Changes Acoss The Lifespan Flashcards
1
Q
What areas are changed by ageing?
A
Strength, ROM, Bone Density, Fitness, Cognition
2
Q
When is loss of strength evident?
A
after 50 yrs
3
Q
When does loss of strength occur rapidly?
A
after70 yrs
4
Q
When does loss of strength occur?
A
evident after 50
increases rapidly after70
5
Q
What is the extent of loss of strength? and where?
A
65- 89 yr loss 1-2% per year in
- elbow flexors, handgrip, an knee extensors
6
Q
What age do people lose 1-2% of strength per year?
A
65-89
7
Q
How much strength does vastus lateralis lose?
A
up to 40%
8
Q
How much strength do plantarflexors lose?
A
Up to 60%
9
Q
How much strength do ankle dorsiflexors loe?
A
20-30%
10
Q
When do ankle dorsiflexors lose strength?
A
Later than plantarflexors
11
Q
What mode of contraction is affected most with age?
A
Loss of concentric and isometric strength is much more sever than loss of eccentric strength
12
Q
Is power or strength reduced more with age?
A
Power
13
Q
How is endurance affected by age?
A
Decrease in mucle endurance
Decreased ability to maintain a force at a given intensity
14
Q
What are the muscular changes that occur with age?
A
Decreased muscle mass
Decreased specific tension of muscle fibres
Decreased shortening velocity
Decreased number of motor units
15
Q
How do he motor units of tibialis anterior change across the lifespan?
A
27 yo 43 motor units
older participants (66 yo) - 22 motr units
very old participant (82 yo) had 15 motor units
16
Q
What muscle fibre is thought to be lost?
A
Repots of more loss of Type II motor units ( unclear whether due to age or inactivity
17
Q
How does muscle mass change with age?
A
20-40% between 30 and 80 yo
18
Q
What is reduced specific tension and reduced shortening velocity?
A
Reduced length ad mass of individual fibres
Reduced myosin concentraton
19
Q
What neural changes occur with ageing? (6)
A
Decreased motor neurones Decreased conduction velocity Decreased motor neurone excitability Decreased motor neurone firing rate Decreased voluntary activation of motor units Excessive co-contraction of muscles
20
Q
Which motor neurone decrease with age?
A
Upper and lower
21
Q
What rate do motor neurones decrease with age?
A
Decrease of up to 35% of UMN after 50 yr
Decrease of up to 25% LMN after 80yr
Decreased capacity for motor neurone sprouting
22
Q
How much is conduction velocity reduced wit age?
A
Reduced byup to 29% in older (65-80 yo) compared to younger participants
23
Q
How does firing rate change with age?
A
Reduced by 20% in 80yo compared to 20 yo
24
Q
What has been found about activation capcacity and cocontraction with ageing?
A
Controversial - different studies have produced different results
A study on plantarflexors:
78% activation capacity in older participants
99% in younger
However, another study on dorsiflexor muscles found no significant difference
Clear defecit in older people who are less active or affected by disease
25
What are the differences in results found in studies of activation capacity likely due to?
Different participant groups
| Difference muscles measured
26
Why is there less muscular endurance with ageing?
Less motor units to share the load
27
Why is there more loss of power than strength?
Less type II muscle fibres
28
What is important in determining the walking speed in normal ageing?
Leg strength
29
What is the impact of normal ageing on standing up?
Older people use significantly more of their available strength to rise from a chair.
At lowest hight, - 97% of available knee extensor strength being used.
30
What does decreased strength result in?
Decreased ability to perform everyday tasks
- standing up
-walking
Slower recovery from repetitive daily tasks
Increased risk of falling
31
How much hip ROM is lose with age?
20-30%
32
How much spine ROM is lost with age?
20-30%
33
How much ankle ROM is lose with age?
30-40%
34
What connective tissue changes occur with ageing?
Collagen becomes thicker and rougher
| Elastin more intertwined and accumulates mineral deposits
35
What changes occur at joints with age?
Decreased synovial fluid volume and viscosity
Fibrotisation of the synovium
Changes in water content and elasticity in cartilage
Narrowing of joint space
36
What is the impact of decreased ROM?
