Older Adults and Physical Activity

What are the 3 main categories that the definition of old age falls in to?

1. Chronology (age - developed countries often refer to the ages 65+ as old age)

2. Change in social role (work/retirement)

3. Change in capabilities (cognitive and physical)

How can critical events influence physical activity levels in this demographic?

First falls, A&E discharge —> these can mark the catalytic moment of loss of independence in older individuals.

Give examples of age-related diseases.

• Heart disease

• Stroke

• Cancer

• Senility - refers to disease affecting cognitive ability e.g. Dementia

• Alzheimer’s diseases

• Diabetes

• Arteriosclerosis

How has ageing, disease and causes of death changed over time since the 1900s?

• Average age at death has increased exponentially - in 2014 most deaths occurred in people in their 90s compared to in 1900 when there was high infant mortality.

• The most common causes of death stem from age-related diseases.

• There is now a new category of cause of death - non-infectious airway disease, likely due to smoking/vaping.

What is the impact of our ageing population?

• Increasing risk of instability and isolation in older women who take on the responsibility of caring for their dependent elderly parents - these individuals may need care themselves.

• Ageing workforce - the need for work environments suitable for older adults; ageism is also still prevalent in the workforce.

• Increasing need for long-term care in the elderly.

• Taxing on healthcare resources/funding.

Define the factors affecting average longevity.

• Genetics

• Environmental - disease, lifestyle, social class —> mostly due to human activity (pollution, social injustice etc).

• Ethnicity

• Gender - women live on average 5 years longer than men.

How does social class relate to longevity?

Individuals of a lower social class have increased poverty and less access to good healthcare and physical activity spaces.

Why do women tend to live longer than men?

• Less vulnerability to disease

• More men are risk-takers

• Less use of alcohol/smoking

• Less likely to allow stress into their lives

• Likely to also involve genetics and hormones.

Define successful ageing.

Increased longevity and quality of life.

Kahn, 1997 defines successful ageing by combining: avoiding disease and disability, engagement with life and high physical and cognitive function.

What are the WHO physical activity recommendations for people aged 65+?

Same for all adults:

• At least 150 mins of moderate intensity aerobic activity or 75 mins of vigorous intensity aerobic activity per week (or equivalent combined).

• Aerobic activity should be done in bouts of at least 10 mins duration

• Do muscle strengthening (targeting major muscle groups), balance and flexibility activities at least 2x per week.

• Aim to be active every day and reduce prolonged sedentary time.

Specific to older adults:

• Those with poor mobility should engage in activity aimed to improve balance and prevent falls at least 3x per week.

• If conditions do not allow them to meet the guidelines, they should engage in as much physical activity as their condition allows.

What patterns can be observed in the physical activity levels of older adults?

• The eldest of the older adults are the least physically active.

• There has been an increase in physical activity in older adults.

• Gender: Women tend to be less physically active than men.

• Ethnicity: ethnic minority individuals tend to be less physically active.

Are the recommended guidelines achievable for this population? Is there a different approach?

It is not achievable for a lot of older adults. The biggest emerging problem in this demographic is sitting behaviour for extensively long periods of time. Instead they should simply be encourage to stop sitting for these extensive periods and engage in some light activity.

How has physical activity been shown to modify the risk of unsuccessful ageing?

• Only intervention showed to consistently reduce functional decline.

• Reduces the effects of sarcopenia.

• Reduces risk of falls.

• Improves mental health and engagement with life.

• Helps prevent and manage over 20 health conditions.

How does physical activity affect social and economic factors?

• Reduces health costs.

• Improves community cohesion and inclusion.

• However, walking trips are declining due to differing definitions of walkable trips between the older and younger generations.

What defines a walkable trip for older adults?

• Access to facilities such as post offices and nearby public toilets.

• Pavement materials and quality also influences walking activity in older adults.