How the relationship between physical activity and health changes with age.

In the context of age-related declines in physical activity (PA) and the dramatic increase in ageing populations in many countries, this paper sheds further light on the link between PA and self-perceived health (SPH) by examining whether the magnitude of this relationship is age specific. With a sample of 14,456 Spanish individuals aged 18-69, we estimated three levels of intensity in PA using the International Physical Activity Questionnaire. Individuals who did more PA per week showed higher levels of SPH (ß = 0.28; 95% CI 0.24-0.32), and age moderated this relationship, with a positive effect over age 49. People aged 50-59 and 60-69 who practiced PA had higher probabilities of better SPH compared with those aged 40-49 (ß = 0.14; 95% CI 0.04-0.24) and (ß = 0.32; 95% CI 0.21-0.43), respectively. This association between PA and SPH also depended on the intensity of PA, especially for walking (ß = 0.14; 95% CI 0.04-0.24). In particular, in comparison with people age 40-49, a statistically significant relationship with SPH was found among people age 50-59 who walked (ß = 0.22; 95% CI 0.07-0.36) and people age 60-69 who did moderate PA (ß = 0.38; 95% CI 0.23-0.54). This paper provides a major rationale for the design, organisation and implementation of public policies promoting PA and healthy ageing for different age groups.

An exercise program with patient's involvement and family support can modify the cognitive and affective trajectory of acutely hospitalized older medical patients: a pilot study.

BACKGROUND: Most hospitalized older adults have reduced functional and physiological reserves, rendering them more vulnerable to the effects of a series of circumstances beyond the existence of health conditions unrelated to the reason for the hospitalization, usually worsening the hospitalization outcome. Despite the theoretical support for the idea that mobility improvement in the hospitalized patient carries multiple benefits, this idea has not been fully translated into clinical practice. AIMS: Our objective was to assess if an exercise intervention involving patients and families could modify the cognitive and affective progression of hospitalized older patients, from admission to discharge and 30 days after discharge. METHODS: This was a prospective intervention study with blinded outcome progression. Patients were recruited over a 3-month period and prospectively followed up. The intervention consisted in a supervised individualized graduated exercise program and education of ward and team staff, patients and caregivers to actively encourage mobility and functional independence. RESULTS: A total of 29 patients were recruited. Mean age was 86.1 (SD 4.92), and 18 (62 %) were women. At discharge, we found a significant improvement in Mini-mental State Examination (p = 0.008), Trail making Test-A (p = 0.03), and verbal fluency (p = 0.019). One month after discharge, Geriatric Depression Scale-Yesavage and Delirium Rating Scale-revised-98 remained statistically different. CONCLUSIONS: This pilot study shows that an exercise program is feasible, and can be suitable to prevent cognitive and affective decline during acute hospitalization of older adults. It is a challenge for the new models of hospitalization to change the actual disease-centered view to the patient-centered view, optimizing traditionally neglected aspects such as functional, cognitive and affective recovery after hospitalization.