Links between poor ROM, mobility and physical independence.
37
At what age is peak bone mass?
20
38
When does bone density decline?
After 30 yo - los of 0.5%/yr
| After menopause - 2-3%/yr
39
What is osteopenia and what is the risk associatedwith?
1-2.5 SD below controls
| Increases fracture risk
40
What are the changes in cardiovascular fitness in normal ageing?
Decreased cardiac output
Slower HR response to exercise
Decreased V02 max - loss of 5-15 % each decade after 30yo
41
What changes occur in the arteries with age?
Increased stiffness
Plaque accumulation
Less vasodilation
42
What does decreased vasodilation mean?
Older people are more affected by the heat
43
What changes occur to pulmonary function in normal ageing?
Stiffer chest wall
Increased risk of atelectasis
Reduced surface area for gas exchange
Increased work of breathing
44
What is the impact of chanes in cardiovascular fitness in normal ageing?
Slowed HR response- takes longer to reach training HR
| For given workload-working at a higher proportion of V02 max
45
What is fluid intelligence?
Relies on short term memory storage while processing information.
- Novel problem solving
- spatial manipulation
- speed of processing
- identifying complex relation among patterns
46
What is crystallized intelligence?
Relies on long term memory - accumulated knowledge and expertise
47
How does ageing affect memory?
Affects fluid intelligence.
- slower information processing
- difficulty selectively attending to information and inhibiting irrelevant information.
Deficits in information processing and attention impact of working memory and short term memory.
48
What happens to crystallized intelligence across the lifespan?
Increases due to
education
occupational, cultural cultural experience
cultural, intellectual pursuits
49
33 item vocab test 25 yo and 70 yo
No difference
50
25 yo and 70 yo recall of digits in order presented
25 recalled about seven
| 70 recalled about 5
51
25 yo and 70 yo coding speed within a time limit
25 coded about seventy eight items correctly
70
About 51 items correctly
52
What is MMSE
Mini mental state exam
| <24/30 used to indicate cognitive impairment
53
Limitation of MMSE
Reliant on English literacy and numeracy skills
Differentiating normal ageing from cognitive impairment requires formal assessment by neurologist, geriatrician or neuropsychologist
54
What happens to physical activity with age
Declines
- measures by self report, interview, body motion sensors, daily caloric expenditure
Lesser intensity
Ie walking, golf, low impact activities
55
Survey of activity in older adults
32 % no exercise in last year
40% one type of activity
53 % exclusively walking
56
What chronic diseases are more likely in older age that can be reduced with exercise
Cardiovascular disease
Diabetes
Cancer
MSK condition:
Osteoporosis, arthritis, sarcopenia
57
Three characteristic behaviours for longevity
Regular exercise
Maintaining a social network
Maintaining a positive mental attitude
58
Physiological factors for longevity
```
Low BP
Low bmi
Low central adiposity
Preserved glucose tolerance
Low cholesterol levels
```
(Physical activity influences all of these(
59
Regular physical activity increases average life expectancy by
1. Decreasing the development of chronic disease
2. Restoring/ maintaining functional
Capacity in older people
60
What happens to older athletes
Thinner and fitter
Cardio protective
Also
30-50% stronger than sedentary peers
Faster nerve conduction velocity
Retention of type II fibres
61
Aerobic training leads to
```
Improved vo2 max
Improved sub maximal metabolic responses
Improved exercise tolerance
Lower resting hr
Lower HR for given workload
Less increases in BP at a given workload
Improved vasodilator and O2 capacity of trained muscles
Numerous cardio protective
```
62
Caution physical activity in older adults
Older people may take longer to reach same levels of improvement as younger person
- Increased risk of heat/cold illness or injury
Cessation of aerobic training leads to rapid loss of cardiovascular fitness
63
Benefits training for bone density
Low intensity weight bearing activities ie walking
- counteract age related loss of bone density
Reduce hip fracture risk
High intensity eg jogging
- more significant effects
64
Resistance training leads to
Increased muscle strength, endurance,size, power, activity
65
Capacity of older adults to adapt to training and increase strength
Equal to younger adults
66
How can resistance training be more functional for older adults
Muscle power (force x velocity) is more strongly associated with function than strength
Using higher velocity training protocols- gains in power may be comparable or greater than gains in strength (include speed in training)
67
What does high intensity resistance training do?
