Final - Exercise and Aging

Question 1

What is aging?

Answer 1

• a process or group of processes occurring in living organisms that with the passage of time, lead to a loss of adaptability, functional impairment, and eventually, death
• difficulty is teasing out the effect of primary aging from concurrent disease, physical inactivity and other environmental factors

Question 2

who is an “older” adult?

Answer 2

someone >65 years old or someone 50-64 with clinically significant conditions or physical limitations that affect movement, physical fitness or physical activity

Question 3

physically elite older adults

Answer 3

• sports competition
• senior olympics
• high risk and power sports

Question 4

physically fit older adults

Answer 4

• moderate physical work
• all endurance sports and games
• most hobbies

Question 5

physically independent older adults

Answer 5

• very light physical work
• hobbies
• low physical demand activities
• can pass all IADL

Question 6

Physically frail

Answer 6

• light housekeeping
• food preparation
• grocery shopping
• can pass some IADLs and all basic ADLs

Question 7

physically dependent older adults

Answer 7

• cannot pass some or all basic ADLs

- needs home or institutional care

Question 8

definition of physically frail

Answer 8

severe impairments in strength, mobility, balance and endurance due to muscles that are weka and highly fatiguable

Question 9

neuromuscular variables associated with aging:

Answer 9

1. decrease in number and size of motor neurons
2. decrease in conduction velocity and maximum frequency
3. increase in the excitability threshold of muscle
4. decreased proprioception and vestibular functions

Question 10

result of aging changes:

Answer 10

1. slower reaction times
2. control of movement is less precise
3. balance abnormalities
4. increased risk of falling

Question 11

sarcopenia

Answer 11

loss of muscle mass with aging

contributes important to decreases in muscular strength with aging

Question 12

strength loss can lead to ….

Answer 12

limited mobility and increased risk of falling

Question 13

Muscle mass decreases with aging

Answer 13

• decrease in total number of muscle fibers –> denervation leads to degeneration of muscle fibers
• contractile protein content dependent on activity status

Question 14

When does number of muscle fibers begin to change?

Answer 14

age 50

Question 15

Does strength or muscle mass decrease at a faster rate?

Answer 15

strength

Question 16

what does the decreased cross bridge kinetics cause?

Answer 16

Slowed contractile velocity and thus isokinetic force (dynamic strength)

Question 17

What occurs to muscle mass and strength if activity is low?

Answer 17

reduction in muscle contractile protein (atrophy) may also contribute to decreased muscle mass strength

Question 18

What can blunt “normal” loss of muscle mass and strength with aging?

Answer 18

• resistance training

- cannot completely prevent it but increases strength due to neural adaptation and increases in muscle mass

Question 19

Can training effect be seen in the elderly (>75)?

Answer 19

Yes

Substantial gains can be seen with frail elderly

Question 20

Positive Effects of Resistance Training in Older Adults

Answer 20

• Maintenance or increase in muscular strength, endurance, flexibility
• Maintain or regain mobility (strength for ADLs)
• Decrease falling risk

Question 21

General Resistance Training Recommendations for Healthy Older Adults

Answer 21

• 2-3 sessions/week (48hr rest between)
• between moderate and vigorous intensity (5-8 RPE, 40-50% 1RM then progress to 60-80%)
• 8-10 exercises, 1 or more sets or 10-15 reps

Question 22

Recommendations for Older, Frail Population

Answer 22

• Train major muscle groups of upper and lower extremities in trunk
• Initial intensity light (30-40% 1RM for 10-20 reps, or as tolerated)
• 2-3 days/week with 2-3 sets
• incorporate balance training
• high degree of supervision and training

Question 23

What happens to VO2 max with age?

Answer 23

Declines

• move it or lose it
• rate of decline in VO2max in endurance trained individuals is determined largely by the corresponding reduction in overall habitual activity

Question 24

Summary of Functional Capacity and Aging

Answer 24

• Reductions in physical function after 60 in part due to declining intrinsic physiologic task capacity
• Large muscle performance relatively well-maintained until 60-70 on average (co-morbidities accelerate functional capacity loss)

Question 25

What causes much of the age-related reductions in large-muscle endurance performance?

Answer 25

reductions in VO2max

Question 26

What is an important factor in maintaining general health and QOL as we age?

Answer 26

exercise

Question 27

CV and respiratory alterations with aging

Answer 27

1. increased resting and exercise BP 2. lower maximal CO, HR, and VO2max 3. higher residual capacity, lower vital capacity, and lower max Ve response

Question 28

At a submax ABSOLUTE exercise intensity, older adults have:

Answer 28

1. somewhat lower CO, due to SV 2. Same VO2 (assuming same economy) and HR 3. a widening of a-v O2 difference 4. higher BP 5. higher TPR

Question 29

CV adaptations to training with aging

Answer 29

- increase in max SV (ONLY IN MEN) - Adaptations at the muscle include increased oxygen extraction (explains increase in VO2max in women) and increased capillary density and oxidative capacity - reduction in rest HR and BP

Question 30

Why does aging increase the work of breathing?

Answer 30

- Due to increased airflow resistance and chest wall stiffness - Work of breathing ma increase to 15% of VO2max

Question 31

What occurs to alveoli with aging?

Answer 31

- loss of alveoli and increased size of alveoli - promotes decrease in forced vital capacity with increased residual volume - Air trapping - Emphysemic change

Question 32

What occurs to maximal ventilatory capacity with aging?

Answer 32

decreases

Question 33

What occurs to Ve/VO2 ratio in older persons

Answer 33

- increases | - older adults rely more on increasing breathing frequency during exercise, as tidal volume is reduced

Question 34

Relative intensity for aerobic exercise for older adults

Answer 34

Moderate 5-6 | Vigorous 7-8

Question 35

Prescribing Exercise for Healthy Older Adults

Answer 35

Intensity: 5-6 (40-60%) for mod, 7-8 (60-89%) vigorous Frequency: min 5 d/week moderate, 3 d/week vigorous Time: mod 150-300 min, vig 75-100 min Type: may need to substitute non WB'ing exercise Progression: relatively slowly; emphasizing increased duration rather than intensity

Question 36

Why does the ability to maintain high levels of training decrease with aging?

Answer 36

decreases in motivation, time, injury, "intrinsic" drive to exercise

Question 37

Submaximal Response to dynamic exercise in aging

Answer 37

aging individuals respond similarly to submax exercise when matched for relative exercise intensity (% of VO2max)