The importance of physical activity in the older population
CAREUP Project
CAREUP is an European project investigates in the implementation of the “inclusive health & care approach "
The older population is increasing worldwide, and it is estimated that it may even double by 2060 (US Dept of Commerce, 2014). Older people are defined as frail individuals as more vulnerable than others and, therefore, more exposed to adverse health outcomes (Clegg A. et al.; 2013), and, in the long term, often result in loss of functional independence and decreased quality of life. The public health system proposes physical activity to prevent such negative health consequences (Fried LP et al.; 2001). Higher levels of physical activity appear to be associated with better health and cognitive function in older adults (HollmannW et al.; 2007). There is evidence that the incidence of chronic diseases is higher in those who do not engage in physical activity (Bielemann RM et al.; 2015). Consequently, physical inactivity with advancing age predisposes more easily to disabling chronic diseases, from atherosclerosis to myocardial insufficiency, coronary artery disease, hypertension, stroke and diabetes (Gill T.M et al; 2004).
Physical activity is, therefore, necessary for frail older individuals and effective as a preventive measure when performed regularly (Kunutsor SK et al., 2021). With ageing, several biological systems undergo deterioration. Consequently, older people must perform sufficient daily activities to compensate for these physiological deficiencies (O'Grady M et al.; 2000). Regular physical activity improves physical and mental functions, attenuates some effects of chronic diseases and ensures motor autonomy and independence (McPhee JS et al.; 2016). Regular exercise promotes what is defined as "healthy ageing" (Hoglund M.W et al.; 2009), characterised by high physical, psychological and social functioning and the absence of serious diseases (Kim HJ et al., 2019).
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Physical activity can be defined as any bodily movement (of skeletal muscles) that requires energy expenditure, from specific exercise (intentional physical activity) to habitual occupational/domestic activity (Bull FC et al., 2020). Exercise, in detail, can be classified by type into Aerobic Activity (or endurance or cardio), Strengthening Activity, Balance and Multi-component Physical Activity. Classifying by intensity gradient, we can discern between absolute, moderate, and relative intensity exercises. For older people, multi-component physical activity is preferable, such as aerobic, muscle strengthening, and balance exercises. Improving balance and strength is particularly important in reducing the risk of falls (Piercy KL et al., 2018). Regarding intensity, moderate and relative intensity exercises are preferred. Since aerobic capacity decreases in older people, it is good to determine their level of effort from time to time and adjust exercise intensity accordingly (American College of Sports Medicine, 2006). Following these indications, the most recommended activity for the older people is walking. Defined as low to moderate-intensity physical activity, walking improves aerobic fitness and facilitates a decrease in body weight. (Lee LL et al.; 2021). As a rule, the faster the walk, the better the cardiovascular health, but generally, any walking at any pace is recommended. The current guidelines, for example, suggest walking 30 min a day for 5 days (Bull FC et al, 2020). Other recommended activities range from specific exercise programs, such as gentle gymnastics, to cycling or various sports, such as table tennis, tai chi or dancing (Piercy KL et al., 2018). It has also been shown that these exercises, being specific and appropriate to elderly needs, are very satisfying for them. (Jung YH et al; 2023). Promoting physical activity for older adults is therefore possible and necessary, as well as highly satisfying!
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