Physical activity and exercise slow the negative consequences of ageing
Robert Butler and colleagues (BMJ, 19 July 2008, 149-150) wrote an
interesting article about a recommendable paradigm shift from research
targeted at individual diseases to multidisciplinary ageing research. We
certainly support this view, and would like to add some comments. Already
in 1981 Fries and Crapo1 revealed their theory of compression of morbidity
in their pioneering work called ‘Vitality and Aging’. The idea behind this
was that strategies for health promotion such as stimulation of physical
activity and improvement of other lifestyle behaviours, could enhance
quality of life and decrease the time spent with diseases.
In the eighties
of the last century an exiting new branch of science started in the area
of physical activity and exercise. An overwhelming amount of evidence has
since then been published on substantial benefits of physical activity,
including physical and cognitive functioning of older people. As the well
known geriatrician Archie Young2 stated already in 1986: “not only can
exercise reverse the effects of immobilization, it can readily produce a
further 10 to 20% improvement in strength and aerobic power, effectively
postponing functionally important thresholds for some 10 to 20 years”.
Knowing these facts, it is amazing that the medical field in general is
still reluctant to advise and prescribe physical activity to (older)
people. This can partly be explained by the fear that people could
experience a fall or get heart complaints. During the last World
Conference of Physical Activity and Aging in Japan (July 2008) it was
stated however, that a visit to the toilet is much more dangerous for
older people than getting started with physical activity (such as for
instance walking).
In our eyes the practical interventions that slow the negative
consequences of ageing are relatively easy to achieve: prescription of
physical activity and exercise, be it as an elixir of life such as
recommended by Nelson et al3 or as a (preventive) medicine in case of a
potential hazardous major life event (e.g. Hulzebos et al4).
1 Fries JF, Crapo LM. Vitality and Aging. San Francisco: WH Freeman,
1981.
2 Young A. Exercise physiology in geriatric practice. Acta Med Scand
Suppl. 1986; 711: 227-232.
3 Nelson ME et al. Physical activity and public health in older adults:
recommendation from the American College of Sports Medicine and the
American Heart Association. Med Sci Sports Exerc 2007; 38(8): 1435-1445.
4 Hulzebos HJ et al. Prevention of postoperative pulmonary complications
in high-risk patients undergoing CABG surgery preoperative intensive
inspiratory muscle training. A randomized clinical trial. JAMA 2006;
296(15): 1851-1857.
Competing interests:
None declared
Competing interests:
No competing interests
07 August 2008
Marijke Hopman-Rock
Epidemiologist, psychologist, biologist
Nico van Meeteren (physiotherapist)
TNO Quality of Life, P.O Box 2215, 2301 CE Leiden, The Netherlands
Rapid Response:
Physical activity and exercise slow the negative consequences of ageing
Robert Butler and colleagues (BMJ, 19 July 2008, 149-150) wrote an
interesting article about a recommendable paradigm shift from research
targeted at individual diseases to multidisciplinary ageing research. We
certainly support this view, and would like to add some comments. Already
in 1981 Fries and Crapo1 revealed their theory of compression of morbidity
in their pioneering work called ‘Vitality and Aging’. The idea behind this
was that strategies for health promotion such as stimulation of physical
activity and improvement of other lifestyle behaviours, could enhance
quality of life and decrease the time spent with diseases.
In the eighties
of the last century an exiting new branch of science started in the area
of physical activity and exercise. An overwhelming amount of evidence has
since then been published on substantial benefits of physical activity,
including physical and cognitive functioning of older people. As the well
known geriatrician Archie Young2 stated already in 1986: “not only can
exercise reverse the effects of immobilization, it can readily produce a
further 10 to 20% improvement in strength and aerobic power, effectively
postponing functionally important thresholds for some 10 to 20 years”.
Knowing these facts, it is amazing that the medical field in general is
still reluctant to advise and prescribe physical activity to (older)
people. This can partly be explained by the fear that people could
experience a fall or get heart complaints. During the last World
Conference of Physical Activity and Aging in Japan (July 2008) it was
stated however, that a visit to the toilet is much more dangerous for
older people than getting started with physical activity (such as for
instance walking).
In our eyes the practical interventions that slow the negative
consequences of ageing are relatively easy to achieve: prescription of
physical activity and exercise, be it as an elixir of life such as
recommended by Nelson et al3 or as a (preventive) medicine in case of a
potential hazardous major life event (e.g. Hulzebos et al4).
1 Fries JF, Crapo LM. Vitality and Aging. San Francisco: WH Freeman,
1981.
2 Young A. Exercise physiology in geriatric practice. Acta Med Scand
Suppl. 1986; 711: 227-232.
3 Nelson ME et al. Physical activity and public health in older adults:
recommendation from the American College of Sports Medicine and the
American Heart Association. Med Sci Sports Exerc 2007; 38(8): 1435-1445.
4 Hulzebos HJ et al. Prevention of postoperative pulmonary complications
in high-risk patients undergoing CABG surgery preoperative intensive
inspiratory muscle training. A randomized clinical trial. JAMA 2006;
296(15): 1851-1857.
Competing interests:
None declared
Competing interests: No competing interests