Exercise Prescription and Rehabilitation Considerations for Older Adults: Summary 73
• During aerobic exercise, venous oxygen content is lower due to the greater oxygen demand of the skeletal muscles and the shunting of blood • Peripheral oxygen use with aging is often impaired (peripheral artery disease, diabetes) Arteriovenous Oxygen Difference Arteriovenous oxygen difference is the difference between arterial and venous oxygen content: • Reflects gas exchange in the peripheral tissues • Sedentary older adults will have a decrease in arteriovenous oxygen difference during aerobic exercise • Deconditioning and bed rest can diminish oxygen use in skeletal muscle and aerobic capacity: will lead to a decrease in arteriovenous oxygen difference
RISK FACTOR DEFINING CRITERIA Dyslipidemia
Low-density lipoprotein (LDL) cholesterol greater than or equal to 130 mg/dL, or high-density lipoprotein (HDL) cholesterol less than 40 mg/dL or on lipid lowering medication. Or total serum cholesterol greater than or equal to 200 mg/dL Impaired fasting glucose greater than or equal to 100 mg/dL, but less than 126 mg/dL; or impaired glucose tolerance test: 2-hour values in oral glucose tolerance test greater than or equal to 140 mg/dL but less than 200 mg/dL confirmed on at least 2 separate occasions
Prediabetes
CARDIOVASCULAR DISEASE RISK FACTORS
LEARNING TIP! Through examination of the patient for cardiovascular risk factors is necessary by all members of the healthcare team.
PHYSICAL ACTIVITY AND EXERCISE
• Physical activity : ○ Body movements that involve muscle contractions and energy expenditure ○ Typical leisure activities ○ Examples: gardening, household chores • Exercise : ○ Greater intensity than physical activity ○ Works towards a specific goal: increase strength, increase flexibility, or increase aerobic activity tolerance CDC Physical Activity Guidelines • All older adults (65 years+) should engage in one of the following options on a regular basis: ○ Option 1 : 150 minutes of moderate-intensity aerobic activity (brisk walking) every week ○ Option 2 : 75 minutes of vigorous-intensity aerobic activity (jogging, hiking, running) every week WORLD HEALTH ORGANIZATION’S (WHO) INTERNATIONAL CLASSIFICATION OF FUNCTION
RISK FACTOR DEFINING CRITERIA Age
Men ages 45 and older; women ages 55 and older Myocardial infarction, coronary revascularization, or sudden death before age 55 in father or other male 1st degree relative, or before age 65 in mother or other female 1st degree relative Current smoker or those who quit within the previous 6 months or exposure to environmental tobacco smoke Not participating in at least 30 minutes of moderate intensity activity on at least 3 days of the week for at least 3 months BMI greater than or equal to 30 or waist girth >40 inches for men and >35 inches for women SBP greater than or equal to 140 mmHg and/or DBP greater than or equal to 90 mmHg, as measured on 2 separate occasions, or on antihypertensive medications
Family history
Cigarette smoking
Sedentary lifestyle
Obesity
Hypertension
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