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Sin ttulo de diapositiva


PHYSICAL ACTIVITY. FOR AGEING SUCCESSFULLY. J. Manuel Gonz lez ... ACSM Fitness Book. ACSM Guidelines for Exercise Testing and Prescription. Active Living. ... – PowerPoint PPT presentation

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Title: Sin ttulo de diapositiva

J. Manuel González Aramendi
PhD Virgen del Pilar Medical Centre San
Sebastian - Euskadi - Spain aramendi_at_infonegocio.
Health is, itself, an opportunity, for everyone
and the community where we live
WHO 2000
Older People - Facts
People aged 60 and over 600 million in
2000 1,2 billion in 2025 2
billion in 2050 Senior citizens
living in developing countries 33 world
population in 2000 75
in 2025 In developed world, aged 80 are the
fastest growing group. In very old age, the ratio
of women/men is 21. (WHO Towards Policy for
Health and Ageing)
Longevity is, probably, the best measure of
physical life quality. It is a precious offer
that science makes to humanity the present of
life, no less.
Carl Sagan
Life Expectancy
Life expectancy is a beautiful result of public
health, mainly because of vacciness, sanitation
and health education. Global life expectancy at
birth is growing In 1955 was 48 years In
1975 was 59 years In 1995 was 65 years

The spanish Basque Country Present Population
and Expectations
The Winds Comb E. Chillida
Year Population 1981 2.141.809
2000 2.069.000 2005 2.048.700 2010 2.039.100
(Source Eustat - Basque Government) Life
expectancy was 35 years in 1900. In 2000 it was
82 years for women and 74 years for
men. Population older than 60 years is 25. It
is, probably, one of the oldest countries in the
  • To sustain
  • health
  • movility
  • independence
  • In other words...
  • To delay
  • illness
  • disability
  • dependence

Objectives for Older People

A challenge for individuals, families and
Increase life expectancy Decrease disability
90 years
80 years
81 years
65 years
In 2000
In 2025
Ageing Successfully
What is successfully ageing ?
To sustain a smile is probably an evidence
of successful ageing. For that, we must take
care of our body and our spirit, and live
together with the rest of persons and beings in a
unique biosphere.
The Determinants of Active Ageing
Risk Factors
Non communicable diseases, mainly
cardiovascular disease, cancer and diabetes,
account 77 of global deaths in developing
countries, and 85 of global burden of disease
in low and middle income countries. These
diseases share few and preventable risk factors
  • Physical inactivity
  • Unhealthy diets
  • Tobacco

Physical Activity and Healthy Ageing
Physical activity has been present in 99 of our
existence on the Earth. Now, over 65 of world
population is not physically active. Around the
world, the inactivity is more prevalent in urban
areas, mainly in poor communities.
Physical Activity in the Basque Country
1 innactive 2 moderadelly active 3 active
4 very active
This situation is similar in other developed
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Benefits of Regular Physical Activity
Prevention of diseases Coronary Heart
Disease Stroke Hypertension Colon cancer Brest
cancer Osteoporosis Obesity Type II diabetes

Benefits of Regular Physical Activity
Prevention of disability Arthritis Intermittent
claudication Low back pain Sleep disturbances

Benefits of Regular Physical Activity
Prevention of dependence and isolation Functiona
l ability Falls Autonomy Socialisation

Components of Fitness
  • Visibles
  • cardiorespiratory fitness
  • muscular strength-endurance
  • flexibility
  • body composition
  • balance and coordination
  • No-visibles
  • metabolics
  • blood glucose and lipids
  • blood pressure
  • bone density.

The range of motion of articulations is afected
by aging of joints, muscles and connective
Flexibility exercises should be incorporated into
the overall fitness program. These exercises
should stretch the major muscle groups.
Recomended exercises yoga, supervised classes
of aerobics, walking and strength exercises.
Good tolerance dont give up.
Muscular Strength and Resistance
  • Aging is associated with a muscular mass loss,
    due to both
  • ageing process and lack of muscular activity.
  • muscular strength decline with age, with
    important effects
  • in the functional capacity
  • Increased risk of falls
  • Reduced capacity for walking
  • Strength - Resistance training should be an
    integral part of
  • adult fitness program, of a sufficient intensity
    to maintain
  • or enhance strength, muscular endurance, and
    fat-free mass.

