International Exercise Recommendations in Older Adults (ICFSR)

Expert Consensus Guidelines

Dados Bibliográficos

ID23314673
AutoresMikel Izquierdo (0000-0002-1506-4272, Universidad Pública de Navarra (UPNA), autor correspondente), Reshma Aziz Merchant (0000-0002-9032-0184, National University of Singapore), John E Morley (0000-0003-1104-0393, Saint Louis University), Stefan D Anker (0000-0002-0805-8683, Berlin-Brandenburger Centrum für Regenerative Therapien), Iván Aprahamian (0000-0003-3806-7895, Faculdade de Medicina de Jundiaí), Hidenori Arai (0000-0001-6747-8680, National Center for Geriatrics and Gerontology), Mylène Aubertin‐Leheudre (0000-0002-6796-6710, Université du Québec à Montréal), M Aubertin-Leheudre, Roberto Bernabei (0000-0002-9197-004X, Università Cattolica del Sacro Cuore), Eduardo Lusa Cadore (0000-0003-4397-9485, Universidade Federal do Rio Grande do Sul), Matteo Cesari (0000-0002-0348-3664, University of Milan), L-K Chen, Liang‐Kung Chen (0000-0002-2387-8508, National Yang Ming Chiao Tung University), Philipe De Souto Barreto (0000-0003-0765-9820, Université Toulouse III - Paul Sabatier), Gustavo Duque (0000-0001-8126-0637, The University of Melbourne), Luigi Ferrucci (0000-0002-6273-1613, National Institute on Aging), Roger A Fielding (0000-0003-2236-9020, Tufts University), Antonio García-Hermoso (0000-0002-1397-7182, Universidad Pública de Navarra (UPNA)), Luis Miguel Gutiérrez‐Robledo (0000-0002-9728-6644, Instituto Nacional de Pediatria), L M Gutiérrez-Robledo, Stephen D R Harridge (0000-0002-8203-0769, King's College London), Ben Kirk (0000-0002-0176-776X, The University of Melbourne), Stephen B Kritchevsky (0000-0003-3336-6781, Wake Forest University), S Kritchevsky, Francesco Landi (0000-0002-3472-1389, Università Cattolica del Sacro Cuore), N Lazarus, Norman R Lazarus (0000-0002-3519-5034, King's College London), Finbarr C Martins (0000-0002-6911-3498, King's College London), F C Martin, Emanuele Marzetti (0000-0001-9567-6983, Università Cattolica del Sacro Cuore), M Pahor (University of Florida), Robinson Ramirez‐velez (0000-0003-3075-6960, Universidad Pública de Navarra (UPNA)), R Ramírez-Vélez, Leocadio Rodríguez‐Mañas (0000-0002-6551-1333, Instituto de Salud Carlos III), L Rodriguez-Mañas, Yves Philippe Rolland (0000-0002-1157-0215, Université Toulouse III - Paul Sabatier), Y Rolland, Jorge G Ruiz (0000-0003-3069-8502, University of Miami), Olga Theou (0000-0001-6460-782X, Dalhousie University), Dennis T Villareal (0000-0003-1365-7960, Baylor College of Medicine), Debra L Waters (0000-0001-7982-2370, University of Otago), Chang Won Won (0000-0002-6429-4461, Kyung Hee University), J Woo (0000-0001-7593-3081, Chinese University of Hong Kong), Bruno Vellas (0000-0002-7678-5065), Maria Fiatarone Singh (0000-0002-1897-8707, The University of Sydney)
Ano2021
Volume25
Fascículo7
Páginas824-853
Data de publicação2021-07-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoThe Journal of nutrition, health and aging (JOURNAL)
Identificadores do periódicoISSN: 1279-7707 • E-ISSN: 1760-4788
EditoraElsevier BV (PUBLISHER)
DOI10.1007/s12603-021-1665-8
PMID34409961
OpenAlexW3191864380
IdiomaEN
Citações recebidas74
Referências citadas275

The human ageing process is universal, ubiquitous and inevitable. Every physiological function is being continuously diminished. There is a range between two distinct phenotypes of ageing, shaped by patterns of living - experiences and behaviours, and in particular by the presence or absence of physical activity (PA) and structured exercise (i.e., a sedentary lifestyle). Ageing and a sedentary lifestyle are associated with declines in muscle function and cardiorespiratory fitness, resulting in an impaired capacity to perform daily activities and maintain independent functioning. However, in the presence of adequate exercise/PA these changes in muscular and aerobic capacity with age are substantially attenuated. Additionally, both structured exercise and overall PA play important roles as preventive strategies for many chronic diseases, including cardiovascular disease, stroke, diabetes, osteoporosis, and obesity; improvement of mobility, mental health, and quality of life; and reduction in mortality, among other benefits. Notably, exercise intervention programmes improve the hallmarks of frailty (low body mass, strength, mobility, PA level, energy) and cognition, thus optimising functional capacity during ageing. In these pathological conditions exercise is used as a therapeutic agent and follows the precepts of identifying the cause of a disease and then using an agent in an evidence-based dose to eliminate or moderate the disease. Prescription of PA/structured exercise should therefore be based on the intended outcome (e.g., primary prevention, improvement in fitness or functional status or disease treatment), and individualised, adjusted and controlled like any other medical treatment. In addition, in line with other therapeutic agents, exercise shows a dose-response effect and can be individualised using different modalities, volumes and/or intensities as appropriate to the health state or medical condition. Importantly, exercise therapy is often directed at several physiological systems simultaneously, rather than targeted to a single outcome as is generally the case with pharmacological approaches to disease management. There are diseases for which exercise is an alternative to pharmacological treatment (such as depression), thus contributing to the goal of deprescribing of potentially inappropriate medications (PIMS). There are other conditions where no effective drug therapy is currently available (such as sarcopenia or dementia), where it may serve a primary role in prevention and treatment. Therefore, this consensus statement provides an evidence-based rationale for using exercise and PA for health promotion and disease prevention and treatment in older adults. Exercise prescription is discussed in terms of the specific modalities and doses that have been studied in randomised controlled trials for their effectiveness in attenuating physiological changes of ageing, disease prevention, and/or improvement of older adults with chronic disease and disability. Recommendations are proposed to bridge gaps in the current literature and to optimise the use of exercise/PA both as a preventative medicine and as a therapeutic agent.

Cardiorespiratory fitness · Disease · Exercise prescription · Intervention (counseling) · Physical activity · Physical medicine and rehabilitation · Physical therapy · Psychiatry · Quality of life (healthcare) · Sarcopenia · Sedentary lifestyle · Stroke (engine) · Cardiovascular and exercise physiology · Internal Medicine · Medicine · Nutrition and Health in Aging · Physical Activity and Health · Gerontology