Redefining Heath and Well Being In Older Adults
- Researchers developed a novel model to help predict the risk of incapacity and death in older adults.
- The findings have implications for assessing and managing the quality of life and health of older adults.
Health is more than just the absence of disease. Health also includes physical, psychological, and social well-being. Many traditional models of health, however, focus mostly on conditions such as diabetes, cancer, and heart disease.
A team led by Dr. Martha McClintock at the University of Chicago set out to classify the health of older adults by using a more comprehensive approach. The research was supported in part by NIH’s National Institute on Aging (NIA). Results were published on May 31, 2016, in Proceedings of the National Academy of Sciences.
The researchers interviewed a sample of more than 3,000 American adults, ages 57 to 85. The sample was designed to represent all older adults nationwide who live at home, regardless of their health status. The team administered questionnaires that covered 54 diverse health variables. Participants were contacted again after 5 years and either re-interviewed or noted as unable to participate due to incapacity or death.
A traditional “medical model” used 19 of the variables. These addressed medical issues and organ function, including heart disease, cancer, lung disease, stroke, diabetes, kidney disease, and liver disease. A “comprehensive model” included 35 measures covering other aspects of health and well-being. These included health behaviors (such as sleeping, drinking, and smoking); psychological health (such as stress, depression, loneliness, and self-esteem); sensory function (such as taste, vision, and hearing); and frailty (such as gait speed, bone fracture, anemia, and urinary incontinence).
The researchers found that about half of the people classified as healthy based on the medical model had vulnerabilities revealed by the comprehensive model that affected the chances that they would die or become incapacitated within 5 years. Conversely, some people with chronic diseases had many strengths that reclassified them as healthy in the comprehensive model. For example, older adults who were obese but otherwise physically and mentally healthy had the lowest risk of dying or becoming incapacitated.
Analysis of the full comprehensive model of health and well-being revealed several unique variables that predicted mortality and incapacity. Poor mental health, poor sensory function and social engagement, and having a broken bone any time after age 45 were all strong markers for future health problems. Conversely, greater mobility predicted well-being.
“The new comprehensive model of health identifies constellations of health completely hidden by the medical model and reclassifies about half of the people seen as healthy as having significant vulnerabilities that affect the chances that they may die or become incapacitated within 5 years,” McClintock says.
—by Carol Torgan, Ph.D. –source: https://www.nih.gov/news-events/nih-research-matters/redefining-health-well-being-older-adults
Physical Activity May Reduce Age-Related Movement Problems
At a Glance
- Physical activity may help improve movement problems associated with brain lesions in older people.
- The results highlight the importance of an active lifestyle for older adults.
Age-related brain lesions known as white matter hyperintensities have been linked to movement problems and disabilities later in life. These lesions, which appear as bright spots on MRI images, can be used as a proxy measure of brain white matter disease. They are thought to reflect small blood vessel disease, and have also have been associated with dementia and other health issues in older people.
Previous research has found that seniors who are more physically active are at lower risk for walking difficulties and other movement problems. Researchers led by Dr. Debra A. Fleischman of Rush University Medical Center in Chicago examined whether physical activity can affect the link between age-related brain lesions and motor function in older adults. The study was partly funded by NIH’s National Institute on Aging (NIA), National Institute of Neurological Disorders and Stroke (NINDS), and National Institute of Minority Health and Health Disparities (NIMHD).
The researchers scanned the brains of 167 healthy older adults who were participating in a larger study of memory and aging. The participants’ average age was 80. The investigators gave the participants various movement and strength tests. Participants also wore monitors on their wrists for up to 11 days to measure daily physical activity. The study appeared online in Neurology on March 11, 2015.
As expected, the researchers found that more physical activity was associated with better motor function. More age-related brain lesions were generally linked to poorer motor function. Physical activity levels were not related to the amount of lesions. However, among participants who were most active, the lesions weren’t linked to poorer motor skills. Other factors like body mass index and vascular disease had no effect on the relationship between the brain lesions, daily activity, and motor function.
These results suggest that the level of physical activity later in life doesn’t affect white matter hyperintensities but influences motor function via some other pathway. How physical activity might protect motor skills from the effects of these age-related brain lesions remains unknown. Previous studies suggest that physical activity may enhance brain health by increasing blood flow and other vascular functions in the brain.
“These results underscore the importance of efforts to encourage a more active lifestyle in older people to prevent movement problems, which is a major public health challenge,” Fleischman says. “Physical activity may create a ‘reserve’ that protects motor abilities against the effects of age-related brain damage.”
