTIVE MEDICINE, PUBLIC HEALTH, GERIATRIC MEDICINE

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          Abstract

          There is evidence from high quality studies to strongly support the positive association between increased levels of physical activity, exercise participation and improved health in older adults. Worldwide, around 3.2 million deaths per year are being attributed to inactivity. In industrialised countries where people are living longer lives, the levels of chronic health conditions are increasing and the levels of physical activity are declining. Key factors in improving health are exercising at a moderate-to-vigorous level for at least 5 days per week and including both aerobic and strengthening exercises. Few older adults achieve the level of physical activity or exercise that accompanies health improvements. A challenge for health professionals is to increase physical activity and exercise participation in older adults. Some success in this has been reported when physicians have given specific, detailed and localised information to their patients, but more high quality research is needed to continue to address this issue of non-participation in physical activity and exercise of a high enough level to ensure health benefits.

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          Most cited references40

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          Interventions for preventing falls in older people living in the community

          Cochrane Database of Systematic Reviews
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            Barriers and motivations to exercise in older adults.

            Although exercise is an established component in the management of many chronic diseases associated with aging, activity levels tend to progressively decline with increasing age. Given the growing proportion of older adults, these suboptimal levels of physical activity represent an increasing public health problem. The predicators of adherence elucidated in younger adults are unreliable in elderly populations. Age-specific barriers and motivators unique to this cohort are relevant and must be acknowledged. The identification of reliable predictors of exercise adherence will allow healthcare providers to effectively intervene and change patterns of physical activity in sedentary elderly. In particular, because older patients respect their physician's advice and have regular contact with their family doctor, physicians can play a key and pivotal role in the initiation and maintenance of exercise behavior among the older population.
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              Physical activity and functional limitations in older adults: a systematic review related to Canada's Physical Activity Guidelines

              Background The purpose was to conduct systematic reviews of the relationship between physical activity of healthy community-dwelling older (>65 years) adults and outcomes of functional limitations, disability, or loss of independence. Methods Prospective cohort studies with an outcome related to functional independence or to cognitive function were searched, as well as exercise training interventions that reported a functional outcome. Electronic database search strategies were used to identify citations which were screened (title and abstract) for inclusion. Included articles were reviewed to complete standardized data extraction tables, and assess study quality. An established system of assessing the level and grade of evidence for recommendations was employed. Results Sixty-six studies met inclusion criteria for the relationship between physical activity and functional independence, and 34 were included with a cognitive function outcome. Greater physical activity of an aerobic nature (categorized by a variety of methods) was associated with higher functional status (expressed by a host of outcome measures) in older age. For functional independence, moderate (and high) levels of physical activity appeared effective in conferring a reduced risk (odds ratio ~0.5) of functional limitations or disability. Limitation in higher level performance outcomes was reduced (odds ratio ~0.5) with vigorous (or high) activity with an apparent dose-response of moderate through to high activity. Exercise training interventions (including aerobic and resistance) of older adults showed improvement in physiological and functional measures, and suggestion of longer-term reduction in incidence of mobility disability. A relatively high level of physical activity was related to better cognitive function and reduced risk of developing dementia; however, there were mixed results of the effects of exercise interventions on cognitive function indices. Conclusions There is a consistency of findings across studies and a range of outcome measures related to functional independence; regular aerobic activity and short-term exercise programmes confer a reduced risk of functional limitations and disability in older age. Although a precise characterization of a minimal or effective physical activity dose to maintain functional independence is difficult, it appears moderate to higher levels of activity are effective and there may be a threshold of at least moderate activity for significant outcomes.
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                Author and article information

                Journal
                Postgrad Med J
                Postgrad Med J
                postgradmedj
                pmj
                Postgraduate Medical Journal
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0032-5473
                1469-0756
                January 2014
                19 November 2013
                : 90
                : 1059
                : 26-32
                Affiliations
                Faculty of Health & Environmental Sciences, Health & Rehabilitation Research Institute, North Shore Campus, AUT University , Auckland, New Zealand
                Author notes
                [Correspondence to ] Dr Denise Taylor, Faculty of Health & Environmental Sciences, Health & Rehabilitation Research Institute, North Shore Campus, AUT University, Northcote, Auckland 0627, New Zealand; Denise.taylor@ 123456aut.ac.nz
                Article
                postgradmedj-2012-131366
                10.1136/postgradmedj-2012-131366
                3888599
                24255119
                fb087625-17f1-4355-b0bb-affaea07a69e
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

                History
                : 19 January 2013
                : 4 June 2013
                : 1 July 2013
                Categories
                1507
                1506
                Review
                Custom metadata
                editors-choice
                unlocked

                Medicine
                public health,geriatric medicine,preventive medicine
                Medicine
                public health, geriatric medicine, preventive medicine

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