Aerobic Power
Maximal oxygen consumption (VO2max) declines 10
per decade after age 25. But, if physical
activity levels are kept constant, the decline
is only about 5 per decade. When VO2max is lower
than 1L/min (14 ml/kg/ min), daily normal
activities are not possible without fatigue.
Then, the quality of life becomes deteriorated.
Cardiovascular Function
Maximum heart rate, stroke volume and cardiac
output decrese as we age. It is unclear how much
decrease is due to aging alone and how much to
decreased activity.
Bone density
Aging is associated with a loss of bone mineral
and bone matrix. These changes affect to 25 of
older people, and lead to greater risk of
fractures, mainly in post-menopausal women. In
theses, the major contributing factors are
estrogen deficiency, low calcium intake and
physical inactivity.
In the elderly person, diabetes type II stems
from cellular resistance to insulin by decresed
number or sensitivity of insulin
receptors. Diabetes is asociated with increased
cardiovascular risk . Physical activity and the
avoidance of obesity are important preventive
measures. In secondary prevention, regular
physical activity helps to normalize both
glucose tolerance and tissue insulin
sensitivity. Improvements are observed as
little as 30 minutes of exercise at moderate
Other chronic diseases
Peripheral vascular disease treadmill training
has been shown to improve walking distance and
claudication (pain on walking).
Chronic lung disease improvements in the
distance walked and quality of life have been
reported after walking, supervised treadmill and
exercise reconditioning. Chronic arthritis
walking and home joint mobility exercises are
successful for improvement in arthritis
symptoms. Well done, PA will not worsen
pre-existing arthritic conditions.
How much exercise?
How much exercise for the frail and very old?
Strength exercises Aim to improve strength,
balance and muscle coordination. Progressive
resistance training of the major muscle groups
2-3 days per week with 2-3 sets of each
exercise. Aerobic exercises Moderate intensity
aerobic training like walking, ergometry or
water exercises, reaching first a target
frequency (three days per week), then duration
(at least 20 min per session), and finally,
appropriate intensity (40-60 heart rate
reserve). Stretching, warming up and cooling
down for older adults should be longer and more
gradual than in younger adults.
Prior to beginning
Men over 40 and women over 50 should obtain
advice from a doctor before starting any
vigorous activity. Persons with symptoms
suggestive of coronary, pulmonary or metabolic
disease should have a physician supervised
maximum exercise test prior to start a vigorous
exercise program. In addition, exercise tests
measure the heart's exercise capacity, and the
aerobic and anaerobic muscular capacity.
Psychological functioning
It is well established that physical activity
and psychological function in the older adult
are related. Improved well-being,
self-efficiency and quality of life have been
reported in several studies. The improved
psychological function is obtained by physical
activity per se and by the concomitant social
contact that it leads.
Economic benefits
The regular practice of appropriate physical
activity can bring economic benefits in terms
of reduced health care costs and increased
productivity, mainly. Two examples Canada
The expected savings from achieving the 2003
target of increasing the physically active
population by 10 5 billion in cost for medical
care. (CFLRI-Health Canada) USA Potential cost
savings can be as much as 29 billion in 1987 (_at_
50 billion in 1998). (Colditz GA.Med Sci Sports
Exer 31suppl, 1999)
Substantial health benefits occur with a
moderate amount of activity on most, if not all,
days of the week. Additional health benefits
can be gained through greater amounts of
physical activity, Anyway, even small amounts
of physical activity are healthier than a
sedentary lifestyle.
Scientits have yet to discover the
philosophers stone that will confer
immortality. However, the ability of regular
exercise to reduce biological age by 10 to 20
years is no mean miracle. Indeed, I know of no
other therapy that could achieve comparable
results. Roy J. Shephard
Suggested lectures
  • ACSM Fitness Book
  • ACSM Guidelines for Exercise Testing and
  • Active Living. Health Promotion (HPR) - WHO
  • Aerobic Fitness and Health - Roy J. Shephard
  • Aging, Physical Activity and Health - Roy J.
  • Health and Ageing. A Discussion Paper- WHO
  • Healthy Ageing and Physical Activity -
  • Older People Physical Activity - Dawn Skelton
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