Preserves or increases bone density
68
Benefits of walking
No change self selected speed (except frail older people)significant Change in maximum walking speed
69
Cessation of resistance training
Leads to loss of strength but at slower rate than loss of cardiovascular fitness
Rest of up to five weeks- no significant loss of strength
70
Delivery resistance training
Gym facility- high adherence
Home- drop out numbers higher
Reduced effectiveness- less supervision
Harder to ensure sufficient resistance
71
Benefits of balance training
Effective at reducing non injurious falls and sometimes injurious falls in people who are ar risk of falling
72
Specificity of training in older adults. Consider
Adaptations will mimic the Kinematics, kinetics of the training programme
Important to include higher velocity movements that mimic ADL
73
Psychosocial benefits exercise in older adults
Significant improvement in overall psychological well being
- moderating effects on self concept and self esteem
Decreased risk for depression or anxiety
74
Benefits exercise cognitive function older adults
Reduced risk cognitive decline and dementia
Combined aerobic and resistance:
Can improve some measures of cognitive functions
- especially on tasks requiring complex processing
75
Clinical implications increasing physical activity in older adults- general
Increase time in warm up
- slower O2 uptake in response to exercise
- slower hr response
76
Clinical implications increasing physical activity in older adults- resistance training
Need moderate to high intensity
Incorporate power training
Concentrate concentric and isometric contractions
Needs to be task specific to carry over to functional improvements
Need to find ways to make the strength gains self sustaining
77
Individual barrier to increasing physical activity in older adults
Disability - hearing, visual problems
Beliefs
- negative beliefs about benefits of exercise
- low self efficacy
- fears associated with injury, fear of falling
Cultural attitudes to exercise
78
Social barriers to older adult increasing physical activity
Social stereotypes - older pellets some engage in moderate/vigorous exercise
Social isolation
Caring for spouse
Lack of role model
Negative attitudes of family, friends and health progfessionals
79
Structural barriers to increasing physical activity in older adults
Access to appropriate venues
Neighbourhood safety
Transport. Socio economic disadvantage
80
Clinical implications increasing aerobic training in older adults
Needs to be ongoing
- need to make it engaging
Incorporate with social interaction
Consider weight bearing intensity for improving bmd
81
Effective programmes for older adults
Studies have found
Home based, group based and community interventions have positive effect on physical activity in older people
- changes are short lived
Longer term adherence higher in structured classes or group based activities
Effective programmes have used :
Individually tailored choice
Combination of behavioural and or cognitive tools (goals, feedback. Support, relapse prevention)
82
CHAMPS project
For people aged 65-90 yo
Individual tailoring of physical activity
- individuals' health status, activity preference, ability
- activities people can do alone and structured programmes available in the community
- initial interview, follow up newsletters, phone support
At one year - Improvements in caloric expenditure and self esteem
83
Increasing activity in older adults , maintenance - what works best?
