Physical Activity Recommendations for the Elderly

personal performance Recommendations for the ElderlyIntroduction well(p)ness is a state of complete strong-arm, mental and social soundly-organism and non merely the absence of disease or infirmity (WHO, 1946). thither argon many factors which wear an seismic disturbance on health and quality of emotional state, including emotional state- fashion choices of each individual. Diets high in fruits and vegetables and participation in regular bodily eubstance process be associated with a glower bump for several chronic diseases and conditions (US department of health and human services, 2005). sensible in action is very frequent globally with 31% of adults over 15 age old macrocosm insufficiently active. Insufficient somatogenetic in activeness results in about 3.2 meg shoemakers lasts per year (WHO, 2008).Elder adults be generally more than vulnerable to malnutrition. This is because both(prenominal) lean body mass and basal metabolic say descend with increas ing be on. It has been represent that many diseases suffered by the older pile are forage- related. Other factors contri furthering to malnutrition include dietary, psychosocial, physiological and economic changes (DiMaria-Ghalili, R. A., Amella, E., 2005).Global Recommendations on visible military action for 65 years and above according to the WHO senior adults should do at least one hundred fifty minutes of mode rank- gaudiness oxidative physical occupation throughout the week or do at least 75 minutes of prompt durability aerobic physical act throughout the week or an equivalent faction of moderate- and vigorous-intensity exertion.Aerobic activity should be performed in bouts of at least 10 minutes duration.For surplus health benefits, older adults should increment their moderate intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate -and vigorous-intensity activity.Older adults, with poor mobility, should perform physical activity to enhance chemical equilibrium and prevent fall on 3 or more years per week.Muscle-strengthening activities, involving major muscle groups, should be done on 2 or more days a week.When older adults rousenot do the recommended amounts of physical activity due to health conditions, they should be as physically active as their abilities and conditions allow.Inactive population should start with small amounts of physical activity and piecemeal increase duration, frequency and intensity over fourth dimension. Inactive adults and those with disease limitations result have added health benefits when they become more active. (WHO, 2011) corporeal activity and jam lossExercise plays an important role in building and maintaining wad and muscle strength. Physical activity positively influences nigh structural components of the musculoskeletal system that are related to functional ca pabilities and the jeopardy of exposure of degenerative diseases. Physical activity also has the potential to postpone or prevent preponderating musculoskeletal disorders, such as mechanical low back pain, bewilder do and shoulder pain, and osteoporosis and related break-dances. Exercise can contribute to the rehabilitation of musculoskeletal disorders and recovery from orthopedic surgery.Muscles and drops respond and strengthen when they are stressed. This can be achieved by weight bearing or conflict put to works which make the clappers denser. Physical activity helpers prevent weak bones and falls in the elderly. One-third of people over 65 have a fall each year and the risk of falling increases as age rises. People who have suffered fractures can benefit from special representatives and training (under medical exam supervision) to improve muscle strength and muscle function for greater mobility and modify quality of life.Balance training and Tai chi have been shown to strike falls by 47% and reduce the risk of hip fracture by approximately 25%.Physical activity and high blood pressurehypertension is defined as the constant pumping of blood through blood vessels with overweening force (WHO, 2011).Hypertension prevalence increases with advancing age and is high in men than in women until the age of 55 years, but is slightly higher(prenominal)(prenominal) in postmenopausal women (Kannel WB, 2003). According to the 2009 NCD report, 38.1% of Mauritian people aged 65 and older were considered as hypertensive but were not on medications. 45.5% were being treated for hypertension.Hypertension is the major risk factor for stroke, heart failure, and coronary thrombosis artery disease in older adults, while all of these disorders are important contributors to mortality and functional dis dexterity.Primary hypertension is the result of treble conditions, such as genetic, nutritional, psychosocial, and life style factors. One of the life style facto rs leading to hypertension is obesity, which is usually related to a sedentary life style and inadequate physical activity. Since most elderly people have an inactive routine, they are at a much higher risk of developing high blood pressure. Therapeutic life-style changes, such as reduced dietary sodium intake, weight loss, regular aerobic activity, and fasting of alcohol consumption, have been shown to benefit elderly patients with hypertension. Regular aerobic operate, consisting of a minimum of 30 min of interval training on a treadmill done three times a week, has been shown to be well tolerated and beneficial (Westhoff TH et al., 2007).The physiological effects of utilization on hypertension are complex and not fully understood. Specific mechanisms have been found to be relevant. An immediate (acute) reduction in BP following exercise has been termed post-exercise hypotension and is concord to be caused by reductions in vascular tube. (Hamer, 2006). The chronic benefits c an be partially explained by a fall downd systemic vascular resistance in which the autonomic nervous system and renin-angiotensin system are most likely the underlying regulatory mechanisms (Cornelissen and Fagard, 