Health Benefits of Exercise for Frailer Older People

More Older People Living Longer 2004: 16% aged >65 yrs 4% aged >80 yrs 4 people working to support 1 retired 2050: 30% aged >65 yrs 11% aged >80 yrs 2 people working to support 1 retired

Ageing affects us all….. 1-2% in functional ability p.a. Strength Power Bone density Flexibility Endurance Balance and co-ordination Mobility and transfer skills Sedentary behaviour accelerates the loss of performance...

Activities of Daily Living…. Wash hair comfortably? 20% women & 14% of men > 50 do not have sufficient shoulder flexibility Confident of getting out of a chair without using arms ? 25% women & 7% men aged 70 – 74 do not have sufficient leg strength Ease of stair use? 47% women aged 70 – 74 do not have sufficient leg power Walk comfortably at a 20 minute a mile pace? 35% men and 80% women aged 70 – 74 do not have sufficient aerobic capacity

Thigh strength in older people Men Women Knee extension strength (N/kg) 12 10 8 6 4 2 Strength to be confident of rising from low chair without using arms 50-54 55-59 60-64 65-69 70-74 Age (years)

Vicious Cycle of Inactivity Physical deterioration - Heart disease - High blood pressure - Aches and pains - Osteoporosis Increasing age Further decrease in physical activity Social / psychological ageing - Feeling ‘old’ - ‘Acting’ one’s age - Increased stress - Anxiety, depression - Low self-esteem Decreased physical abilities - Increased body fat - Sagging muscles - Decreased energy Less exercise

UK’S Sedentary Ways 40% of people aged 50 or over in the UK are sedentary 60-85% are sedentary in ethnic minority groups Half of the sedentary over 50’s and 2/3 of over 70’s believe they take part in enough physical activity to keep fit.

How much exercise do you do? All stand up Sit down if you Walk to or from work daily Play sports, cycle or swim more than twice a week Spend more than 4 hours on your feet every day

Increasing the fracture risk? No standing activity leads to active loss of bone and muscle 1 wk bed rest  strength by ~ 20% 1 wk bed rest  spine BMD by ~1% Nursing home residents spend 80-90% of their time seated or lying down

Too frail to benefit? Dose response curve The lower the baseline level of physical activity, the greater the health benefit associated with an increase in physical activity. Exercise can be adapted for any medical condition (Haskell 1994)

Benefits of Exercise Prevention of : immobility Pressure sores disease Coronary Heart Disease, Osteoporosis, Obesity, Stroke, Depression, Type 2 Diabetes, Hypertension, Colon Cancer, disability Arthritis, Intermittent claudication, Angina, Sleep, low back pain complications of Constipation, Deep vein thrombosis, Oedema, immobility Pressure sores isolation Socialisation, Self-efficacy, Confidence dependence Functional ability, Falls, Autonomy, Dignity, Caring skills

Benefits of Regular Exercise IMPROVES OR MAINTAINS Good posture & body image Intake of nutrients and immunity to infection Cerebral function, mood, memory Sleep pattern and duration Social contacts, play INDEPENDENCE AND QUALITY OF LIFE REDUCES OR PREVENTS Likelihood of falls and fractures Breathlessness, Obesity Constipation, incontinence, urinary urgency Anxiety, Depression, Stress DEPENDENCE AND ISOLATION

“Man does not cease to play because he grows old “Man does not cease to play because he grows old. Man grows old because he ceases to play” George Bernard Shaw If I’d known I was going to live this long, I’d have taken better care of myself Dubey Blake