National physical activity recommendations for older Australians: Discussion Document

9.1 The old- older person

The National Ageing Research Institute was commissioned by The Department of Health and Ageing to review the evidence and develop physical activity recommendations for older people.

Page last updated: 01 February 2011

This categorisation spans all four of the WHO classes, although the focus tends to be upon the physically unfit- unhealthy and dependent individuals. Physical activity considerations for this group are encompassed within the following sections, as physical activity involvement is largely determined by health status rather than chronological age.

Whilst many studies have considered older people on aggregate, the Zutphen Elderly Study looked at physical activity patterns across different age groups in their cohort (Bijnen, Caspersen et al. 1998). There was an age-related decline in physical activity, with walking contributing more to overall activity amongst the oldest age group. This was not wholly related to functional decline. However, as the authors noted, with slowing down of routine actions and the potentially greater effort needed to conduct them, the time available for incidental activity and the associated motivation required may lead to less overall activity. This has implications for measuring only incidental activity in studies of older people. It also points to a tendency for reduced diversity of activity with ageing: strategies to promote different forms of activity are particularly pertinent for the old-old. Relatively few intervention studies have focused on the old-old. Simons and Andel (2006) trialled two types of supervised exercise in people with a mean age of 83.5 years. They found similar levels of improvement in functional status (albeit with no between group analyses) amongst those who followed a walking program and those completing a PRT program. For some frail older people, the walking may be a more feasible option in the long term, although they may require initial lower limb strength training to enable independent walking.

It has been difficult to disentangle the effects of ageing from disuse and disease when assessing older people’s functionality. Much of the so-called ‘age-related changes in body composition (e.g. fat, muscle, bone) are associated with decreased physical activity, excess energy intake or both (Fiatarone Singh 2002). Cross sectional studies have reported declines in muscle strength with ageing. Longitudinal data indicates that the declines may be greater than had been estimated from cross sectional data, with older old people demonstrating a greater rate of decline than younger age groups, particularly for leg strength (Hughes, Frontera et al. 2001). In this study, physical activity decline was not directly associated with the strength changes over time. The data indicated that isokinetic strength decreases were not universal, with some gains being seen, even with concurrent muscle mass loss (muscle mass change accounted for only 5% of the change in strength).
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