IT intervention resulted in better maintenance than standard clinical intervention
Diabetes network internet based physical activity intervention program
Online "personal coach"
- more consistent intervention as less disruption and transport requirements
84
33 item vocab test 25 yo and 70 yo
No difference
85
25 yo and 70 yo recall of digits in order presented
25 recalled about seven
| 70 recalled about 5
86
25 yo and 70 yo coding speed within a time limit
25 coded about seventy eight items correctly
70
About 51 items correctly
87
What is MMSE
Mini mental state exam
| <24/30 used to indicate cognitive impairment
88
Limitation of MMSE
Reliant on English literacy and numeracy skills
Differentiating normal ageing from cognitive impairment requires formal assessment by neurologist, geriatrician or neuropsychologist
89
What happens to physical activity with age
Declines
- measures by self report, interview, body motion sensors, daily caloric expenditure
Lesser intensity
Ie walking, golf, low impact activities
90
Survey of activity in older adults
32 % no exercise in last year
40% one type of activity
53 % exclusively walking
91
What chronic diseases are more likely in older age that can be reduced with exercise
Cardiovascular disease
Diabetes
Cancer
MSK condition:
Osteoporosis, arthritis, sarcopenia
92
Three characteristic behaviours for longevity
Regular exercise
Maintaining a social network
Maintaining a positive mental attitude
93
Physiological factors for longevity
```
Low BP
Low bmi
Low central adiposity
Preserved glucose tolerance
Low cholesterol levels
```
(Physical activity influences all of these(
94
Regular physical activity increases average life expectancy by
1. Decreasing the development of chronic disease
2. Restoring/ maintaining functional
Capacity in older people
95
What happens to older athletes
Thinner and fitter
Cardio protective
Also
30-50% stronger than sedentary peers
Faster nerve conduction velocity
Retention of type II fibres
96
Aerobic training leads to
```
Improved vo2 max
Improved sub maximal metabolic responses
Improved exercise tolerance
Lower resting hr
Lower HR for given workload
Less increases in BP at a given workload
Improved vasodilator and O2 capacity of trained muscles
Numerous cardio protective
```
97
Caution physical activity in older adults
Older people may take longer to reach same levels of improvement as younger person
- Increased risk of heat/cold illness or injury
Cessation of aerobic training leads to rapid loss of cardiovascular fitness
98
Benefits training for bone density
Low intensity weight bearing activities ie walking
- counteract age related loss of bone density
Reduce hip fracture risk
High intensity eg jogging
- more significant effects
99
Resistance training leads to
Increased muscle strength, endurance,size, power, activity
100
Capacity of older adults to adapt to training and increase strength
Equal to younger adults
101
How can resistance training be more functional for older adults
Muscle power (force x velocity) is more strongly associated with function than strength
Using higher velocity training protocols- gains in power may be comparable or greater than gains in strength (include speed in training)
102
What does high intensity resistance training do?
Preserves or increases bone density
103
Benefits of walking
No change self selected speed (except frail older people)significant Change in maximum walking speed
104
Cessation of resistance training
Leads to loss of strength but at slower rate than loss of cardiovascular fitness
Rest of up to five weeks- no significant loss of strength
105
Delivery resistance training
Gym facility- high adherence
Home- drop out numbers higher
Reduced effectiveness- less supervision
Harder to ensure sufficient resistance
106
Benefits of balance training
Effective at reducing non injurious falls and sometimes injurious falls in people who are ar risk of falling
107
Specificity of training in older adults. Consider
Adaptations will mimic the Kinematics, kinetics of the training programme
Important to include higher velocity movements that mimic ADL
108
Psychosocial benefits exercise in older adults
Significant improvement in overall psychological well being
- moderating effects on self concept and self esteem
Decreased risk for depression or anxiety
109
Benefits exercise cognitive function older adults
Reduced risk cognitive decline and dementia
Combined aerobic and resistance:
Can improve some measures of cognitive functions
- especially on tasks requiring complex processing
110
Clinical implications increasing physical activity in older adults- general
Increase time in warm up
- slower O2 uptake in response to exercise
- slower hr response
111
Clinical implications increasing physical activity in older adults- resistance training
Need moderate to high intensity
Incorporate power training
Concentrate concentric and isometric contractions
Needs to be task specific to carry over to functional improvements
Need to find ways to make the strength gains self sustaining
112
Individual barrier to increasing physical activity in older adults
Disability - hearing, visual problems
Beliefs
- negative beliefs about benefits of exercise
- low self efficacy
- fears associated with injury, fear of falling
Cultural attitudes to exercise
113
Social barriers to older adult increasing physical activity
Social stereotypes - older pellets some engage in moderate/vigorous exercise
Social isolation
Caring for spouse
Lack of role model
Negative attitudes of family, friends and health progfessionals
114
Structural barriers to increasing physical activity in older adults
Access to appropriate venues
Neighbourhood safety
Transport. Socio economic disadvantage
115
Clinical implications increasing aerobic training in older adults
Needs to be ongoing
- need to make it engaging
Incorporate with social interaction
Consider weight bearing intensity for improving bmd
116
Effective programmes for older adults
Studies have found
Home based, group based and community interventions have positive effect on physical activity in older people
- changes are short lived
Longer term adherence higher in structured classes or group based activities
Effective programmes have used :
Individually tailored choice
Combination of behavioural and or cognitive tools (goals, feedback. Support, relapse prevention)
117
CHAMPS project
For people aged 65-90 yo
Individual tailoring of physical activity
- individuals' health status, activity preference, ability
- activities people can do alone and structured programmes available in the community
- initial interview, follow up newsletters, phone support
At one year - Improvements in caloric expenditure and self esteem
118
Increasing activity in older adults , maintenance - what works best?
