Physical Exercise in the Oldest Old

Valenzuela, Pedro L.; Castillo‐García, Adrián; Morales, Javier S.; Izquierdo, Mikel; Serra-Rexach, J.A.; Santos‐Lozano, Alejandro; Lucía, Alejandro

doi:10.1002/cphy.c190002

Cited by 107 publications

(107 citation statements)

References 295 publications

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“…These authors found that 15%, 49% and 38% of the participants in the exercise group obtained no benefits (or even a deterioration) in some functional outcomes (physical performance, gait velocity, and muscle strength) despite the intervention being safe and overall beneficial compared to usual care. Thus, our results provide additional evidence in support of the beneficial effects of physical exercise for oldest old people and particularly for those who are hospitalized-which include improvements not only in muscle mass/strength, but also in cardiorespiratory fitness, in inflammatory and hormonal status, or cognitive function [29]. However, taken together, previous [16] and present results support that there is a considerable individual variability in the response to an in-hospital intervention for very old patients.…”

Section: Discussionsupporting

confidence: 70%

“…Thus, we could hypothesize that the response to the exercise intervention might have had a ceiling effect, with those patients with greater fitness levels needing more demanding interventions (i.e., longer and/or more intense programs) to obtain meaningful benefits. In this context, multi-component exercise interventions applying greater volumes or higher intensities (e.g., resistance training with fast or 'explosive' movements) might be more effective in these fitter patients, as previously reported for older adults who were overall fitter at baseline than our participants [29,33,34]. A number of studies have previously reported that implementation of higher training loads can enhance responsiveness in individuals who were classified a priori as non-responders [35,36].…”

Section: Discussionsupporting

confidence: 66%

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Individual Responsiveness to Physical Exercise Intervention in Acutely Hospitalized Older Adults

Ortiz-Alonso

Bustamante-Ara

Vidán

et al. 2020

JCM

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We analyzed inter-individual variability in response to exercise among acutely hospitalized oldest-old adults. In this ancillary analysis of a randomized controlled trial, 268 patients (mean age 88 years) were assigned to a control (n = 125, usual care) or intervention group (n = 143, supervised exercise, i.e., walking and rising from a chair [1–3 sessions/day]). Intervention group patients were categorized as responders, non-responders, or adverse responders (improved, no change, or impaired function in activities of daily living [ADL, Katz index] from hospital admission to discharge, respectively). We analyzed the association between responsiveness to exercise and variables assessed at baseline (2 weeks pre-admission), admission, during hospitalization, at discharge, and during a subsequent 3-month follow-up. An impaired ADL function and worse nutritional status at admission were associated to a greater responsiveness, whereas a better ADL function at admission, longer hospitalization and lower comorbidity index were associated with a poorer response (p < 0.05). Adverse responders had worse outcomes at discharge and during the follow-up (e.g., impaired physical performance and greater fall number) (p < 0.05). Although exercise intervention helps to prevent ADL function decline in hospitalized oldest-old people, a number of them—particularly those with a better functional/health status at admission and longer hospitalization—are at higher risk of being adverse responders, which can have negative short/middle-term consequences.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionsupporting

confidence: 66%

Individual Responsiveness to Physical Exercise Intervention in Acutely Hospitalized Older Adults

Ortiz-Alonso

Bustamante-Ara

Vidán

et al. 2020

JCM

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“…A recent study found that frail elderly patients of advanced age have obvious benefits from participating in exercise, even if they begin late in life 161 . Moreover, exercise interventions during the in-hospital stay have been shown to increase the proportion of patients discharged to their homes and to reduce the length and cost of hospital stays for hospitalized older medical patients 98 .…”

Section: The Role Of the Physical Therapistmentioning

confidence: 99%

Physical Fitness in Hospitalized Frail Elderly Patients

Åhlund

2020

Linköping University Medical Dissertations

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“…These aforementioned processes can be viewed as a cascade of events, beginning with aging, which are associated with greater muscle fat infiltration [17,18]. Aging and accumulation of infiltrating fat leads to a decline in muscle quality and quantity-therefore resulting in a poorer performance (lower muscle strength)-and, ultimately, affecting functional dependence in ADL [19,20].…”

Section: Introductionmentioning

confidence: 99%

Relative Handgrip Strength Diminishes the Negative Effects of Excess Adiposity on Dependence in Older Adults: A Moderation Analysis

Ramírez‐Vélez

Pérez-Sousa

García-Hermoso

et al. 2020

JCM

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The adverse effects of fat mass on functional dependence might be attenuated or worsened, depending on the level of muscular strength. The aim of this study was to determine (i) the detrimental effect of excess adiposity on dependence in activities of daily living (ADL), and (ii) whether relative handgrip strength (HGS) moderates the adverse effect of excess adiposity on dependence, and to provide the threshold of relative HGS from which the adverse effect could be improved or worsened. A total of 4169 participants (69.3 ± 7.0 years old) from 244 municipalities were selected following a multistage area probability sampling design. Measurements included anthropometric/adiposity markers (weight, height, body mass index, waist circumference, and waist-to-height ratio (WHtR)), HGS, sarcopenia “proxy” (calf circumference), and ADL (Barthel Index scale). Moderation analyses were performed to identify associations between the independent variable (WHtR) and outcomes (dependence), as well as to determine whether relative HGS moderates the relationship between excess adiposity and dependence. The present study demonstrated that (i) the adverse effect of having a higher WHtR level on dependence in ADL was moderated by relative HGS, and (ii) two moderation thresholds of relative HGS were estimated: 0.35, below which the adverse effect of WHtR levels on dependency is aggravated, and 0.62, above which the adverse effect of fat on dependency could be improved. Because muscular strength represents a critically important and modifiable predictor of ADL, and the increase in adiposity is inherent in aging, our results underscore the importance of an optimal level of relative HGS in the older adult population.

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Physical Exercise in the Oldest Old

Cited by 107 publications

References 295 publications

Individual Responsiveness to Physical Exercise Intervention in Acutely Hospitalized Older Adults

Individual Responsiveness to Physical Exercise Intervention in Acutely Hospitalized Older Adults

Physical Fitness in Hospitalized Frail Elderly Patients

Relative Handgrip Strength Diminishes the Negative Effects of Excess Adiposity on Dependence in Older Adults: A Moderation Analysis

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