ARE WE SENIOR CITIZENS REALLY ACTIVE

No, a significant portion of senior citizens is not active enough, with
inactivity increasing with age and leading to poor health outcomes. While
the need for activity increases with age to maintain physical and mental
health, many older adults do not meet recommended levels of exercise,
including strength, balance, endurance, and flexibility, due to factors
like decreased energy, fear of injury, and lack of support. However, it is
never too late to start, and many seniors can and do stay active by
engaging in various physical and mental activities.

 Why are many senior citizens inactive?

Age-related changes: A natural slowdown of the body and mind occurs with
age.

Decreased energy levels: As people age, they often have less energy, making
it harder to move.

Health conditions: Poor health and chronic diseases can limit activity.

Psychosocial factors: Lack of social support, loneliness, and fear of
injury can contribute to inactivity.

Lifestyle changes: People who retire from work are more likely to decrease
their physical activity levels.

The importance of an active lifestyle

Physical benefits:

An active lifestyle strengthens the body, improves balance, increases
flexibility, and helps prevent chronic diseases.

Mental benefits:

Staying active keeps the mind sharp, improves mood, enhances
decision-making abilities, and can boost self-image.

Independence:

Regular physical activity helps maintain independence and can lead to a
longer life.

How to stay active

Incorporate various types of exercise: Aim for a mix of endurance (walking,
swimming), strength training, balance exercises, and flexibility work.

Start slowly: Begin with a comfortable level of activity and gradually
increase intensity as you feel able.

Find enjoyable activities: Engage in activities you like to increase
motivation to stick with them.

Stay mentally active: Challenge your mind with puzzles, reading, or memory
games.

Attend social events: Participate in communal events, group activities, and
social clubs.

Get medical advice: Consult your doctor to discuss appropriate exercises
given your health condition.

2       As populations continue to extend life expectancy, a central
concern is whether the added time comprises years of healthy life and
promotes a high health-related quality of life into old age. PA is defined
as any bodily movement produced by skeletal muscles that result in energy
expenditure. PA encompasses exercise, sports, and physical activities
performed as part of daily living, occupation, leisure, or active
transportation. Exercise is a subcategory of PA that is planned,
structured, and repetitive and that has as a final or intermediate
objective for improvement or maintenance of physical fitness. Physical
function is the capacity of an individual to perform the physical
activities of daily living. Physical function reflects motor function and
control, physical fitness, and habitual PA .



PA is a protective factor for noncommunicable diseases such as
cardiovascular disease, stroke, diabetes, and some types of cancer and PA
is associated with improved mental health , delay in the onset of dementia
, and improved quality of life and wellbeing . The health benefits of PA
are well documented with higher levels and greater frequency of PA being
associated with reduced risk and improved health in a number of key areas

The dose of PA or exercise is described by the duration, frequency,
intensity, and mode . For optimal effects, the older person must adhere to
the prescribed exercise program and follow the overload principle of
training, i.e., to exercise near the limit of the maximum capacity to
challenge the body systems sufficiently, to induce improvements in
physiological parameters such as VO2max and muscular strength .

Improvements in mental health, emotional, psychological, and social
well-being and cognitive function are also associated with regular PA.
Despite these health benefits, PA levels amongst older adults remain below
the recommended 150 min/week. The crude global prevalence of physical
inactivity is 21.4% . This translates to one in every four to five adults
being physically inactive, or with activity levels lower than the current
recommendations from WHO. Inactivity and aging increase the risk of chronic
disease, and older people often have multiple chronic conditions . The
exercise recommendations from WHO include both aerobic exercise and
strength exercise as well as balance exercises to reduce the risk of falls.
If older adults cannot follow the guidelines because of chronic conditions,
they should be as active as their ability and conditions allow . It is
important to note that the recommended amount of PA is in addition to
routine activities of daily living like self-care, cooking, and shopping,
to mention a few.

Inactivity is associated with alterations in body composition resulting in
an increase in percentage of body fat and a concomitant decline in lean
body mass. Thus, significant loss in maximal force production takes place
with inactivity. Skeletal muscle atrophy is often considered a hallmark of
aging and physical inactivity. Sarcopenia is defined as low muscle mass in
combination with low muscle strength and/or low physical performance.
Consequently, low physical performance and dependence in activities of
daily living is more common among older people . However, strength training
has been shown to increase lean body mass , improve physical performance ,
and to a lesser extent have a positive effect on self-reported activities
of daily living . These aspects are at focus in the papers of K.
Kropielnicka et al. “Influence of the Physical Training on Muscle Function
and Walking Distance in Symptomatic Peripheral Arterial Disease in Elderly”
as well as G. Piastra et al. “Effects of Two Types of 9-Month Adapted
Physical Activity Program on Muscle Mass, Muscle Strength, and Balance in
Moderate Sarcopenic Older Women.”

