Geriatric Nursing
Volume 28, Issue 6 , Pages 339-340, November 2007

Physical Activity and Public Health in Older Adults: Recommendation from the American College of Sports Medicine and the American Heart Association (ACSM/AHA)

Article Outline

 

Regular physical activity, including aerobic and muscle-strengthening activities, is essential for healthy aging. This preventive recommendation specifies how older adults, by engaging in each recommended type of physical activity, can reduce the risk of chronic disease, premature mortality, functional limitations, and disability.

The objectives of this article are to 1) provide a preventive recommendation on physical activity for older adults that consists of the updated ACSM/AHA recommendation for adults with additions and modifications appropriate for older adults, 2) explain and clarify the additions and modifications, and 3) discuss the promotion of physical activity in older adults so as to provide guidance about appropriate types and amounts of physical activity.

The following recommendation for older adults describes the amounts and types of physical activity that promote health and prevent disease. The recommendation applies to all adults aged 65 years and older and to adults aged 50–64 with clinically significant chronic conditions or functional limitations that affect movement ability, fitness, or physical activity.

1.To promote and maintain good health, older adults should maintain a physically active lifestyle.

2.They should perform moderate-intensity aerobic (endurance) physical activity for a minimum of 30 minutes on 5 days each week or vigorous-intensity aerobic activity for a minimum of 20 minutes on 3 days each week. Moderate-intensity aerobic activity involves a moderate level of effort relative to an individual’s aerobic fitness. On a 10-point scale on which sitting is 0 and all-out effort is 10, moderate-intensity activity is a 5 or 6 and produces noticeable increases in heart rate and breathing. On the same scale, vigorous-intensity activity is a 7 or 8 and produces large increases in heart rate and breathing. For example, given the heterogeneity of fitness levels in older adults, for some older adults, a moderate-intensity walk is a slow walk, and for others it is a brisk walk.

3.Combinations of moderate- and vigorous-intensity activity can be performed to meet this recommendation. These moderate- or vigorous-intensity activities are in addition to the light-intensity activities frequently performed during daily life (e.g., self-care, washing dishes) or moderate-intensity activities lasting 10 minutes or less (e.g., taking out trash, walking to parking lot at store or office).

4.In addition, at least twice each week, older adults should perform muscle-strengthening activities that maintain or increase muscular strength and endurance and use the major muscles of the body. It is recommended that 8–10 exercises be performed on at least 2 nonconsecutive days per week using the major muscle groups. To maximize strength development, a resistance (weight) should be used that allows 10–15 repetitions for each exercise. The level of effort for muscle-strengthening activities should be moderate to high.

5.Because of the dose-response relationship between physical activity and health, older persons who wish to further improve their personal fitness, reduce their risk for chronic diseases and disabilities, or prevent unhealthy weight gain will likely benefit by exceeding the minimum recommended amount of physical activity.

6.To maintain the flexibility necessary for regular physical activity and daily life, older adults should perform activities that maintain or increase flexibility on at least 2 days each week for at least 10 minutes each day.

7.To reduce risk of injury from falls, community-dwelling older adults with substantial risk of falls should perform exercises that maintain or improve balance.

8.Older adults with one or more medical conditions for which physical activity is therapeutic should perform physical activity in a manner that effectively and safely treats the condition(s).

9.Older adults should have a plan for obtaining sufficient physical activity that addresses each recommended type of activity. Those with chronic conditions for which activity is therapeutic should have a single plan that integrates prevention and treatment. For older adults who are not active at recommended levels, plans should include a gradual (or stepwise) approach to increase physical activity over time. Many months of activity at less-than-recommended levels is appropriate for some older adults (e.g., those with low fitness) as they increase activity in a stepwise manner. Older adults should also be encouraged to self-monitor their physical activity on a regular basis and to reevaluate plans as their abilities improve or as their health status changes.

The free online version of this article is located on the World Wide Web at: http://circ.ahajournals.org.

Source: Circulation 2007;116:1094-105

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Safety and Effectiveness of Topical Dry Mouth Products Containing Olive Oil, Betaine, and Xylitol in Reducing Xerostomia for Polypharmacy-Induced Dry Mouth 

Polypharmacy is a common cause of salivary hypofunction, producing symptoms of dry mouth or xerostomia, especially among older populations. As the number of older people continues to increase, polypharmacy-induced salivary hypofunction is a growing problem. Many over-the-counter products are available for relieving symptoms of dry mouth, but few have been tested in controlled clinical investigations. The purpose of this investigation was to evaluate the safety and efficacy of a group of topical dry mouth products (toothpaste, mouth rinse, mouth spray, and gel) containing olive oil, betaine, and xylitol. Forty adults were entered into this single-blinded, open-label, crossover clinical study, and 39 of these individuals completed all the visits. Subjects were randomly assigned at baseline to use the novel topical dry mouth products daily for 1 week or to maintain their normal dry mouth routine care. After 1 week, they were crossed over to the other dry mouth regimen. The results demonstrated that the use of the novel topical dry mouth products significantly increased unstimulated whole salivary flow rates, reduced complaints of xerostomia, and improved xerostomia-associated quality of life. No clinically significant adverse events were observed. These data suggest that the daily use of topical dry mouth products containing olive oil, betaine, and xylitol is safe and effective in relieving symptoms of dry mouth in a population with polypharmacy-induced xerostomia.

Source: J Oral Rehab 2007;34:724-32.

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Congratulations 

John A. Hartford Foundation announced a major expansion of its Centers of Geriatric Nursing Excellence (CGNE) initiative. Four Centers—at Arizona State University, Pennsylvania State University, the University of Minnesota, and the University of Utah—will each receive $1 million to prepare more than 500 nursing faculty with expertise in geriatrics. These new faculty will educate the next (and critically needed) generation of nurses to improve the health and well-being of older adults.

PII: S0197-4572(07)00303-5

doi:10.1016/j.gerinurse.2007.10.002

Geriatric Nursing
Volume 28, Issue 6 , Pages 339-340, November 2007

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