IT intervention resulted in better maintenance than standard clinical intervention
Diabetes network internet based physical activity intervention program
Online "personal coach"
- more consistent intervention as less disruption and transport requirements
119
33 item vocab test 25 yo and 70 yo
No difference
120
25 yo and 70 yo recall of digits in order presented
25 recalled about seven
| 70 recalled about 5
121
25 yo and 70 yo coding speed within a time limit
25 coded about seventy eight items correctly
70
About 51 items correctly
122
What is MMSE
Mini mental state exam
| <24/30 used to indicate cognitive impairment
123
Limitation of MMSE
Reliant on English literacy and numeracy skills
Differentiating normal ageing from cognitive impairment requires formal assessment by neurologist, geriatrician or neuropsychologist
124
What happens to physical activity with age
Declines
- measures by self report, interview, body motion sensors, daily caloric expenditure
Lesser intensity
Ie walking, golf, low impact activities
125
Survey of activity in older adults
32 % no exercise in last year
40% one type of activity
53 % exclusively walking
126
What chronic diseases are more likely in older age that can be reduced with exercise
Cardiovascular disease
Diabetes
Cancer
MSK condition:
Osteoporosis, arthritis, sarcopenia
127
Three characteristic behaviours for longevity
Regular exercise
Maintaining a social network
Maintaining a positive mental attitude
128
Physiological factors for longevity
```
Low BP
Low bmi
Low central adiposity
Preserved glucose tolerance
Low cholesterol levels
```
(Physical activity influences all of these(
129
Regular physical activity increases average life expectancy by
1. Decreasing the development of chronic disease
2. Restoring/ maintaining functional
Capacity in older people
130
What happens to older athletes
Thinner and fitter
Cardio protective
Also
30-50% stronger than sedentary peers
Faster nerve conduction velocity
Retention of type II fibres
131
Aerobic training leads to
```
Improved vo2 max
Improved sub maximal metabolic responses
Improved exercise tolerance
Lower resting hr
Lower HR for given workload
Less increases in BP at a given workload
Improved vasodilator and O2 capacity of trained muscles
Numerous cardio protective
```
132
Caution physical activity in older adults
Older people may take longer to reach same levels of improvement as younger person
- Increased risk of heat/cold illness or injury
Cessation of aerobic training leads to rapid loss of cardiovascular fitness
133
Benefits training for bone density
Low intensity weight bearing activities ie walking
- counteract age related loss of bone density
Reduce hip fracture risk
High intensity eg jogging
- more significant effects
134
Resistance training leads to
Increased muscle strength, endurance,size, power, activity
135
Capacity of older adults to adapt to training and increase strength
Equal to younger adults
136
How can resistance training be more functional for older adults
Muscle power (force x velocity) is more strongly associated with function than strength
Using higher velocity training protocols- gains in power may be comparable or greater than gains in strength (include speed in training)
137
What does high intensity resistance training do?
