Physical activity and behavior in the elderly: a pilot study. Can practice nurses increase physical activity in the over 65s? Methodological considerations from a pilot study. Physical Activity and the Risk of Dementia in Oldest Old Volume and intensity of physical activity in a large population-based cohort of middle-aged and older Australians: prospective relationships with weight gain, and physical function. Is physical activity counseling effective for older people? A cluster randomized, controlled trial in primary care. Exercise: effects on physical functional performance in independent older adults. Can physical activity attenuate aging-related weight loss in older people? The Yale Health and Aging Study, 1982-1994. Pilot randomized controlled trial: elastic-resistance-training and lifestyle-activity intervention for sedentary older adults. Physical activity in middle-aged adults reduces risks of functional impairment independent of its effect on weight. Weight loss, exercise, or both and physical function in obese older adults. Social-cognitive and perceived environment influences associated with physical activity in older Australians. Physical activity and mental well-being in older people participating in the Better Ageing Project Association between leisure time physical activity and 10-year body mass change among working-aged men and women Physical activity in prefrail older adults: confidence and satisfaction related to physical function. Exercise attenuates the weight-loss-induced reduction in muscle mass in frail obese older adults. Predictors of weight gain in the Pound of Prevention study Self-monitoring of spontaneous physical activity and sedentary behavior to prevent weight regain in older adults
Although exercise is usually promoted for weight loss and better heart health , there is growing evidence that regular physical activity helps people preserve their mental ability . We describe the results of a pilot longitudinal study addressing the impact of a moderate intensity exercise program on behavioral problems  of frail , elderly , demented patients living in nursing home . Overall , patients in the treatment group ( combination of aerobic/endurance activities , strength training , balance , and flexibility training ) showed a statistically significant reduction in the behavioral problems , such as w and ering , physical and verbal abuse , and in the sleep disorders . As a consequence , a significant reduction in the use of antipsychotic and hypnotic medications was observed in subjects of the treated group . In conclusion , our preliminary results suggest that engaging in regular physical activity , among other health benefits , may delay or prevent the onset of behavior problems in demented frail elderly people living in nursing home There is ample evidence of the benefits of exercise for older people . Less is known about the most effective strategies for promoting the participation of older people in exercise regimes . An approach whereby practice nurses  used motivational interviewing , based on Prochaska and Di Clemente 's model of behaviour change , was piloted in two general practice s. The strategy appeared feasible and will be tested further in a large controlled trial Objective : This study evaluated the protective role of physical activity ( PA ) against  cognitive impairment ( CI ) in the oldest old ( age ≥ 85 ) . Method : Prospect i ve data on 66 optimally healthy , oldest old adults ( mean age 88.5 ) were analyzed using survival analysis . Results : In all , 12 men and 11 women reported exercising > 4 hours per week , and 38 participants developed CI ( mean onset age 93 ; mean follow-up 4.7 years ) . The effect of exercise was modified by gender . In more active women ( > 4 hours/week ) , the risk of CI was reduced by 88 % ( 95 % confidence interval 0.03 , 0.41 ) compared to those less active . Less active women had 2 times the incidence rate of CI compared to less active men and almost 5 times the rate compared to active women . Discussion : This study demonstrates the beneficial effects of exercise  on healthy brain aging even in the oldest old and emphasizes the importance of increasing PA in older women OBJECTIVES To examine prospect ively whether higher proportions of vigorous physical activity ( VPA ) , independent of total activity volume , are associated with better outcomes in weight maintenance and physical function . METHODS We used three-year longitudinal data ( 2006/07 - 2009/10 ) of adults 45 and older ( n=32,087 ; 59.5±9.3years ) from New South Wales , Australia . Logistic regression models examined odds of weight gain and functional decline by volume and intensity of physical activity . RESULTS On average , body weight increased by 0.66 kg ( SD=5.83 , p<0.001 ) ; a vali date d physical function score ( MOS-PF ) decreased by 4.79 ( SD=12.56 , p<0.001 ) . There was a 10 % reduction in the odds