Prescribing Exercise for Older Men
- Wed, 7/15/09 - 10:02am
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Pages 42 - 47
Introduction
The benefits of exercise and physical activity on health are well known and seldom debated. The value of physical training has been recognized for more than 2400 years. The first nonreligious schools of higher learning, called “Gymnasiums,” were created in Ancient Athens. The curriculum included the study of language, philosophy, mathematics, and physical fitness training; their principle was “healthy minds in healthy bodies,” as described in Plato’s writings. In Ancient Rome, Galen attributed some of the illnesses common in the nobility to their sedentary lifestyles. We now know that regular exercise training has positive effects on insulin sensitivity, body composition, blood pressure, cardiovascular and pulmonary function, lipid profile, bone mineral density, muscle strength and power, cognitive function, and chronic inflammation. All of these parameters show signs of deterioration with aging. Exercise is therefore a powerful intervention strategy to prevent or minimize the physiological changes associated with aging and to improve general health. In conjunction with diet, exercise is often the recommended first line of defense in the treatment and prevention for chronic diseases, such as cardiovascular disease, diabetes, and cognitive impairment. In fact, some epidemiological evidence shows that lack of physical activity is a greater risk factor for coronary heart disease than obesity, high cholesterol, family history, or hypertension.1 In addition, it has been shown that middle-aged adults who adopt a healthy lifestyle (regular exercise, 5 or more fruits and vegetables daily, maintaining healthy weight and no current smoking) receive a quick return on their investment in terms of significantly reduced all-cause mortality and 35% lower risk for cardiovascular disease after 4 years.2
What is less established is determining what kind of exercise programs are optimal for older adults. In 2007, the American College of Sports Medicine (ACSM) and the American Heart Association (AHA) published recommendations for physical activity in older adults.3 Older adults were defined as men and women 65 years of age or older and adults age 50-64 years with clinically significant chronic conditions and/or functional limitations. These guidelines emphasized reducing sedentary behavior in older adults, increasing moderate activity including muscle-strengthening activity, and defining moderate- versus high-intensity. An overview of these recommendations is shown in Table I.
In this article we will attempt to provide clinicians with information in the areas of exercise and lifestyle modifications that are specifically designed to help prevent sarcopenia and increase physical function in older men. We will focus mainly on the importance of muscle power. We will also review the most common exercise-related injuries in older men and suggest measures that can minimize the risk for injury. Lastly, the role of growth hormone and other supplements as an adjunct therapy will be discussed. These guidelines are intended to assist clinicians in making specific recommendations to their patients as part of a comprehensive evaluation and treatment plan.
Muscular Function and Body Composition in Aging Men
Aging is associated with a gradual loss of skeletal muscle mass, usually called sarcopenia, which starts as early as age 25-30 years and continues at a more rapid rate after age 50. By the age of 80 years, approximately 50% of the muscle mass is lost. For the lower-extremity muscles, the loss of muscle strength is even greater than the loss of muscle mass, indicating reduced muscle quality. The greatest loss is observed for muscular power.4 Muscle power is a product of the force and velocity of muscle shortening and is, therefore, more relevant to the completion of many daily activities than muscle strength.
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Your article perfectly shows what I needed to know, thkans!
Reply to this comment »I have been doing RT and aerobic as the study suggests, except for the lower body recommendations. This is a valuable piece of information. The article is immensely useful in confirming my general observations of personal performance and regimens.
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