New Rx for Seniors: Move More for Healthy Aging

Canadian Medical Association Journal

Can physical activity extend the lifespans of older adults? A review article published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.231336 summarizes the considerable evidence supporting the important role physical activity plays in preventing or reducing the effects of diseases and discusses how to prescribe effective exercise for older adults.

Canada's population is aging, with at least 1 in 5 people aged 65 years or older in 2025, and the number of people older than age 85 years is expected to triple in the next 20 years. However, for many people, these added years do not mean healthy years. More than 80% of adults do not meet the recommendations for physical activity from the Canadian Physical Activity Guidelines.

"Physical activity is one of the most important ways to preserve or improve functional independence, including among older adults who are frail or deemed to be at increased risk of falling," writes Dr. Jane Thornton, associate professor at Schulich School of Medicine & Dentistry, Western University, London, Ontario, and director of health, medicine and science at the International Olympic Committee. "Higher levels of physical activity in older age are associated with improvements in cognition, mental health, and quality of life."

A 2023 meta-analysis of several large studies found that 150 minutes of moderate physical activity every week reduced risk of death from all causes by 31%. Physical activity is essential for aging well and can help prevent or reduce disease in more than 30 chronic conditions, such as coronary artery disease, heart failure, type 2 diabetes mellitus, chronic obstructive pulmonary disease, osteoporosis, depression, dementia, and cancer.

Benefits of activity include the following:

  • Protection against risk of death from any cause
  • Falls prevention through increased muscle strength and better balance
  • Bone and joint health, including improved bone density and alleviation of some osteoarthritis symptoms
  • Improved cognitive function, and better mood and mental health
  • Ability to engage in daily activities and improved quality of life

The World Health Organization (WHO) recommends 150–300 minutes weekly of moderate-to-intense physical activity for adults, including older adults.

How can clinicians prescribe physical activity?

"As many older adults live with chronic health conditions or reduced mobility, clinicians should tailor and encourage them to take a gradual approach to increasing their physical activity, which should include resistance training (muscle strengthening) as an essential component," said Dr. Samir Sinha, professor of medicine at the University of Toronto and director of health policy research, National Institute on Ageing.

The WHO 5-step framework — called the "5As" — can provide clinicians with a roadmap to promote activity in their patients. The authors also suggest inputting physical activity in patient records as a vital sign to follow over time.

"Physical activity is underused as a health intervention both in the community and in the delivery of health care for older adults. Age, frailty, or existing functional impairments should not be viewed as absolute contraindications to physical activity but rather key reasons to prescribe it, considering the benefits of physical activity interventions for older adults. Older adults who become more physically active can potentially add years to their lives as well as higher quality of life to those years," the authors conclude.

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