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Exercise like an Olympian : My thoughts for and aging contemporary society

Exercise like an Olympian : My thoughts for and aging contemporary society. Gareth R Jones PhD CEP Human Kinetics. Years of active life expectancy and years of dependent living. males. females. Additional Life Expectancy Beyond 65 years. 70-74. 75-79. 80-84. 85+. 65-69.

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Exercise like an Olympian : My thoughts for and aging contemporary society

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  1. Exercise like an Olympian:My thoughts for and aging contemporary society Gareth R Jones PhD CEP Human Kinetics 19th John K. Friesen Conference

  2. 19th John K. Friesen Conference

  3. Years of active life expectancy and years of dependent living males females Additional Life Expectancy Beyond 65 years 70-74 75-79 80-84 85+ 65-69 19th John K. Friesen Conference

  4. Decline of Physical Activity • Work-related (PA decline) • Leisure (no change) • Recreation • Exercise • Household (PA decline) • Activities of Daily Living • Instrumental ADL • Sedentary Activity (increasing) • Sleep • Screen time (computer, TV) 19th John K. Friesen Conference

  5. Sedentary Population: young and old % of Population - sedentary Age (Statistics Canada, 2007) 19th John K. Friesen Conference

  6. Health Status of Older Canadians • 91% live with one or more chronic diseases • Disease prevention – too late? • 40% live with one or more physical disabilities • Active life expectancy – shorter? • 55-70% of older men and women do not meet minimal physical activity (PA) and exercise recommendations • Why are they not listening? (NACA, 2006) 19th John K. Friesen Conference

  7. Age-related decline in Aerobic Capacity VO2max men 30 TVE men VO2max women TVE women (ml·kg-1·min-1) 20 10 (Stathokostas et al,. 2004) 70 60 80 90 Age Years 19th John K. Friesen Conference

  8. Aerobic capacity required for selected activities % Aerobic Capacity 40 100% 30 75% Walk Staircase VO2 (ml·kg-1·min-1) 100% Walk level 7km/hr, 116m/min) 20 50% 75% Domestic Work (vacuum, mow lawn, make beds) % Aerobic Capacity 50% 25% 10 Dressing 25% 20 40 60 80 Age Years 19th John K. Friesen Conference

  9. Age-associated decline of muscle strength • Atrophy • Sarcopenia • Delayed but not avoided • Decline in muscle quality can be slowed with exercise 19th John K. Friesen Conference

  10. Poor Fitness Directly Related to Functional Dependence Cardiorespiratory Fitness Pathology Morphology Dependence Components of Fitness Muscular Performance (Morey et al., 1998) 19th John K. Friesen Conference

  11. Odds ratio of becoming dependent by groupings of fitness J. Am. Geriatr. Soc. Paterson et al. (2004) 19th John K. Friesen Conference

  12. Evidence for the exercise pill • Prevention and therapy for most chronic diseases • Exercise as effective as medication • Select cases more effective or additive effect • Long-term exercise participation reduces dependency risk by 50% • All age cohorts improve functional capacity with exercise (65-100+) (Paterson, Jones, Rice, 2007) 19th John K. Friesen Conference

  13. Life BecomesA Precarious Balancing Act Assets Deficits Fitness Health Attitude Resources Inactivity Obesity Disability Dependence 19th John K. Friesen Conference

  14. 20-40% robust • 50% consider pre-frail (living on the edge) • 10-30% of community dwelling older adults considered frail Appl. Physiol. Nutr. Metab. 33: 651-665 (2008) 19th John K. Friesen Conference

  15. Exercise Management of the Older Adult EXERCISE 19th John K. Friesen Conference

  16. Exercise the New Activity of Daily Living Think about it… • Exercise engenders fitness reducing the risk of dependence • Exercise is the best medicine to reduce the impact of chronic disease • Exercise becomes an essential self-care activity (Activity of Daily Living) • Arguably, this concept applies across all age-groups 19th John K. Friesen Conference

  17. Exercise Training for Life Skill Tuning (development) Skill Retuning 19th John K. Friesen Conference

  18. Moderate to vigorous aerobic exercise ‘brisk walking’ reduce risk of dependence • Resistance exercise reduce disability • Balance – challenge the system • Flexibility – less time standing more time walking • Progression – dose (FITT), alternate activities (cross-train) Appl. Physiol. Nutr. Metab. 32: S69-S108 (2007) 19th John K. Friesen Conference

  19. Where to start and how to progress? • Look for experienced and certified help • Start with a ‘safe’ workload (light) but progress to moderate/vigorous within 1-2 weeks • A light workload will only provide a small (less meaningful) adaptation, therefore, challenge yourself sooner than later 19th John K. Friesen Conference

  20. Are we getting the message across? 19th John K. Friesen Conference

  21. Exercise like an Olympian 19th John K. Friesen Conference

  22. Old News is New News • Today's Olympians aim to prove age is just a number … 21 of the U.S. Olympians headed to Beijing are 40 or older • Olympians over 30 make their mark …although not suggested outright that some of the Olympians of 2012 remember to bring their walkers • The Starting Line: At the Olympics, Age Is Just a Number… • Olympian longevity … a significantly older age group than a generation ago, thanks to dramatic changes in the way athletes train and recover 19th John K. Friesen Conference

  23. Ageless Canadian Olympians • Ian Miller –equestrian (61 years) • Jujie Luan - fencing (50 years) • Susan Nattrass- trap shooting (57 years) • Duff Gibson – ‘gold’ skelton (39 years, holding) 19th John K. Friesen Conference