2005). Another factor contributing to this accrue in vascular resistance is the increase of nitric oxide production (from distinguishable sites in the body) causing a vasodilation in response to regular aerobic exercise.Physical exercise and diabetesDiabetes is a chronic disease, which cash in ones chipss when the pancreas does not produce abundant insulin, or when the body cannot effectively use the insulin it produces. This leads to an increase concentration of glucose in the blood (hyperglycemia).Diabetes is classified in three main categoriesType 1 diabetes (also known as insulin-dependent)Type 2 diabetes (also called non-insulin-dependent)Gestational diabetes347 million people worldwide have diabetes (Danaei G et al., 2011). The prevalence of diabetes in adults aged 20-74 years was 21.3% 21.9% in men and 20.6% in women (NCD report, 2009).Physical activity plays an important role in the management of type 2 diabetes, particularly glycemic control (Canadian Diabetes railroad tie Clinical Practice Guidelines Expert Committee, 2003., Zinman B, et al., 2004., Boule NG et al., 2001., Ronnemaa T et al., 1986) and improvements in cardiovascular risk profile such as rock-bottom hyperinsulinemia, increase insulin sensitivity, reduced body fat, decreased blood pressure and improve lipid profiles (Lehmann R et al.,1997., Schneider SH et al.,1992).Regular moderate physical activity and cardiorespiratory fittingness are also associated with reductions in mortality of approximately 45 to 70% in type 2 diabetes populations (Wei M, Gibbons, et al., 2000) Moreover, regular moderate physical activity can decrease glycosylated hemoglobin (A1C) to a level associated with reduced risk of diabetic complications (Boule NG et al., 2001) and is therefore fa vorably delaying the onset of type 2 diabetes in high-risk groups (Knowler WC et al., 2002., Lindstrom AM et al., 2003).The decline in insulin sensitivity with develop is sexual intercoursely due to a lack of physical activity. It is likely that maintaining better levels of fitness in the older population will lead to little chronic vascular disease and an amend quality of life (ADA, 2004).Physical activity and obesityObesity is defined as an unhealthy excess accumulation of fat in the body, which increases the risk if medical illness and premature mortality. It is due to an im chemical equilibrium between energy intake and energy expenditure. Physical activity contributes to the creation of an energy deficit by increasing fall energy expenditure, and this can promote weight loss.Aging is associated with a decrease in all major components of total energy expenditure (TEE) including resting metabolic rate (RMR which accounts for 70% of TEE), thermic effect of food (which acco unts for 10% of TEE), and physical activity (which accounts for 20% of TEE). Physical activity decreases with increasing age, and it has been estimated that decreased physical activity accounts for about one-half of the decrease in TEE that occurs with aging (Elia M, Ritz P, Stubbs RJ., 2000).Hormonal changes such as reduced responsiveness to thyroid hormone, decreased secretion of growth hormone, decrease in serum testosterone and resistance to leptin that occur during aging can also enhance the accumulation of fat ( American Journal of Clinical Nutrition, 2005).Obesity is associated with a number of complications asdecreased survivalmetabolic abnormalitieshigh blood pressureinsulin resistancedyslipidemia pulmonic abnormalitiesarthritisurinary incontinencecataracts cancerModerate weight loss in conjunction with physical activity improves physical function and health-related quality of life in obese older persons.Physical activity and cardiovascular healthA higher rate of cardiovasc ular events and a higher death rate have been observed in those individuals with low levels of physical fitness (Pate RR et al., 1995., US Public Health Service, Office of the Surgeon General, 1996). Even midlife increases in physical activity, through change in occupation or amateurish activities, are associated with a decrease in mortality (Paffenbarger RS et al., 1993). Despite this evidence, however, the grand majority of adults remain effectively inactive.According to AHA, a sedentary lifestyle is one of the major risk factors for cardiovascular diseases. Evidence from many scientific studies shows that regular exercise decreases the chance of having a heart attack or experiencing another cardiac event, such as a stroke, and reduces the possibility of needing a coronary revascularization procedure (bypass surgery or coronary angioplasty).Benefits of regular exercise on cardiovascular risk factors include addition in exercise toleranceReduction in body weightReduction in bloo d pressureReduction in bad (LDL and total) cholesterolIncrease in good (HDL) cholesterolIncrease in insulin sensitivityIn addition, exercise training positively impacts the above risk factors even in patients older than 75 years (American Family Physician, 2005). There is also evidence that exercise training improves the capacity of the blood vessels to dilate in response to exercise or hormones, consistent with better vascular wall function and an improved ability to provide oxygen to the muscles during exercise. As ones ability to transport and use oxygen improves, regular daily activities can be performed with less fatigue. This is particularly important for patients with cardiovascular disease, whose exercise capacity is typically lower than that of healthy individuals.Patients with newly diagnosed heart disease who participate in an exercise program report a more positive mindset in terms of quality of life, such as more self-confidence, lower stress, and less anxiety. Importan tly, researchers have found that for heart attack patients who participated in a formal exercise program, the death rate is reduced by 20% to 25%. This is strong evidence in support of physical activity for patients with heart disease (Circulation, 2003).Physical activity and cancerThe