Inactivity Causing Problems for Older Adults

Conor Cunningham, PhD

Cardiovascular mortality, prostate cancer, and dementia are among the diseases and disorders linked to inactivity for geriatric adults.

A team led by Conor Cunningham, PhD, of the Institute of Public Health in Ireland, examined multiple databases for systematic reviews and meta-analyses of longitudinal observational studies on the relationship between physical activity and any physical or mental health outcomes for adults older than 60.

Ultimately, they found 24 systematic reviews and meta-analyses showing physically active older adults are a reduced risk of all-cause and cardiovascular mortality, breast and prostate cancer, fractures, recurrent falls, activities of daily living disability and functional limitation and cognitive decline, dementia, Alzheimer disease, and depression.

Geriatric adults also often experience healthier aging trajectories, better quality of life, and improved cognitive functioning when they are physically active.

"This research highlights the benefits of physical activity to our physical and mental health in older age,” Cunningham said in a statement. “For some time, we have known of the benefits of physical activity for our physical health; however, what is important about this research is that it highlights compelling emerging evidence of the positive effects of being physically active on our mental health--including depression, cognition, and dementia and Alzheimer's disease.”

With the population aging across the globe, estimates on the impact of physical inactivity for the population often fail to specifically focus on geriatric adults.

Along with physical health, mental health is worsening in the aging population.

In a recent study, investigators analyzed approximately 2.5 million patients and found aged 60—69 years old experienced a pattern of decreasing mental health, even when physical and general health remained stable or improved.

The investigators found that trends in decreasing mental health were greater for individuals with lower income or education than those with higher income or education.

General and physical health improved or remained stable for individuals at least 65 years old from 2003—2017. For those aged 65–69 years old, 23% said they were in fair or poor general health in 2003, while 19% said so for 2017.

Last year, investigators from Duke University Medical Center found diet and exercise could slow the development of cognitive impairment in older patients.

The randomized clinical trial, which was called the Exercise and Nutritional Interventions for Cognitive and Cardiovascular Health Enhancement (ENLIGHTEN) study, found aerobic exercise and a healthy diet improved patients’ ability to function and to think, remember, and make decisions.

Patients included in the study were randomized to 1 of 4 interventions groups—interventions included aerobic exercise alone, Dietary Approach to Stop Hypertension (DASH) diet alone, a combination of the DASH diet and aerobic exercise, and a health education control group.

Of the 160 patients included, 40 were randomized to the combination group, 41 to exercise alone, 41 to diet alone, and 38 to the health education group. For inclusion in the study, patients needed to be 55 or older, have subjective memory or cognitive complaints, be sedentary, and have documented cardiovascular disease at least 1 additional cardiovascular disease risk factor.

Upon analysis, investigators found patients in the exercise groups were able to maintain higher levels of executive function at 1-year compared to patients in non-exercise groups (d = .27; P = .041). This association was weaker but still present when compared to DASH groups (d = .20; P = .054). Additionally, patients in the exercise groups achieved greater sustained improvements in the 6-Minute Walk Test compared to those in non-exercise groups.

When examining rates of cardiovascular disease, results revealed patients randomized to DASH groups had lower risk compared to patients not included in DASH groups (P = .32). Furthermore, no differences between participants in exercise groups and non-exercise groups when assessing cardiovascular disease risk (P = .711).

The study, “Consequences of physical inactivity in older adults: A systematic review of reviews and meta‐analyses,” was published online in the Scandinavian Journal of Medicine & Science in Sports.