Participation in PA and exercise can contribute to maintaining quality of
life, health, and physical function and reducing falls  among older people
in general and older people with morbidities in particular. The increased
attention to the relationship between exercise and HRQOL in older adults
over the last decade is reflected in a recent review, which showed that a
moderate PA level combining multitasking exercise components had a positive
effect on activities in daily living, highlighting the importance of
physical, mental, and social demands . To reduce falls, balance training is
also recommended to be included in physical exercise programs for older
adults . Exercise has also been shown to reduce falls with 21%, with a
greater effect of exercise programs including challenging balance
activities for more than 3 hours/week .

The gender perspective and motivators for fall prevention are at focus in
M. Sandlund et al. qualitative study “Gender Perspective on Older People's
Exercise Preferences and Motivators in the Context of Falls Prevention: A
Qualitative Study,” in this special issue.

Exercise training in older people has been associated with health benefits
such as decreased cardiovascular mortality . Explanatory mechanism likely
to be involved following exercise was a change in the cardiac autonomic
balance producing an increase, or a relative dominance, of the vagal
component . Furthermore, endurance exercise training in older people
decreases resting and submaximal exercise heart rate and systolic and
diastolic blood pressure and increases stroke volume . This is especially
notable during peak effort in which stroke volume, cardiac output,
contractility, and oxygen uptake are increased, while total peripheral
resistance and systolic and diastolic blood pressure decreased. Thus
lowering after-load in the heart muscle, which in turn facilitates left
ventricular systolic and diastolic function, emphasizes the importance of
high intensity training also for the elderly. E. Tamuleviciute-Prasciene et
al. focus on the frail elderly individuals and exercise in their
contribution “Frailty and Exercise Training: How to Provide Best Care after
Cardiac Surgery or Intervention for Elder Patients with Valvular Heart
Disease.”

Exercise may also have benefits for the brain centers that support
executive control. It may be that strong executive functioning in itself
may facilitate consistency for this challenging activity. Poor executive
control has been associated with lower self-reported PA rates over a 2-year
period . The executive control's contribution to PA has been found to be
50% greater in magnitude than the contribution of PA to subsequent changes
in executive control. In the paper of M. A. McCaskey et al. “Making More of
T: Enabling Intensive Motor Cognitive Rehabilitation Exercises in
Geriatrics sing INFORMATION Technology Solutions,” the authors also include
new technology to enhance and maintain exercise in cognitive rehabilitation.

In order to attain a high level of cardiorespiratory fitness, it is
recommended to be physically active for 6 months or longer. These
recommendations may also be applied to balance exercises in order to reduce
falls . Many elderly individuals are incapable of sustaining activities for
this long on their own. Successful maintenance of PA typically requires
substantial support and supervision. Even then, a high percentage of people
drop out due to difficulties negotiating everyday costs of activity
participation like scheduling conflicts and competing sedentary activities
or health issues. This issue is highlighted in the study of T. Adachi et
al. “Predicting the Future Need of Walking Device or Assistance by Moderate
to Vigorous Physical Activity: A 2-Year Prospective Study of Women Aged 75
Years and Above.”

In addition, reduced bodily functions can make it difficult for elderly
persons to maintain exercise under different environmental circumstances,
which is demonstrated in the contribution of B. N. Balmain et al. “Aging
and Thermoregulatory Control: The Clinical Implications of Exercising under
Heat Stress in Older Individuals.”

In this special issue, we have included papers that focus on the aging
process and PA in a broad perspective, focusing on different aspects on PA,
exercise, and older people. PA and exercise play an important role in the
primary, secondary, and tertiary prevention, in the management of diseases,
to counteract sarcopenia and falls as well as improving physical
performance and activities of daily living, as these papers illustrate.

Promoting exercise among the older population is an important public health
and clinical issue. A core issue is how to get older people with
comorbidities to exercise. [NATIONAL RESEACH PAPER EXTRACTED AND HENCE
AUTHENTIC]                  k Rajaram IRS 2925

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