Health, Exercise and Aging

Reality

Life expectancy

20 in 2020

Inadequate physical activity is responsible 30% of deaths

Inadequate Physical Activity

60% of adults over 18 are sedentary

At most, 20% of adults obtain sufficient regular activity

Healthy People 2000

Physiologic Function

Increases throughout childhood & young adults

peaks in early 30s

Physiologic Function

Age (years)

Gen

eral

leve

l of

phys

iolo

gic

func

tion

(%)

100

30

Strength Trends

Strength and x-sectional area greatest in 3rd decade

Denervation muscle atrophy (II)

40-50% reduction

Strength Trends

Aging process

loading

can be counter-acted

Strong Elderly

Ages 60-7212 wk resistance (80% 1 RM)107% knee strength227% knee / strengthHypertrophy of FT & ST --> cross-

sectional area = 28 y.o.

Strength Trends

Strength Trends

020406080

100120140160180200

20 30 40 50 60 70 80

Age (years)

Pea

k kn

ee e

xten

sor

stre

ng

th

(Nm

) Untrained

Strength-trained

Strength Trends

0

10

20

30

40

50

60

70

80

CompetitiveRunners

Fitness Trained Untrained

% s

low

-tw

itch

fib

ers

1974

1992

Neurological Trends

Central control reduction reflexes unaffected

Loss of > 1/3 of SC Axons

Reaction Times

Cardiovascular Trends

no in resting HR

SV CO

VO2max of about 1%/year

2x in sedentary

Cardiovascular Trends

Effects of Exerciseregular aerobic training no in VO2max

systolic / diastolic properties

SV

a-v O2 difference

Body Composition Trends

35 - 60 BW and fat

60+ fat but BW same

Body Composition Trends

Body Composition Trends

Trainability

Ability to adapt was thought to w/ age

Healthyrate & magnitude of physiologic

improvement is independent of age

Intensity is important

Effects of Physical Activity

Disease or Condition Strength of EvidenceAll-cause mortality E

CAD EHTN G

Obesity GCVA S

Colon CA GBreast/Prostate/Lung CA S

NIDDM GOsteoporosis G

Functional Capability G

1995 Causes of Death

42.10%

1.70%23.40%

3.00%

21.50%

4.50% 3.80%

Accidents

CV Diseases

AIDS

Cancer

Pneumonia/Flu

Other

COPD

CAD

Nonmodifiable Risk Factorsagesexethnicitymale pattern baldnessfamily history

CAD

Modifiable Risk Factorsdietblood lipidsHTNbehavior patternssmokinguric acid levels

CAD

Modifiable Risk Factorssedentary lifestylepulmonary function abnormalitiesobesityDMECG abnormalitiesstresseducation

Blood Pressure (18+)

Category Systolic(mmHg)

Diastolic(mmHg)

Normal < 130 < 85High normal 130-139 85-89HTN 140 90

Stage 1 (mild) 140-159 90-99Stage 2 (moderate) 160-179 100-109

Stage 3 (severe) 180-209 110-119Stage 4 (very severe) 210 120

Cholesterol

Age (years) Goal Moderate Risk(75th)

High Risk(90th)

20-29 < 180 > 200 > 22030-39 < 200 > 220 > 24040+ < 200 > 240 > 260

Undesirable LevelsHDL < 35 mg/dLLDL > 130 mg/dL

Relative level of Risk

Risk Factor VeryLow

Low Moderate High VeryHigh

SBP <110 120 130-140 156-160 >170DBP <70 76 82-88 94-100 >106

Cigarettes/day Never 5 10-20 30-40 >50Cholesterol

(mg/dl)<180 <200 220-240 260-280 >300

Cholesterol :HDL

<3.0 <4.0 <4.5 >5.2 >7.0

Relative level of Risk

Risk Factor VeryLow

Low Moderate High VeryHigh

Triglycerides(mg/dl)

<50 <100 >130 >200 >300

Glucose(mg/dl)

<80 90 100-110 120-130 >140

% BF (men) 12 16 25 30 >35% BF (women) 16 20 30 35 >40

BMI <25 25-30 30-40 >40

Relative Level of Risk

Risk Factor VeryLow

Low Moderate High VeryHigh

Stress tension Never Almostnever

Occasional Frequent NearlyConstant

Activity(min/wk)

>60% HRmax

120 90 30 0 0

Activity(min/wk)

>6 kcal/min (5METS)

240 180-120

100 80-60 <30