Exercise is a protective factor for noncommunicable diseases such as cardiovascular disease, stroke, diabetes, and some types of cancer and exercise is associated with improved mental health, delay in the onset of dementia, and improved quality of life and wellbeing. The health benefits of exercise are well documented with higher levels and greater frequency of exercise being associated with reduced risk and improved health in a number of key areas.
The dose of exercise is described by the duration, frequency, intensity, and mode. For optimal effects, the older person must adhere to the prescribed exercise program and follow the overload principle of training, i.e., to exercise near the limit of the maximum capacity to challenge the body systems sufficiently, to induce improvements in physiological parameters such as cardiorespiratory fitness and muscular strength.
Improvements in mental health, emotional, psychological, and social well-being and cognitive function are also associated with regular exercise. Despite these health benefits, exercise levels amongst older adults remain below the recommended 150 min/week. The crude global prevalence of physical inactivity is 21.4%. This translates to one in every four to five adults being physically inactive, or with activity levels lower than the current recommendations from the World Health Organisation (WHO). Inactivity and ageing increase the risk of chronic disease, and older people often have multiple chronic conditions. The exercise recommendations from WHO include both aerobic exercise and strength exercise as well as balance exercises to reduce the risk of falls. If older adults cannot follow the guidelines because of chronic conditions, they should be as active as their ability and conditions allow. It is important to note that the recommended amount of exercise is in addition to routine activities of daily living like self-care, cooking, and shopping, to mention a few.
Inactivity is associated with alterations in body composition resulting in an increase in percentage of body fat and a concomitant decline in lean body mass. Thus, significant loss in maximal force production takes place with inactivity. Skeletal muscle atrophy is often considered a hallmark of aging and physical inactivity. Sarcopenia is defined as low muscle mass in combination with low muscle strength and/or low physical performance. Consequently, low physical performance and dependence in activities of daily living is more common among older people. However, strength training has been shown to increase lean body mass, improve physical performance, and to a lesser extent have a positive effect on self-reported activities of daily living.
Participation in PA and exercise can contribute to maintaining quality of life, health, and physical function and reducing falls among older people in general and older people with morbidities in particular. The increased attention to the relationship between exercise and HRQOL in older adults over the last decade is reflected in a recent review, which showed that a moderate PA level combining multitasking exercise components had a positive effect on activities in daily living, highlighting the importance of physical, mental, and social demands. To reduce falls, balance training is also recommended to be included in physical exercise programs for older adults. Exercise has also been shown to reduce falls with 21%, with a greater effect of exercise programs including challenging balance activities for more than 3 hours/week.
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