For seniors, any exercise may be better than none - Reuters

(Reuters Health) - Even 15 minutes a day of brisk walking, cycling or swimming could help older adults live longer, according to a review of past research that found any physical activity is better than none.

For people over age 60, meeting current U.S. guidelines for moderate-to-vigorous exercise was linked to a 28 percent lower risk of dying over about 10 years, compared to being completely sedentary. But even lower levels of exercise were tied to a 22 percent reduction in mortality risk.

“When our older patients cannot do 150 minutes of moderate-intensity physical activity a week because of chronic diseases, we (the 2008 guidelines) recommend them to be as physically active as their abilities and conditions allow,” said lead author Dr. David Hupin of the department of clinical and exercise physiology, University Hospital of Saint-Etienne, France, by email.

But, Hupin’s team writes in the British Journal of Sports Medicine, the 150-minutes per week of moderate-to-vigorous exercise suggested in the 2008 Physical Activity Guidelines for Americans could be too much for some older adults, discouraging them from exercising. The authors point out that more than 60 percent of older adults don’t meet that requirement.

For the new study, Hupin’s team looked at whether less exercise could still be beneficial. They analyzed data from past studies covering a total of 122,417 men and women between the ages of 60 and 101 in the U.S., Taiwan and Australia.

The studies evaluated participants' physical activity levels and their risk of dying from any cause over about 10 years. Theyalso factored in participants’ self-reported health status, physical or mental illnesses, weight, cholesterol and other details.

Hupin’s team standardized participants' exercise amount and intensity into units known as Metabolic Equivalent of Task, or METs, representing the amount of energy expended per minute in a specific activity. Resting expends 1 MET, moderate activity like walking uses 3 to 5.9 METs and vigorous exercise like running uses more than 6 METs.

A weekly exercise “dose” was low if it totaled 1 to 499 METs, moderate at 500 to 999 METs and high if it was more than 1,000 METs.

The mortality rate was 22 percent lower among people in the low METs category than among those who did no exercise at all beyond the activities of daily living.

For people in the moderate METs category - which is equivalent to the recommended 150 minutes per week of moderate-to-vigorous exercise - there were 28 percent fewer deaths compared to those with no exercise.

People who expended at least 1,000 METs per week had a 35 percent lower mortality rate.

The link between exercise and mortality risk was especially strong for cardiovascular disease and less so for cancer, the researchers note.

Older women showed an even greater benefit from exercise than men, with their mortality risk decreasing by 32 percent compared to men’s 14 percent in the low-METs category. One reason could be that women underestimated their exercise level and men overestimated theirs, the authors write.

The researchers recommend 15 minutes per day of exercise based on these results, but Hupin said adults who couldn’t even meet that goal would benefit by merely moving around more on a consistent basis.

“Scientific evidence is now emerging to show that there may be health benefits from light physical activity and from replacing sedentary activities with light intensity activities, when the dose of (moderate-to-vigorous physical activity) is held constant,” Hupin said. “They must become less sedentary: cooking or working at a standing desk, rather than sitting.

“Age is not an excuse to do no exercise,” he said.

Thomas Buford, who directs the Health Promotion Center at the University of Florida in Gainesville, said that while the study offered great examples of exercise, such as walking briskly, bicycling and swimming or gymnastics, he agreed that even increasing exercise in small bouts would help.

“For each individual, they would have to be tailored depending on their physical abilities,” Buford said by email.

SOURCE: bit.ly/1HEXnpf British Journal of Sports Medicine, online August 3, 2015.

http://www.reuters.com/article/2015/08/21/us-health-elderly-fitness-mortality-idUSKCN0QQ1M620150821

U.S. Seniors Losing Grip on Muscle Strength

U.S. Seniors Losing Grip on Muscle Strength - Signs of frailty seen as early as age 60.


The first national survey on grip strength in older adults found that 5% of those over 60 had weak muscle strength, and 13% had intermediate strength.

According to data collected in 2011-2012, weak and intermediate strength (considered reduced) increased with age, while normal strength declined with age, wrote Anne Looker, PhD, and Chia-Yih Wang, PhD, of the CDC's National Center for Health Statistics (NCHS) in Atlanta.

The data were generated using criteria developed by the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project. The findings may help clinicians identify those who will be at greater risk for impaired mobility, the authors stated in an NCHS Data Brief.

"We have tried to identify ahead of time those most at risk for developing the kind of disabilities and problems that are going to make them not be able to live independently anymore," said Looker in an interview with MedPage Today. "Our numbers give people some ideas of what the size of the problem is."

Looker and Wang used data from the National Health and Nutrition Examination Survey (NHANES), which used interviews and a grip strength dynamometer to measure muscle weakness. Weak muscle strength was defined as a maximum hand grip strength of less than 26 kg for men and less than 16 kg for women.

Among those over 80, 19% had weak strength and 34% had intermediate strength. Asians and Hispanics had a higher prevalence of reduced muscle strength than did white people. Men and women were at equal risk except in the above 80 category, in which women were at greater risk than men for muscle weakness (22% versus 15%).

Muscle weakness has been associated with slower gait speed, the authors noted. Not surprisingly, they found that it was also associated with greater difficulty getting out of a chair. The criteria used in the study were presented last year by the NIH Sarcopenia Project. Looker said she hopes the new criteria will signal who is at risk of becoming prematurely disabled.

"It would then be possible to, depending on what the cause is, intervene and help them avoid these difficult and bad outcomes," she said.

Looker also noted that muscle weakness doesn't seem to relate to the amount of muscle. "It started out that this was just an issue of how much muscle you had, but in recent years they've found that it doesn't really link all that well to developing problems in the future," she said. "It's really more related to things like muscle strength."

Fonte:
http://www.medpagetoday.com/Geriatrics/GeneralGeriatrics/49754?xid=nl_mpt_DHE_2015-01-29&utm_content&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=ST&eun=g891176d0r&userid=891176&email=dtruags%40gmail.com&mu_id=7114932&utm_term=Daily


http://www.medpagetoday.com/upload/2015/1/28/db179.pdf