  24. New limits or no limitsAge and athletic performance • Ed Whitlock “Marathon Man” 2:54:48 at age 73 • Sister Madonna Buder “The Iron Nun” at 77 • Fauja Singh, “Oldest Marathoner’ at 94 runs 5:40.00 • Arthur Thompson 103 yrs shot 97 on the 6,215 yd Uplands course Victoria, BC. 19th John K. Friesen Conference

  25. Exercise goals of Boomers / Zoomers • Beyond disease prevention • Cognitive preservation • Viagra generation • Not older – JUST BOLDER 19th John K. Friesen Conference

  26. Olympian Values • Citius(FASTER) – walk briskly, pick-up the pace, increase intensity • Altius (Think HIGHER) – set goals, remarkable what can be achieved • Fortius (STRONGER)- to ward-off disability and keep aging muscle moving they way we want it too 19th John K. Friesen Conference

  27. Man does not cease to play because he is grows old – he grows old because he ceases to play George Bernard Shaw 19th John K. Friesen Conference

  28. Obesity Growth in Canada Statistics Canada, CCHS, 2004 19th John K. Friesen Conference

  29. Benefits of strength training • Older adults respond as well or better than young adults • Not all improvements explained by muscle size (Porter, 2001) • Older adults rely on neural changes more than young adults (Grabiner & Enoka, 1995) • Training can improve strength >100%, power >20% in only a few weeks, effects attenuated after 12-weeks. 19th John K. Friesen Conference

  30. Exercise Recommendations Strength and Power Strength (ACSM 2002) • Single joint and multi-joint movements • Slow to moderate movements • 1-3 sets per exercise • 60-80% of 1RM for 8-12 Reps • Power (de Vos et al. 2005) • Light to moderate loads (40-60% 1Rm) • High velocity movement • 6-10 Reps (power), 10-15 Reps (endurance) • Gradual overload, adequate recovery, low intensity (< 50% 1RM) insufficient stimulus 19th John K. Friesen Conference

  31. Future considerations for strength training research • Effect on physical disability & mobility yet to be elucidated • Few studies examine MSK fitness and morbidity • Grip strength too simple a measure for overall muscle strength, yet poor grip strength risk factor for early death (Brill et al, 2000) • Dynamic actions more relevant to everyday function 19th John K. Friesen Conference

  32. Balance and mobility ‘detuning’ • Age-associated decline of sensory systems • Fear of falling an insidious effect • Short-term gain long-term risk • Exercise paradox with falls • Increase activity increases falls • Most vigorous suffer most serious falls 19th John K. Friesen Conference

  33. Balance & mobility ‘retuning’ • No perfect program (Tai chi, strength, balance etc.) • Individualized (challenge sensory assets) • Dynamic programs that progress activities • Alter environmental challenges under different conditions to train global balance skills. 19th John K. Friesen Conference

  34. Flexibility • Stretching is joint specific • Utility for therapy but no general application to older adults • No evidence to suggest stretching any more beneficial than warming-up or cooling-down prior to exercise. • Exercise classes should spend more time on exercising than stretching 19th John K. Friesen Conference

  35. Factors contributing to muscle weakness • Sarcopenia • Muscle quality (ability to generate force) • Muscle fiber characteristics • Neural control • Muscle activation • Contractile kinetics • Muscle stiffening 19th John K. Friesen Conference

  36. Power required to rise from an armless chair 75 50 75 50 25 25 0 0 20 40 60 80 Age (yrs) 19th John K. Friesen Conference

  37. Top 10 reasons for an older adult to exercise muscular strength • Increase muscle mass • Increase force output • Improved endurance capacity • Improved bone density and strength • Increase levels of circulating testosterone and GH • Improve insulin resistance • Increased energy expenditure • Aide with weight management • Improved motor function • Reduce risk of early mortality 19th John K. Friesen Conference

  38. Sarcopenic obesity Fat tissue > Muscle tissue 19th John K. Friesen Conference

  39. Frailty: right next door • 20-40% robust • 50% consider pre-frail (living on the edge) • 10-30% of community dwelling older adults considered frail • Objective clinical measures needed. • Frailty Criteria • Weight loss • Exhaustion • Low PA • Muscle weakness • Slow walking speed • 0 - Robust • 1-2 - Prefrail • 3 > - Frail (Fried et al. 2001) 19th John K. Friesen Conference

  40. Mixed MessagesHow much is enough? • 20 min , 3 days of the week (ACSM, AHA, 1980) • 30 minutes most days of the week (CDC, ACSM, 1996) • Accumulate 60 minutes, everyday (Health Canada, CSEP, 1998) • Accumulate 60-90 minutes (IOM, 2005) 19th John K. Friesen Conference

  41. Exercise goals of Boomers / Zoomers • Beyond disease prevention • Cognitive preservation • Viagra generation 19th John K. Friesen Conference

  42. Planning Communities for Successful Aging Courtesy of Lawrence Berg 19th John K. Friesen Conference

  43. Accumulation of Daily Physical ActivityLittle or No Benefit to Sustaining Independence • PA explains less than 1% of the change in fitness • PA activity may be related to disease prevention but not fitness • Only PA in the moderate-vigorous realm, 3x per wk, 30min+ can reduce the risk of becoming dependent by over 50% Stathokostas, 2004 19th John K. Friesen Conference

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