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Education And Debate

ABC of Sports Medicine: Fitness for older people

BMJ 1994; 309 doi: (Published 30 July 1994) Cite this as: BMJ 1994;309:331
  1. A Young,
  2. S Dinan


    Throughout life the health benefits of regular, vigorous, physical activity far outweigh the hazards. Moreover, the hazards can be reduced by education and guidance of participants.

    Prevention of disease

    Regular exercise helps prevent conditions important in old age, notably osteoporosis, non-insulin dependent diabetes mellitus, hypertension, ischaemic heart disease, and probably stroke.

    Prevention of disability

    Not only does regular exercise have important effects in preventing disease but its effects in preserving function are also important. Appropriate physical training improves the functional abilities of people with disabling symptoms of intermittent claudication, angina pectoris, heart failure, asthma, and chronic bronchitis. Even frail older patients with multiple disabilities may also derive functional benefits from graded physical training.

    Even healthy older people lose strength (the ability to exert force) at some 1-2% a year and power (force × speed) at some 3-4% a year. In addition, many older people have further problems because they have chronic disease. The resulting weakness has important functional consequences for the performance of everyday activities. A similar argument applies for endurance capacity.

    Regular exercise increases strength, endurance, and flexibility. In percentage terms, the improvements seen in older people are similar to those in younger people. For example, in a recent study in our laboratory, women aged 75 to 93 training three times a week for 12 weeks increased their strength by 24-30%, equivalent to a “rejuvenation” of strength by 16- 20 years.

    Prevention of immobility

    For severely disabled people, immobility itself brings substantial hazards. For them just movement itself, even in the absence of a training effect, is crucial in preventing, for example, faecal impaction (and incontinence), deep vein thrombosis (and pulmonary embolism), and gravitational oedema (and skin ulceration).

    Preventive effects of exercise

    Disease, such as:

    • Oteoporosis

    • Non-insulin dependent diabetes

    • Hypertension

    • Ischaemic heart disease

    • Stroke

    Disability caused by:

    • Intermittent claudication

    • Angina pectoris

    • Heart failure

    • Asthma

    • Chronic bronchitis

    Immobility, which can cause:

    • Faecal impaction …

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