Healthy Ageing with Physio and Exercise Physiology
The United Nations has declared 2021-2030 as the Decade of Healthy Ageing (Gichu and Harwood, 2023).
Worldwide the population is ageing and it is estimated that by the year 2050 more than 20% of the population will be over the age of 60 (Diaz and Banerjee 2023).
Healthy ageing means different things to different people, but primarily it is achieving or maintaining the ability to do what you value. Our genetics influence our ageing once we are over the age of 95, but before that only account for one third of our health and survivability (NIH, 2016). Therefore, the majority of our physical health and ageing is affected our lifestyles.
There are many ways healthy ageing can be measured, this includes:
- The ability to get up from a chair or from the floor
- Walking distance and speed
- Balance
- Strength and endurance
- Bone density
The inability to stand on one leg for ten or more seconds or to get up from the floor is associated with increased risk of mortality (Brito et al., 2014; Woodley, 2022). These movements require good baseline joint position sense, balance and strength, and poor performance is associated with a higher number of health issues. Whilst prevention is ultimately better than a cure, the good news is even mild increases in physical activity can significantly offset a number of health risks (Löllgen et al., 2009) and this is where physiotherapy and exercise physiology can help.
Physiotherapists and exercise physiologists are well equipped to assess and identify where improvements in physical function can be made and to provide targeted, safe and achievable exercise programs for home, individual or group settings. Even after just one week of daily cardiovascular exercise the risk of developing type II diabetes decreases and for those who already have it, insulin sensitivity can be improved (Colberg et al. 2010). Exercise programs including a variety of exercise types decrease the incidence of falls by up to 42% (Sherrington et al., 2020), and the likelihood of sustaining injuries during a fall also decreases (Zhao et al., 2019). Arthritis symptoms can also be managed with exercise, one review of the GLA:D (Good Living with Arthritis: Denmark) program demonstrated a 26-33% improvement in pain intensity, 8-12% improvement in walking speed, 18-30% improvement in ability to stand from sitting and 12-26% improvement in joint-related quality of life after just eight weeks of exercise twice weekly (Roos et al., 2021). Additionally, high-intensity resistance and impact training is a safe and effective way to improve bone density (Watson et al., 2018) with improvements seen after 8 months with exercises performed 2x weekly. Whilst exercise is no fountain of youth the right exercises for you and your goals, performed regularly, can help you live better and longer.
References
Brito LB, Ricardo DR, Araújo DS, Ramos PS, Myers J, Araújo CG. (2014) Ability to sit and rise from the floor as a predictor of all-cause mortality. Eur J Prev Cardiol. 21(7):892-8. doi: 10.1177/2047487312471759.
Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, Chasan-Taber L, Albright AL, Braun B; American College of Sports Medicine; American Diabetes Association. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care. 2010 Dec;33(12):e147-67. doi: 10.2337/dc10-9990. PMID: 21115758; PMCID: PMC2992225.
Diaz T, Banerjee A (2023) Welcome to the supplement on measurement of healthy ageing. Age and Ageing 28(52):iv1-iv2. https://doi.org/10.1093/ageing/afad103
Gichu M, Harwood RH (2023) Measurement of healthy ageing. Age and Ageing 28(52):iv3-iv5. doi: 10.1093/ageing/afad118
Löllgen H, Böckenhoff A, Knapp G. (2009) Physical activity and all-cause mortality: an updated meta-analysis with different intensity categories. Int J Sports Med. 30(3):213-24. doi: 10.1055/s-0028-1128150.
National Institutes of Health (2016) Can You Lengthen Your Life? Researchers Explore How To Stay Healthy Longer. https://newsinhealth.nih.gov/2016/06/can-you-lengthen-your-life (accessed May 2024). U.S. Department of Health and Human Services
Roos EM, Grønne DT, Skou ST, Zywiel MG, McGlasson R, Barton CJ, Kemp JL, Crossley KM, Davis AM. (2021) Immediate outcomes following the GLA:D® program in Denmark, Canada and Australia. A longitudinal analysis including 28,370 patients with symptomatic knee or hip osteoarthritis. Osteoarthritis Cartilage. 29(4):502-506. doi: 10.1016/j.joca.2020.12.024.
Sherrington, C., Fairhall, N., Kwok, W. et al. Evidence on physical activity and falls prevention for people aged 65+ years: systematic review to inform the WHO guidelines on physical activity and sedentary behaviour. Int J Behav Nutr Phys Act 17, 144 (2020). https://doi.org/10.1186/s12966-020-01041-3
Watson SL, Weeks BK, Weis LJ, Harding AT, Horan SA, Beck BR. (2018) High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial. J Bone Miner Res. 33(2):211-220. doi: 10.1002/jbmr.3284.
Woodley M. (2022) Balance test shows risk of death: Study.https://www1.racgp.org.au/newsgp/clinical/balance-test-shows-risk-of-death-study#:~:text=Standing%20on%20one%20leg%20measures,period%2C%20new%20research%20has%20found. (accessed May 2024) The Royal Australian College of General Practitioners
Zhao, R., Bu, W. & Chen, X. The efficacy and safety of exercise for prevention of fall-related injuries in older people with different health conditions, and differing intervention protocols: a meta-analysis of randomized controlled trials. BMC Geriatr 19, 341 (2019). https://doi.org/10.1186/s12877-019-1359-9
Written by Sascha Wise, Physiotherapist (B. Biotech, B. Physio)