Many body system changes accelerate after age 65, leading to a progressive decline in mobility and physical function in older adults (Davan-Wetton et al., 2021). In addition to decreased physical function, aging has also been associated with the development of a number of serious systemic diseases such as cancer, heart disease, and type 2 diabetes. However, aging does not have to result in decreased mobility or increased disease. Many of the age-associated changes that lead to decreased mobility and increased disease are directly or indirectly linked to a lack of physical activity and exercise (WHO, 2020). A lack of physical activity over a lifetime can actually accelerate aging and physiological changes in the body, which results in premature health and mobility problems (Murach et al., 2022; WHO, 2020). may be more likely to adhere to low-intensity exercises if they do not have a history of exercise behaviors, and to higher- intensity programs if they have a history of exercise behaviors (Liguori & American College of Sports Medicine, 2020). Home- based exercise programs have shown higher compliance rates than those initiated in other rehabilitation settings (Liguori & American College of Sports Medicine, 2020).
eventually death (Englund et al., 2021). The emerging studies though cellular senescence, which is initiated upon detection of cellular damage or stress, show that the mechanism can be used to track aging and multiple aging-relating systems (Davan- Wetton et al., 2021). Senescence studies show that regular physical activity reverses many biomarkers of age and age- related conditions of the heart, immune system, and skeletal muscles. Regular physical activity also reverses or stabilizes inflammatory and lymphatic negative responses, age-related circadian rhythm disturbances, and perceived low energy in people over age 65, even if they were previously sedentary (Davan-Wetton et al., 2021; Filelfi et al., 2021; Frontera, 2017; Murach et al., 2022 Panagiotou et al., 2021; Papp et al., 2021). FITT A useful framework for exercise prescription is the acronym FITT, which stands for frequency, intensity, time, and type (Liguori & American College of Sports Medicine, 2020). FITT is a principle of exercise prescription (Ex Rx) with many variations that can help with client adherence, especially considering each client’s opportunity for autonomy. Allowing a client to self-select frequency and time may influence adherence. Clients Physical activity guidelines for older adults The Physical Activity Guidelines for Americans currently suggest that older adults participate in 150 to 300 minutes of varied, multicomponent moderate activity (or greater) for three or more days a week, including both aerobic and resistance training, with
an emphasis on functional balance and strength training (Liguori & American College of Sports Medicine, 2020). Table 1 shows the complete guidelines.
Table 1: Key Guidelines for Older Adults Key Guidelines for Adults and Older Adults
Key Guidelines Just for Older Adults
• As part of their weekly physical activity, older adults should do multicomponent physical activity that includes balance training as well as aerobic and muscle strengthening activities. • Older adults should determine their level of effort for physical activity relative to their level of fitness. • Older adults with chronic conditions should understand whether and how their conditions affect their ability to do regular physical activity safely. • When older adults cannot do 150 minutes of moderate- intensity aerobic activity each week because of chronic conditions, they should be as physically active as their abilities and conditions allow.
• Adults should move more and sit less throughout the day. • Some physical activity is better than none. • Adults who sit less and do any amount of moderate-to- vigorous physical activity gain some health benefits. • For substantial health benefits, adults should do at least 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) to 150 minutes (2 hours and 30 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. • Preferably, aerobic activity should be spread throughout the week. • Additional health benefits are gained by engaging in physical activity beyond the equivalent of 300 minutes (5 hours) of moderate-intensity physical activity a week. • Adults should also do muscle strengthening activities of moderate or greater intensity that involve all major muscle groups on two or more days a week, as these activities provide additional health benefits.
Note : Adapted from HHS (2018). The HHS encourages this dosage through a number of promotional materials, including the example that can be found in Figure 1.
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