Preserves or increases bone density
138
Benefits of walking
No change self selected speed (except frail older people)significant Change in maximum walking speed
139
Cessation of resistance training
Leads to loss of strength but at slower rate than loss of cardiovascular fitness
Rest of up to five weeks- no significant loss of strength
140
Delivery resistance training
Gym facility- high adherence
Home- drop out numbers higher
Reduced effectiveness- less supervision
Harder to ensure sufficient resistance
141
Benefits of balance training
Effective at reducing non injurious falls and sometimes injurious falls in people who are ar risk of falling
142
Specificity of training in older adults. Consider
Adaptations will mimic the Kinematics, kinetics of the training programme
Important to include higher velocity movements that mimic ADL
143
Psychosocial benefits exercise in older adults
Significant improvement in overall psychological well being
- moderating effects on self concept and self esteem
Decreased risk for depression or anxiety
144
Benefits exercise cognitive function older adults
Reduced risk cognitive decline and dementia
Combined aerobic and resistance:
Can improve some measures of cognitive functions
- especially on tasks requiring complex processing
145
Clinical implications increasing physical activity in older adults- general
Increase time in warm up
- slower O2 uptake in response to exercise
- slower hr response
146
Clinical implications increasing physical activity in older adults- resistance training
Need moderate to high intensity
Incorporate power training
Concentrate concentric and isometric contractions
Needs to be task specific to carry over to functional improvements
Need to find ways to make the strength gains self sustaining
147
Individual barrier to increasing physical activity in older adults
Disability - hearing, visual problems
Beliefs
- negative beliefs about benefits of exercise
- low self efficacy
- fears associated with injury, fear of falling
Cultural attitudes to exercise
148
Social barriers to older adult increasing physical activity
Social stereotypes - older pellets some engage in moderate/vigorous exercise
Social isolation
Caring for spouse
Lack of role model
Negative attitudes of family, friends and health progfessionals
149
Structural barriers to increasing physical activity in older adults
Access to appropriate venues
Neighbourhood safety
Transport. Socio economic disadvantage
150
Clinical implications increasing aerobic training in older adults
Needs to be ongoing
- need to make it engaging
Incorporate with social interaction
Consider weight bearing intensity for improving bmd
151
Effective programmes for older adults
Studies have found
Home based, group based and community interventions have positive effect on physical activity in older people
- changes are short lived
Longer term adherence higher in structured classes or group based activities
Effective programmes have used :
Individually tailored choice
Combination of behavioural and or cognitive tools (goals, feedback. Support, relapse prevention)
152
CHAMPS project
For people aged 65-90 yo
Individual tailoring of physical activity
- individuals' health status, activity preference, ability
- activities people can do alone and structured programmes available in the community
- initial interview, follow up newsletters, phone support
At one year - Improvements in caloric expenditure and self esteem
153
Increasing activity in older adults , maintenance - what works best?
IT intervention resulted in better maintenance than standard clinical intervention
Diabetes network internet based physical activity intervention program
Online "personal coach"
- more consistent intervention as less disruption and transport requirements
154
33 item vocab test 25 yo and 70 yo
No difference
155
25 yo and 70 yo recall of digits in order presented
25 recalled about seven
| 70 recalled about 5
156
25 yo and 70 yo coding speed within a time limit
25 coded about seventy eight items correctly
70
About 51 items correctly
157
What is MMSE
Mini mental state exam
| <24/30 used to indicate cognitive impairment
158
Limitation of MMSE
Reliant on English literacy and numeracy skills
Differentiating normal ageing from cognitive impairment requires formal assessment by neurologist, geriatrician or neuropsychologist
159
What happens to physical activity with age
Declines
- measures by self report, interview, body motion sensors, daily caloric expenditure
Lesser intensity
Ie walking, golf, low impact activities
160
Survey of activity in older adults
32 % no exercise in last year
40% one type of activity
53 % exclusively walking
161
What chronic diseases are more likely in older age that can be reduced with exercise
Cardiovascular disease
Diabetes
Cancer
MSK condition:
Osteoporosis, arthritis, sarcopenia
162
Three characteristic behaviours for longevity
Regular exercise
Maintaining a social network
Maintaining a positive mental attitude
163
Physiological factors for longevity
```
Low BP
Low bmi
Low central adiposity
Preserved glucose tolerance
Low cholesterol levels
```
(Physical activity influences all of these(
164
Regular physical activity increases average life expectancy by
1. Decreasing the development of chronic disease
2. Restoring/ maintaining functional
Capacity in older people
165
What happens to older athletes
Thinner and fitter
Cardio protective
Also
30-50% stronger than sedentary peers
Faster nerve conduction velocity
Retention of type II fibres
166
Aerobic training leads to
```
Improved vo2 max
Improved sub maximal metabolic responses
Improved exercise tolerance
Lower resting hr
Lower HR for given workload
Less increases in BP at a given workload
Improved vasodilator and O2 capacity of trained muscles
Numerous cardio protective
```
167
Caution physical activity in older adults
Older people may take longer to reach same levels of improvement as younger person
- Increased risk of heat/cold illness or injury
Cessation of aerobic training leads to rapid loss of cardiovascular fitness
168
Benefits training for bone density
Low intensity weight bearing activities ie walking
- counteract age related loss of bone density
Reduce hip fracture risk
High intensity eg jogging
- more significant effects
169
Resistance training leads to
Increased muscle strength, endurance,size, power, activity
170
Capacity of older adults to adapt to training and increase strength
Equal to younger adults
171
How can resistance training be more functional for older adults
Muscle power (force x velocity) is more strongly associated with function than strength
Using higher velocity training protocols- gains in power may be comparable or greater than gains in strength (include speed in training)
172
What does high intensity resistance training do?