The associations found in this study suggest, but don’t prove, that physical activity can protect against the loss of motor function caused by age-related brain lesions. The group is now monitoring brain scans over time to more closely examine the relationships between white matter hyperintensities, physical activity, and motor function.
You’re Never Too Old
Keep Active as You Age!
We’ve all heard that exercise is good for you. Did you know that it’s as true for older people as it is for any age group? You’re never too old to get moving, get stronger and improve your health.
Fitting exercise and physical activity into your day can enhance your life in so many ways. Regular physical activity can improve your balance and boost or maintain your strength and fitness. It may also improve your mood and help you manage or lessen the impact of conditions like diabetes, heart disease, osteoporosis and depression.
Despite these proven benefits, exercise and physical activity rates among older people are surprisingly low. Only about 30% of people ages 45 to 64 say they engage in regular leisure-time physical activity. This falls to 25% of those between the ages of 65 and 74 and 11% of people age 85 and older.
Experts recommend 4 types of exercise for older adults: endurance, balance, strength and flexibility. Brisk walking, dancing and other endurance exercises improve the health of your heart, lungs and circulatory system. These exercises can make it easier for you to mow the lawn, climb stairs and do other daily activities. Strength exercises include lifting weights or using resistance bands. They can increase muscle strength to help with activities such as carrying groceries or lifting grandchildren. Balance exercises can help prevent falls—a major health risk for older adults. Stretching, or flexibility exercises, can give you more freedom of movement for bending to tie your shoes or looking over your shoulder as you back out of the driveway.
“Even if you haven’t been active previously, it’s important to get started and stay active,” says Dr. Richard J. Hodes, director of NIH’s National Institute on Aging. “We know that people want to live independently for as long as they possibly can. By exercising regularly and including more physical activity in their daily routine, older people can preserve their physical function, which is key to doing the everyday things they want to do.”
To help you get started and keep moving, NIH brought together some of the nation’s leading experts on aging, exercise and motivation. They developed a guide to exercise for older adults. The guide serves as the basis for a new national exercise and physical activity campaign for people ages 50 and older. It’s called Go4Life.
“Older adults can exercise safely, even those who have physical limitations,” Hodes says. “Go4Life is based on studies showing the benefits of exercise and physical activity for older people, including those with chronic health conditions.”
Go4Life exercises are designed to be done safely at home without special equipment or clothing. The free book Exercise & Physical Activity: Your Everyday Guide from the National Institute on Aging is the core resource for the campaign. Other free materials, such as an exercise DVD and tip sheets, are also available. Workout to Go, a mini exercise guide, shows you how you can be active anytime, anywhere.
To learn more, visit the Go4Life website. You’ll find exercises, success stories and tips to help you stay motivated. Or call 1-800-222-2225, or e-mail niaic@nia.nih.gov.
source: https://newsinhealth.nih.gov/2011/12/youre-never-too-old
The efficacy of mind-body (Baduanjin) exercise on self-reported sleep quality and quality of life in elderly subjects with sleep disturbances: a randomized controlled trial
Abstract
Objectives
To examine the efficacy of a 24-week Baduanjin exercise program on self-reported sleep quality and quality of life in community-dwelling elderly subjects with sleep disturbances.
Methods
Community-dwelling elderly men and women meeting criteria for sleep disturbances (i.e., Pittsburgh Sleep Quality of Index (PSQI) score ≥ 5) were recruited and randomized to a Baduanjin exercise intervention group or a control group. Participants in the intervention group completed five 45-min exercise sessions per week for 24 weeks, while those in control group were instructed to maintain their usual lifestyle behaviors.
Results
A total of 139 participants were enrolled and randomized. Sixty-two of 67 participants in the intervention group (response rate of 92.5%) and 57 of 72 participants (response rate of 79.6%) in the control group completed intervention and follow-up. The intervention group reported significant improvements in overall sleep quality after 24 weeks compared with those randomized to control (PSQI endpoint-to-baseline change = − 2.6 ± 4.0 vs. − 0.5 ± 4.2, time × group interaction p = 0.007). Intervention group participants had higher response rates at both week 12 (23.9% vs. 9.7%, p = 0.025) and week 24 (40.3% vs. 15.3%, p = 0.001) when compared with the control group. There was a trend that the intervention group had increased quality of life (The Short Form Health Survey [SF-36] endpoint=tobaseline change 6.3 ± 10.9 vs. 2.2 ± 10.9, time × group interaction p = 0.06) when compared with the control group.
Conclusions
Baduanjin exercise is an effective and feasible approach to improve self-reported sleep quality but less likely the quality of life in community-dwelling elderly men and women with sleep disturbances.
https://link.springer.com/article/10.1007/s11325-019-01999-w
The Healthcare Note 