Rationale for the Integration of Exercise Prescription into Health Care for Older Adults
The rationale for the integration of a physical activity prescription
into geriatric health care is based on four essential concepts.26
First, there is a great similarity between the physiologic changes
which are attributable to disuse (sarcopenia, osteopenia, central
and generalized adiposity, low fitness, insulin resistance, etc.)
and those that have been typically observed in aging populations,
leading to the speculation that the way in which we age may in
fact be greatly modulated with attention to activity levels,27 as
summarized in Table 1. Second, chronic diseases increase with
age, and exercise has now been shown to be an independent risk
factor and/or potential treatment for most of the major causes of
morbidity and mortality in industrialized societies (see Table 2), a
potential which is currently vastly underutilized. Third,
traditional medical interventions don’t typically address disuse
syndromes accompanying chronic disease, which may be
responsible for much of their associated disability. Exercise is
particularly good, and often the only appropriate means to target
disuse. Finally, many pathophysiologic features that are central to
a disease or its treatment are better addressed by physical
activity than by pharmacologic therapy (e.g. the visceral adiposity
of metabolic syndrome). Exercise therefore deserves a place in the
mainstream of medical care, not as an optional adjunct.
It is clear that the optimum approach to “successful aging” or to
health care in the older population cannot ignore the primacy of
these issues. In some cases, exercise can be used to avert
“age-related” decrements in physiologic function and thereby
maximize function and quality of life in older adults. On the other
hand, the combination of exercise and sound nutrition,
particularly in relation to favorable alterations in body
composition, will have numerous important effects on risk
factors for chronic disease as well as the disability that
accompanies such conditions. In the sections which follow, an
overview of the prescription and monitoring of physical activity in
older adults is presented, as well as two specific examples of
tailored, evidence-based exercise prescription for conditions of
great importance to older adults: type 2 diabetes and
osteoporosis.
Rationale for the Integration of Exercise Prescription into Health Care for Older AdultsThe rationale for the integration of a physical activity prescriptioninto geriatric health care is based on four essential concepts.26First, there is a great similarity between the physiologic changeswhich are attributable to disuse (sarcopenia, osteopenia, centraland generalized adiposity, low fitness, insulin resistance, etc.)and those that have been typically observed in aging populations,leading to the speculation that the way in which we age may infact be greatly modulated with attention to activity levels,27 assummarized in Table 1. Second, chronic diseases increase withage, and exercise has now been shown to be an independent riskfactor and/or potential treatment for most of the major causes ofmorbidity and mortality in industrialized societies (see Table 2), apotential which is currently vastly underutilized. Third,traditional medical interventions don’t typically address disusesyndromes accompanying chronic disease, which may beresponsible for much of their associated disability. Exercise isparticularly good, and often the only appropriate means to targetdisuse. Finally, many pathophysiologic features that are central toa disease or its treatment are better addressed by physicalactivity than by pharmacologic therapy (e.g. the visceral adiposityof metabolic syndrome). Exercise therefore deserves a place in themainstream of medical care, not as an optional adjunct.
It is clear that the optimum approach to “successful aging” or to
health care in the older population cannot ignore the primacy of
these issues. In some cases, exercise can be used to avert
“age-related” decrements in physiologic function and thereby
maximize function and quality of life in older adults. On the other
hand, the combination of exercise and sound nutrition,
particularly in relation to favorable alterations in body
composition, will have numerous important effects on risk
factors for chronic disease as well as the disability that
accompanies such conditions. In the sections which follow, an
overview of the prescription and monitoring of physical activity in
older adults is presented, as well as two specific examples of
tailored, evidence-based exercise prescription for conditions of
great importance to older adults: type 2 diabetes and
osteoporosis.
การแปล กรุณารอสักครู่..