Preserves or increases bone density
173
Benefits of walking
No change self selected speed (except frail older people)significant Change in maximum walking speed
174
Cessation of resistance training
Leads to loss of strength but at slower rate than loss of cardiovascular fitness
Rest of up to five weeks- no significant loss of strength
175
Delivery resistance training
Gym facility- high adherence
Home- drop out numbers higher
Reduced effectiveness- less supervision
Harder to ensure sufficient resistance
176
Benefits of balance training
Effective at reducing non injurious falls and sometimes injurious falls in people who are ar risk of falling
177
Specificity of training in older adults. Consider
Adaptations will mimic the Kinematics, kinetics of the training programme
Important to include higher velocity movements that mimic ADL
178
Psychosocial benefits exercise in older adults
Significant improvement in overall psychological well being
- moderating effects on self concept and self esteem
Decreased risk for depression or anxiety
179
Benefits exercise cognitive function older adults
Reduced risk cognitive decline and dementia
Combined aerobic and resistance:
Can improve some measures of cognitive functions
- especially on tasks requiring complex processing
180
Clinical implications increasing physical activity in older adults- general
Increase time in warm up
- slower O2 uptake in response to exercise
- slower hr response
181
Clinical implications increasing physical activity in older adults- resistance training
Need moderate to high intensity
Incorporate power training
Concentrate concentric and isometric contractions
Needs to be task specific to carry over to functional improvements
Need to find ways to make the strength gains self sustaining
182
Individual barrier to increasing physical activity in older adults
Disability - hearing, visual problems
Beliefs
- negative beliefs about benefits of exercise
- low self efficacy
- fears associated with injury, fear of falling
Cultural attitudes to exercise
183
Social barriers to older adult increasing physical activity
Social stereotypes - older pellets some engage in moderate/vigorous exercise
Social isolation
Caring for spouse
Lack of role model
Negative attitudes of family, friends and health progfessionals
184
Structural barriers to increasing physical activity in older adults
Access to appropriate venues
Neighbourhood safety
Transport. Socio economic disadvantage
185
Clinical implications increasing aerobic training in older adults
Needs to be ongoing
- need to make it engaging
Incorporate with social interaction
Consider weight bearing intensity for improving bmd
186
Effective programmes for older adults
Studies have found
Home based, group based and community interventions have positive effect on physical activity in older people
- changes are short lived
Longer term adherence higher in structured classes or group based activities
Effective programmes have used :
Individually tailored choice
Combination of behavioural and or cognitive tools (goals, feedback. Support, relapse prevention)
187
CHAMPS project
For people aged 65-90 yo
Individual tailoring of physical activity
- individuals' health status, activity preference, ability
- activities people can do alone and structured programmes available in the community
- initial interview, follow up newsletters, phone support
At one year - Improvements in caloric expenditure and self esteem
188
Increasing activity in older adults , maintenance - what works best?
IT intervention resulted in better maintenance than standard clinical intervention
Diabetes network internet based physical activity intervention program
Online "personal coach"
- more consistent intervention as less disruption and transport requirements
