Evidence-based yet still challenging! Research on physical activity in old age

Abstract

Preserving functional health and quality-of-life in old age is a major goal and global challenge in public health. The high rate of sedentary behavior that is characteristic of the older adult population exacerbates impairments of physiological and structural systems that are typically seen in the aging process. Achieving an understanding of the profound influence of physical activity on all aspects of health in old age is the driving force behind the emergence of "physical activity in old age" as a growing area of research. Accumulated evidence implies that being physically active and exercising is far superior to other optimal aging facilitators. Yet this area of research faces numerous constraints and obstacles. This commentary addresses some of these challenges, primarily the heterogeneity of the aging process, which induces both inter- and intra-individual differences among aged individuals, heterogeneity in assessment tools, unjustified inclusion/exclusion criteria and insufficient recruitment strategies, difficulties in implementing research results in real-world conditions, and rudimentary exploitation of innovative technology. We explain the importance of establishing a network of multidisciplinary scientists and stakeholders to propose consensus-based goals and scientifically evidenced wide-ranging plans for dealing with these challenges. In addition, we suggest work directions for this network.

Effects of chronic physical exercise on executive functions and episodic memory in clinical and healthy older adult populations: a systematic review and meta-analysis protocol

“…Our comprehensive review will potentially include healthy and non-healthy older adults and a wide range of exercise modes. This argument stems from a gap in evidence-based literature as pointed in a recent article [ 49 ]. For example, it has been argued that research on older populations is typically biased towards healthy and relatively young older adults, with certain groups of older individuals frequently being excluded from research on aging — especially in studies with physical activity interventions [ 49 ].…”

“…This argument stems from a gap in evidence-based literature as pointed in a recent article [ 49 ]. For example, it has been argued that research on older populations is typically biased towards healthy and relatively young older adults, with certain groups of older individuals frequently being excluded from research on aging — especially in studies with physical activity interventions [ 49 ]. Such a review will pose a general question on the effect of exercise on cognition in advanced age (a general effect size will be calculated) followed by examining the moderating effect of various exercise modes (e.g., aerobics, strength, balance), several exercise characteristics (e.g., intensity, frequency, length), and a wide range of population characteristics (e.g., education level, percentage of females, health status), protocol characteristics (e.g., type of control group, type of analysis — intention-to-treat vs. per-protocol), and exercise settings (community dwelling and nursing homes).…”

Chronic exercise effects on overall depression severity and distinct depressive symptoms in older adults: A protocol of a systematic and meta-analytic review

“…We are aware that by that we might miss some clinically relevant insights. We chose this approach to extract the “pure” impact of chronic exercise on depression in old age and to obtain results comparable to reviews of other aspects of health in old age that will be conducted in the “Network on evidence-based physical activity in old age” [ 108 ]. We further anticipate limitations in form of heterogenous data and a wide variance in the reporting of the exercise characteristics (e.g., detailedness) and the individual characteristics.…”

The Longitudinal Association between Multiple Frailty Criteria and Depressive Symptomatology Five Years Later in Older Adults: A Decision Tree Modelling Approach

“…Suggestions for future investigations: (1) focus on the inter- and intra-individual differences that men and women present, which, in turn, influence the process of frailty and DEP symptomatology from age 50 onwards. Therefore, it would be important for investigations to look for behavioral and biological markers that consider the peculiarities of human aging; (2) expand and qualify the understanding of strategies based on physical exercise capable of increasing PA levels in the European older adult population, as a possible strategy to mitigate DEP symptomatology and frailty criteria [ 81 ]; (3) researchers should keep in mind the multicomponent arrangement of the human organism and that the coordination of all functions occur through an integrated system. From this perspective, it is important that strategies are not reduced to a single physiological system, but rather incorporate holistic principles [ 6 ], and seek to differentiate and specify interventions according to frail and non-frail older adults.…”