Focus on physical activity can help avoid unnecessary social care
BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j4609 (Published 17 October 2017) Cite this as: BMJ 2017;359:j4609
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What are the mechanisms whereby exercise provides this 'miracle cure'?
Evidence suggests that the role of nitric oxide-mediated vasodilation could be key to this process, in that exercise can prevent the age-related reduction of nitric oxide availability. (Black et al 2008).
Nitric oxide is a produced within the vascular endothelium, diffuses to vascular smooth muscle and acts as powerful vasodilator of blood vessels (Johnson et al 2017). In conditions where nitric oxide availability is reduced, such as ageing, endothelial dysfunction and stiffening of the arteries occurs, leading to an increased risk of cardiovascular disease (CVD) (Johnson et al 2017). Therefore, restoring the availability of nitric oxide may help prevent CVD in older adults (Johnson et al 2017).
A further intriguing aspect of the nitric oxide story is that it can be produced not only endogenously, but from the nitrate-nitrite-nitric oxide pathway, using oral commensal bacteria as the first step (Lundberg et al 2008). Dietary nitrate has been shown to reduce blood pressure and improve endothelial dysfunction and it has been suggested that diets high in nitrate rich vegetables (green leafy vegetables and beetroot), such as the Mediterranean diet, reduce risk of CVD (Lidder & Webb 2013).
Black MA et al (2008). Exercise prevents age-related decline in nitric-oxide-mediated vasodilator function in cutaneous microvessels. J Physiol 586, pp 3511–3524.
Johnson et al (2017). Nitrate and nitrite in aging and age-related disease. In: Nitrite and nitrate in human health and disease, Springer International Publishing.
Lidder S & Webb AJ (2013). Vascular effects of dietary nitrate (as found in green leafy vegetables and beetroot) via the nitrate-nitrite-nitric oxide pathway. British Journal of Clinical Pharmacology, 75, pp 677-696.
Lundberg JO et al (2008). The nitrate–nitrite–nitric oxide pathway in physiology and therapeutics. Nature Reviews Drug Discovery 7, pp156-176.
Competing interests: No competing interests
Taking up the interesting issue published by Scarlett McNally, David Nunan, Anna Dixon, Mahiben Maruthappu, Kenny Butler and Muir Gray, Focus on physical activity can help avoid unnecessary social care and especially the arguments of Scarlett McNally and colleagues when they affirm: to provide support and opportunities for physical activity to help older adults maintain independence and lessen the costly burden of social care. We were motivated to make some opportune reflections related to the dramatic aging presented by the current Cuban population.
The functional capacity of older people is crucial with respect to the way in which they can carry out and support the activities of daily living, which in turn affects their quality of life.
Health and functional capacity are of vital importance for the quality of social life of people: the level of functional capacity determines the extent to which they can be autonomously managed within the community, participate in different events, visit other people, use the services offered by society, and in general, enrich their own lives and those of the people closest to them.
The assessment of functional capacity includes an assessment of a person's ability to perform various activities of daily living. Performing these functions is an integral part of measuring functional health, and it is impaired when fatigue appears.
For "healthy aging", according to The elderly, a sector of the population in boom, reach this age with a higher quality of life than in the past, thanks to the improvement of the various services currently provided. Most of these people are in good health and demand activities that are not exclusively "senior".
"The impact of exercise on improving the quality and longevity of life in people is sufficiently proven. We talked about two basic objectives to consider in the intervention with older adults and where the major research paradigms focus: making life longer in terms of quantity and providing it with the highest quality in terms of integral health. (Párraga, 2009).
The benefits of physical exercise include improved functional capacity, health, and quality of life. Even if it is too intense it can cause injury or illness. Their reasonable use would produce greater benefits than adverse effects.
Any form of physical exercise is appropriate for anyone at any age, as long as it is not excessive in terms of general or local stress. Age does not in itself constitute an obstacle to physical exercise. The most important issue to be addressed is how physical activity can be incorporated into the lifestyle of older people.
The challenge for exercise professionals working with older people is to design physical activity programs that provide an adequate stimulus for the development of the different components of health-related physical condition in this population (strength, strength, flexibility, and balance) and that can be included as a daily activity of these people.
Studies have shown that older people can be trained, as evidenced by their ability to adapt to both strength training and resistance training. Resistance or aerobic training can help maintain or improve cardiovascular function. Strength training helps compensate for the loss of muscle mass and strength associated with the aging process, thus improving the functional capacity of older people.
In our country, there are multiple sectors efforts to guarantee and stimulate the physical activity of the elderly: new "grandparent circles" that achieve as their main activity the physical activity in public spaces, well oriented by professionals dedicated to the physical culture in the elderly and promote social relations between them and promote a healthier aging.
Healthy aging, to which physical activity can contribute substantially, is a challenge that gives its own rewards to those who are willing to confront it.
It is important that professionals who focus their activity with older people, in such a complex field and that involves the interaction of multiple factors to achieve goals of improvement, maintenance and / or progressive loss of certain capacities, are aware of the impact that the adequate stimulation by means of movement in its different manifestations in the person. That is why it is crucial to enter into the knowledge of the means that physical activity puts within our reach to contribute to the integral improvement of the quality of life in the population segment of older adults. It is necessary to generate a critical professional conscience that stimulates and encourages the practice of physical activity and encourages the adoption of an active lifestyle and adjusted to each need and personal reality. All this from the necessary prism of excellence in the adequacy of the activity
Our contribution as health professionals working with older people must be to face the new challenges presented to this group, providing them with diversity and quality in our services, investigating possible innovations; looking for excellence in the adequacy of the activity, in this case physical. In this way we will contribute to promoting an active and healthy aging.
References
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11. Cagigas, A., González, T. Y René, J. Envejecimiento saludable. Departamento de Bioquímica y Fisiología, Instituto de Nutrición e Higiene de los Alimentos. Ciudad de la Habana. Cuba https://www.monografias.com/trabajos17/envejecimiento-saludable/envejeci.... acceso a internet 22 de octubre 2017.
12. Diaz, Trejo, Torres, (2003) Efectos beneficiosos del ejercicio físico sobre el cerebro. Recopilado de http/: sunsite.dcc.uchile.cl/nuevo/ciencia/ CienciaAlDia/volumen5/numero1/artículos/articulo2.html
Competing interests: No competing interests
The Science of Ageing.
The increase in financial flow and social change causes a dramatic shift in morals and ethics. The undesirability of this is observed in the various corners of life. The prime cause of this is present-day education system. We become slaves to the word “stress”, mainly because of our own pride and jealousy. What is ageing? Ageing is nothing more than a change in our consciousness. This brings a paradigm shift in our psychosomatic body, especially the mind, which influences all our sympathetic and parasympathetic activities. In short, this shift is reflected in the change in the Soma or Body. The right thing at this juncture is to understand our mind, which is the cause of all happenings.
We have shifted from communicable to the era of non-communicable disorders. Almost all non-communicable disorders are the result of stress. Besides spending a lot of money for geriatric manifestation, genetic rehabilitation, etc., we have to educate our mind in such a way that is positive in thinking. Yoga techniques, mindfulness, activeness, breathing exercises, etc. all will not only reduce geriatric illness but also save the national income.
Finally, we have to teach our citizens to love our own old people: they contributed to the growth of this civilian society in their own way. We should not treat them as if they are a burden to us otherwise the next generation will treat us as a burden.
Competing interests: No competing interests