Health Health

Benefits of Benefits of

Exercise Exercise

for Frailer for Frailer

Older Older

People People

PHYSICAL ACTIVITY and HEALTH

Age

Disease Disease PreventionPrevention

Maintenance of Maintenance of IndependenceIndependence

More Older People Living More Older People Living LongerLonger

2004:

16% aged >65 yrs

4% aged >80 yrs

4 people working to support 1 retired

2050:

30% aged >65 yrs

11% aged >80 yrs

2 people working to support 1 retired

Proportion of UK population aged 65 or over

0

5

10

15

20

25

1901 1921 1961 1999 2026

Year

Per

cen

t

Population aged 85 or over

0

0.5

1

1.5

2

2.5

1952 2002 2022

Year

mil

lio

ns

1-2% in functional ability 1-2% in functional ability

p.a.p.a.– StrengthStrength

– Power Power

– Bone densityBone density

– FlexibilityFlexibility

– EnduranceEndurance

– Balance and co-ordinationBalance and co-ordination

– Mobility and transfer skillsMobility and transfer skills

Ageing affects us all…..Ageing affects us all…..

Sedentary behaviour Sedentary behaviour accelerates the loss of accelerates the loss of performance...performance...

Activities of Daily Activities of Daily Living….Living….

Wash hair comfortably? Wash hair comfortably? 20% women & 14% of men > 50 do not have 20% women & 14% of men > 50 do not have

sufficient shoulder flexibilitysufficient shoulder flexibility

Confident of getting out of a chair without using Confident of getting out of a chair without using arms ?arms ?

25% women & 7% men aged 70 – 74 do not have 25% women & 7% men aged 70 – 74 do not have sufficient leg strengthsufficient leg strength

Ease of stair use?Ease of stair use? 47% women aged 70 – 74 do not have sufficient leg 47% women aged 70 – 74 do not have sufficient leg

powerpower

Walk comfortably at a 20 minute a mile pace?Walk comfortably at a 20 minute a mile pace? 35% men and 80% women aged 70 – 74 do not 35% men and 80% women aged 70 – 74 do not

have sufficient aerobic capacityhave sufficient aerobic capacity

Thigh strength in older peopleThigh strength in older people

Men

Women

Knee e

xte

nsi

on

str

en

gth

(N

/kg

) 12

10

8

6

4

2

0

Strength to be confident of risingfrom low chair without using arms

50

-54

55

-59

60

-64

65

-69

70

-74

50

-54

55

-59

60

-64

65

-69

70

-74

Age (years

)

Vicious Cycle of Vicious Cycle of InactivityInactivity

Physical deterioration - Heart disease- High blood pressure- Aches and pains- Osteoporosis Further decrease

in physical activity

Social / psychological ageing- Feeling ‘old’- ‘Acting’ one’s age- Increased stress- Anxiety, depression- Low self-esteem

Increasing age

Less exercise

Decreased physical abilities- Increased body fat- Sagging muscles - Decreased energy

UK’S Sedentary UK’S Sedentary WaysWays

40% 40% of people aged 50 or over in the UK are of people aged 50 or over in the UK are sedentary sedentary

60-85%60-85% are sedentary in are sedentary in ethnic minority groupsethnic minority groups

HalfHalf of the sedentary over 50’s of the sedentary over 50’s and 2/3 of over 70’s believe they and 2/3 of over 70’s believe they take part in enough physical take part in enough physical

activity to keep fitactivity to keep fit..

How much exercise do How much exercise do you do?you do? All stand upAll stand up Sit down if youSit down if you

– Walk to or from work dailyWalk to or from work daily– Play sports, cycle or swim more than Play sports, cycle or swim more than

twice a weektwice a week– Spend more than 4 hours on your Spend more than 4 hours on your

feet every dayfeet every day

Increasing the fracture Increasing the fracture risk?risk?

No standing activity leads No standing activity leads to active loss of bone and to active loss of bone and musclemuscle

1 wk bed rest 1 wk bed rest strength by ~ 20% strength by ~ 20%

1 wk bed rest 1 wk bed rest spine BMD by ~1% spine BMD by ~1%

Nursing home residents spend Nursing home residents spend 80-90% of their time seated 80-90% of their time seated or lying downor lying down

Too frail to benefit? Too frail to benefit? Dose response curveDose response curve The lower the baseline The lower the baseline

level of physical activity, level of physical activity,

the greater the health the greater the health

benefit associated with benefit associated with

an increase in physical an increase in physical

activity. Exercise can be activity. Exercise can be

adapted for any medical adapted for any medical

conditioncondition

(Haskell 1994)(Haskell 1994)

Benefits of ExerciseBenefits of Exercise

Prevention of :Prevention of :diseasedisease Coronary Heart Disease, Osteoporosis, Coronary Heart Disease, Osteoporosis, Obesity, Stroke, Obesity, Stroke,

Depression, Type 2 Diabetes, Depression, Type 2 Diabetes, Hypertension, Colon Cancer, Hypertension, Colon Cancer,

disabilitydisability Arthritis, Intermittent claudication, Arthritis, Intermittent claudication, Angina, Angina, Sleep, low back painSleep, low back pain

complications ofcomplications of Constipation, Deep vein thrombosis, Constipation, Deep vein thrombosis, Oedema,Oedema,

immobilityimmobility Pressure soresPressure sores

isolationisolation Socialisation, Self-efficacy, Socialisation, Self-efficacy,

ConfidenceConfidence

dependencedependence Functional ability, Falls, Autonomy, Dignity, Functional ability, Falls, Autonomy, Dignity, Caring skillsCaring skills

Benefits of Regular Benefits of Regular ExerciseExercise

IMPROVES OR MAINTAINSIMPROVES OR MAINTAINS

Good posture & body imageGood posture & body image Intake of nutrients and immunity to Intake of nutrients and immunity to

infectioninfection Cerebral function, mood, memoryCerebral function, mood, memory Sleep pattern and durationSleep pattern and duration Social contacts, playSocial contacts, play

INDEPENDENCE

AND QUALITY OF LIFE

DEPENDENCE AND

ISOLATION

REDUCES OR PREVENTSREDUCES OR PREVENTS Likelihood of falls and fractures Likelihood of falls and fractures Breathlessness, ObesityBreathlessness, Obesity Constipation, incontinence, urinary Constipation, incontinence, urinary

urgencyurgency Anxiety, Depression, StressAnxiety, Depression, Stress

“Man does not cease to play because he grows old. Man grows old because he ceases

to play” George Bernard Shaw

If I’d known I was going to live this long, I’d have taken better care of myself

Dubey Blake