Actividad fisica

Physical Activity Guidelines for Older Adults
BASSEM ELSAWY, MD, and KIM E. HIGGINS, DO, Methodist Charlton Medical Center, Dallas, Texas

Few older adults in the United States achieve the minimum recommended amount of physical activity. Lack of physical activity contributes to many chronic diseases that occur in older adults, including heart disease, stroke, diabetes mellitus, lung disease,Alzheimer disease, hypertension, and cancer. Lack of physical activity, combined with poor dietary habits, has also contributed to increased obesity in older persons. Regular exercise and increased aerobic fitness are associated with a decrease in all-cause mortality and morbidity, and are proven to reduce disease and disability, and improve quality of life in older persons. In 2008, The U.S.Department of Health and Human Services released guidelines to provide information and guidance on the amount of physical activity recommended to maintain health and fitness. For substantial health benefits, the guidelines recommend that most older adults participate in at least 150 minutes of moderate-intensity aerobic activity, 75 minutes of vigorous-intensity aerobic activity, or an equivalentcombination of each per week. Older adults should also engage in strengthening activities that involve all major muscle groups at least two days a week. Those at risk of falling should add exercises that help maintain or improve balance. Generally healthy adults without chronic health conditions do not need to consult with a physician before starting an exercise regimen. (Am Fam Physician.2010;81(1):55-59, 60-62. Copyright © 2010 American Academy of Family Physicians.)
See related editorial on page 24. Patient information: A handout on exercise in older adults, written by the authors of this article, is provided on page 60.

T

he number of older Americans is expected to double from 35 to 70 million over the next 25 years. By the year 2030, 20 percent of the U.S. population will be olderthan 65 years.1 Lack of physical activity contributes to many of the chronic diseases that occur in older adults, including heart disease, stroke, diabetes mellitus, lung disease, Alzheimer disease, hypertension, and cancer. Lack of physical activity, combined with poor dietary habits, has also contributed to increased obesity in this population.2 In response to these trends, the U.S. Department ofHealth and Human Services published the 2008 Physical Activity Guidelines for Americans to provide specific minimum guidelines for regular physical activity.3 Unlike previous recommendations, these guidelines suggest a total amount of activity per week and allow for individualized activity plans. Relatively few older adults in the United States achieve the minimum amount of recommended physicalactivity, and 28 to 34 percent of adults 65 to 74 years of age are inactive.4 The medical costs for inactive adults are substantially higher than for active adults and increase with age. This suggests that it may be possible to significantly lower health care costs by improving physical activity levels in older adults, as compared with any other age group.4

Health Benefits of Physical ActivityRegular physical activity has beneficial effects on a variety of health outcomes4 (Table 13). It is a proven public health strategy that reduces disease and disability while improving quality of life in older persons.5
MAINTAINING FUNCTION

Muscle strength decreases with age and may lead to a loss of autonomy and increased disability.6 A randomized controlled trial examining the effects of progressiveweight training in 142 healthy adults 60 to 80 years of age found that long-term resistance training increased dynamic muscle strength, muscle size, and functional capacity.6
PROTECTING THE MIND

Physically active adults have a lower risk of depression and cognitive decline than inactive adults.3 In a study of 1,740 persons 65 years and older without a diagnosis of dementia at baseline,...