International position for Research on Cancer estimates that 25% of cancer cases worldwide are caused by obesity and a sedentary lifestyle. These factors may increase cancer risk by several mechanisms such as increased estrogens and testosterone, hyperinsulinemia and insulin resistance, increased inflammation, and depressed immune function. Several studies have shown that physical activity and diet changes can alter biomarkers of cancer risk (Journal of Nutrition, 2007).There is strong epidemiological evidence for reduced risk of some cancers with increasing physical activity. The strongest evidence exists for colorectal and postmenopausal breast cancer, with possible associations for prostate, endo metrial, and lung cancer (Friedenreich CM, Orenstein MR., 2002).Types of physical activitiesThere are 4 main types of physical activities namely aerobic, muscle strengthening, bone strengthening, and stretching and balance activities. (Dairy Council of California, 2014) (National heart, blood and lung institute, 2011).Aerobic activities also called cardiovascular exercises help improve the condition of lungs and heart, increase stamina, improve blood circulation and burn body fat.Such activities might include walking, jogging, bicycling, climbing stairs, walking on a treadmill, move, swimming or jumping rope. These types of activities help to raise your heart rate and increase your breathing for an elongate period of time as well as decrease the blood pressure.Muscle strengthening increases the body transfiguration by burning more calories after having stopped exercising. This is achieved by an increase in muscle mass.Muscle-strengthening activities improve the strength, power, a nd endurance of muscles. Doing pushups and sit-ups, lifting weights, climbing stairs, and digging in the garden are some examples. specialness training helps make bones stronger, improves balance and increases muscle strength. All of this helps prevent osteoporosis and lowers the risk of hip fractures from falls. Strength training has also been shown to lessen arthritis pain.Stretching helps to ease presence, improve tractability and prevent muscle strain and injury. Stretching also helps to warm up the body and prepare for exercise.Balance activities help you maintain posture and balance to keep from falling. This is particularly important for the elderly who are at risk for bone fractures.Levels of physical activities by intensitiesIntensity refers to the rate at which the activity is being performed or the magnitude of the effort required to perform an activity or exercise (WHO, 2014).The levels of intensities of physical activities are usually expressed in METs, Metabolic Equi valents.MET is the ratio of a persons working metabolic rate relative to their resting metabolic rate.One MET is defined as the energy cost of session quietly and is equivalent to a caloric consumption of 1kcal/kg/hour. It is estimated that compared with sitting quietly, a persons caloric consumption is three to six times higher when being moderately active (3-6 METs) and more than six times higher when being vigorously active (6 METs).One limitation to this way of bar exercise intensity is that it does not consider the fact that some people have a higher level of fitness than others. Thus, walking at 3 to 4 miles-per-hour is considered to require 4 METs and to be a moderate-intensity activity, disregarding of who is doing the activity whether a young marathon runner or a 90-year-old adult.Light-intensity activities require the least amount of effort, compared to moderate and vigorous activities. Light intensity activity is related to energy expenditure of less than 3 METs. It d oes not increase the heart rate.Moderate-intensity physical activity raises the heart rate, breathing rate and body temperature. During such type of activity, one can talk but not sing. The caloric consumption is from 3 to 6 METS.Vigorous intensity physical activity causes the greatest amount of oxygen consumption. It burns more than 6 METS. A person cannot utter more than a a couple of(prenominal) words without gasping for breath.Examples of physical activities based on intensityLight applicationless than 3.0 METS*(less than 3.5 calories per minute)Moderate Activityless 3.0-6.0 METS*(3.5 7 calories per minute)Vigorous Activitygreater than 6.0 METS*(more than 7 calories per minute)Casual WalkingBicycling less than 5 mphStretchingSittingLight weight training leaping slowlyLeisurely sports (table tennis, playing catch)FloatingBoatingFishing golfusing cartLight yard/house workOccupations requiring extended periods of sittingBrisk walking (3 4.5 mph)Walking uphillHikingRoller glide at leisurely strideBicycling 5-9 mphLow impact aerobicsAqua aerobicsLight calisthenicsYogaGymnasticsjump on a trampolineWeight trainingModerate dancing boxingpunching bagMost aerobic machines (e.g., stair climber, elliptical, stationary bike)moderate chiliadCompetitive tennis, volleyball, badminton, divingRecreational swimmingCanoeingHorseback ridinggolf gamecarrying clubsHousework that involves intense scrubbing/cleaningShoveling snowCarrying a babe weighing more than 50 poundsOccupations that require an extended amount of time standing or walkingRace walking (more than 4.5 mph)Jogging/ racecourseWheeling a wheelchairMountain climbingBackpackingFast pace in-line skatingBicycling more than 10 mphHigh impact aerobicsStep aerobicsVigorous calisthenicsKarate, judo, tae kwon do, jujitsu parachuting rope, jumping jacksCircuit weight trainingVigorous dancingBoxingsparringMost aerobic machines (e.g., stair climber, elliptical, stationary bike)vigorous paceCompetitive basketball, soccer , football, rugby, kickball, hockey, lacrosseSwimming laps or synchronized swimmingTreading weeweeWater joggingWater poloDownhill or cross artless skiingPushing non-motorized lawnmowerOccupations that require heavy lifting or rapid movementSource U.S. Department of Health and gracious Services. (1999). Promoting physical activity. Champaign, IL Human Kinetics.