Exercise Training and Nutritional Supplementation for Physical Frailty in Very Elderly People

Fiatarone, Maria A.; O’Neill, Evelyn F.; Ryan, Nancy; Clements, Karen M.; Solares, Guido R.; Nelson, Miriam E.; Roberts, Susan B.; Kehayias, Joseph J.; Lipsitz, Lewis A.; Evans, William J.

doi:10.1056/nejm199406233302501

Cited by 2,524 publications

(1,775 citation statements)

References 27 publications

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“…Perhaps more importantly, in such drug studies a finding that joint pain relief is not associated with improved walking velocity can be explained by the fact that 1 here was not sufficient time for improvement in muscle function to occur, even though the joints were less inflamed and painful. These findings are also consistenl with observations by other investigators that strengthening of lower extremity muscles can improve one's ability to ambulate efficiently (12,13).…”

Section: Discussionsupporting

confidence: 87%

The determinants of walking velocity in the elderly

Chang¹,

Dunlop²,

Gibbs³

et al. 1995

Arthritis & Rheumatism

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Objective. To determine predictors of walking velocity in the elderly.Methods. Five hundred thirty-two persons from 3 cohorts of elderly persons (retirement community, ambulatory care medical clinic, or chronically homebound population) performed a 10-foot (for the homebound subjects) or SO-foot (for all other subjects) walk time test and underwent a standardized interview, chart review, and clinical examination. The 73 independent variables that were evaluated included demographic, musculoskeletal, neurologic, psychologic, and other comorbidity items. Least-squares and least-absolute-deviation regression tree analyses were performed to determine the strongest predictive factors associated with walking velocity.Results, Sampling cohort (homebound versus non-homebound), quadriceps strength, hip flexion strength, lumbosacral spine impairment, lower joint impairment, and education were found to be associated with walking velocity. Joint pain measures were not associated with walking velocity.

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Section: Discussionsupporting

confidence: 87%

The determinants of walking velocity in the elderly

Chang¹,

Dunlop²,

Gibbs³

et al. 1995

Arthritis & Rheumatism

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“…We showed that mitochondria are damaged within cells instead of being frail and damaged during the isolation procedure. A functional muscle that has not lost the capacity to synthesize healthy mitochondria is an important contributor to the prevention of frailty, a major problem in medicine, particularly in geriatrics (Fiatarone et al 1994;Gill et al 2010). Thus, understanding the molecular mechanisms of mitochondriogenesis in aging has both theoretical and practical importance.…”

Section: Discussionmentioning

confidence: 99%

“…Muscle aging is a key component of the increase in frailty in human and animal populations (Vanitallie 2003). Physical exercise is an obvious antiaging mechanism and it is intended to serve as a prevention of cardiovascular aging but also as a prevention of sarcopenia as well as loss in muscle functionality (Fiatarone et al 1994).…”

Section: Introductionmentioning

confidence: 99%

Age associated low mitochondrial biogenesis may be explained by lack of response of PGC-1α to exercise training

Derbré

Gómez-Cabrera

Nascimento

et al. 2011

AGE

114

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Low mitochondriogenesis is critical to explain loss of muscle function in aging and in the development of frailty. The aim of this work was to explain the mechanism by which mitochondriogenesis is decreased in aging and to determine to which extent it may be prevented by exercise training. We used aged rats and compared them with peroxisome proliferator-activated receptor-γ coactivator-1α deleted mice (PGC-1α KO). PGC-1α KO mice showed a significant decrease in the mitochondriogenic pathway in muscle. In aged rats, we found a loss of exercise-induced expression of PGC-1α, nuclear respiratory factor-1 (NRF-1), and of cytochrome C. Thus muscle mitochondriogenesis, which is activated by exercise training in young animals, is not in aged or PGC-1α KO ones. Other stimuli to increase PGC-1α synthesis apart from exercise training, namely cold induction or thyroid hormone treatment, were effective in young rats but not in aged ones. To sum up, the low mitochondrial biogenesis associated with aging may be due to the lack of response of PGC-1α to different stimuli. Aged rats behave as PGC-1α KO mice. Results reported here highlight the role of PGC-1α in the loss of mitochondriogenesis associated with aging and point to this important transcriptional coactivator as a target for pharmacological interventions to prevent age-associated sarcopenia.

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“…In the positive direction, people who are ®t tend to be physically active, and people with chronic diseases who enter an exercise program demonstrate an increase in their physical activity outside of the training program. Studies from our laboratory have previously shown this for adults with rheumatoid arthritis (Rall et al, 1996a, b), HIV infection (Roubenoff et al, 1997b), as well as for frail elderly nursing home residents (Fiatarone et al, 1994). In the negative direction, as people become weaker, either because of disease or because of age-related sarcopenia, the proportion of maximal effort required to perform daily tasks increases, so that it becomes progressively uncomfortable to perform these tasks, and they are abandoned.…”

Section: Impact Of Sarcopeniamentioning

confidence: 93%

Sarcopenia and its implications for the elderly

2000

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Sarcopenia is the loss of muscle mass and strength with age. Sarcopenia is a part of normal aging, and occurs even in master athletes, although it is clearly accelerated by physical inactivity. Sarcopenia contributes to disability, reduced ability to cope with the stress of a major illness, and to mortality in the elderly. The etiology of sarcopenia is unclear, but several important factors have been identi®ed. These include loss of alpha motor neurons, decline in muscle cell contractility, and several potential humoral factors, such as androgen and estrogen withdrawal and increase in production of catabolic cytokines. Treatment of sarcopenia with progressive resistance training is safe and effective, but dissemination of this technique to the general population has yet to occur. As the number of elderly persons increases exponentially in the new century, a public health approach to prevention and treatment of sarcopenia, based on increasing physical activity at all ages, will be crucial to avoiding an epidemic of disability in the future.

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Exercise Training and Nutritional Supplementation for Physical Frailty in Very Elderly People

Abstract: High-intensity resistance exercise training is a feasible and effective means of counteracting muscle weakness and physical frailty in very elderly people. In contrast, multi-nutrient supplementation without concomitant exercise does not reduce muscle weakness or physical frailty.

Cited by 2,524 publications

References 27 publications

The determinants of walking velocity in the elderly

The determinants of walking velocity in the elderly

Age associated low mitochondrial biogenesis may be explained by lack of response of PGC-1α to exercise training

Sarcopenia and its implications for the elderly

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