of weight gain for participants who reported 300min/week or more of moderate to vigorous physical activity ( MVPA ) compared to less than 150min of MVPA . The proportion of MVPA that was vigorous was not associated with weight change . With the physical functioning outcome , there were independent protective effects from volume and intensity of physical activity . Independent of total MVPA , each 1 % increase in the proportion of total activity that was vigorous was associated with a 0.3 % decrease in the odds of decline in physical function . CONCLUSION These prospect i ve findings indicate that VPA per se plays an important role in the prevention of functional decline OBJECTIVES To establish the effectiveness of the Green Prescription physical activity counseling program in increasing activity and quality of life in older community-dwelling people . DESIGN Post hoc subgroup analysis of a large cluster r and omized , controlled trial . SETTING One hundred seventeen doctors in 42 primary care practice s ( 74 % participation rate ) in the Waikato region of New Zeal and . PARTICIPANTS Two hundred seventy sedentary primary healthcare patients aged 65 and older ( 67 % participation rate ) . INTERVENTION Patients in intervention practice s prompted their primary care doctors or practice nurse to deliver brief activity counseling . A " Green Prescription " was written involving the negotiation of activity goals . Trained exercise specialists from a regional sports foundation gave follow-up telephone support over 3 months . MEASUREMENTS Leisure moderate and vigorous physical activity , total energy expenditure , systolic and diastolic blood pressure , health-related quality of life , musculoskeletal injuries , falls , and hospitalizations . RESULTS After 12 months of follow-up , leisure time moderate activity increased by 0.67 h/wk more in the intervention group than the control group ( 95 % confidence interval (CI)=0.17 - 1.17 ) and energy expenditure increased by 2.67 kcal/kg per week ( 95 % CI=0.87 - 4.47 ) more . For intervention group participants , vitality and general health scales of the 36-item Short Form showed statistically and clinical ly relevant improvements , and there was a decrease in hospitalizations ( P<.03 ) . There were no observable changes in blood pressure , injuries , or falls as a result of the Green Prescription program . CONCLUSION This physical activity intervention improved activity , energy expenditure , health-related quality of life , and hospitalizations for older primary care patients . Systematic inclusion of the Green Prescription in routine primary health care will probably lead to health gain for older people BACKGROUND Age-related loss in physiologic capacities contributes to the decline in physical function in the elderly population . Despite the beneficial effects of exercise interventions on maximal physiologic capacity measures , the functional benefits have not been shown in independently living older adults . The objective of this study was to evaluate exercise in independent older adults for significant and meaningful improvements in physical function , not detected by commonly used measures of physical function . METHODS In a r and omized controlled study , 49 independently living men and women were assigned to either a nonexercise control group ( Control ; n = 26 ) or an exercise training group ( Exercise ; n = 23 ) . Participants ( age = 76+/-4 ) in good general health were recruited from retirement communities or apartments . The combined endurance and strength training was performed at 75 % to 80 % intensity ; the groups met 3 times/week for 6 months of supervised sessions . Outcome measures included physical capacity , health status , and physical function using a newly developed performance test -- the Continuous Scale-Physical Functional Performance test ( CS-PFP ) . RESULTS Compared to the Control group , the Exercise group showed significant increases in maximal oxygen consumption ( 11 % ) and muscle strength ( 33 % ) . No significant differences were found between groups for changes in the Sickness Impact Profile , SF-36 scales , or the 6-minute walk . However , the CS-PFP score improved significantly in the Exercise group ( 14 % , effect size 0.80 ) . CONCLUSIONS Independent older adults gain meaningful functional benefits from several months of exercise training . The public health importance of physical activity may relate not just to its role in preventing decline , but also to its role in enhancing physical function The purpose of this analysis was to determine the longitudinal relation between physical activity and the trajectory of weight change in an older cohort ( > or = 65 years ) living in New Haven , Connecticut , who participated in the Established Population s for the Epidemiologic Study of the Elderly between 1982 and 1994 ( n=2,812 ) . The authors hypothesized that body weight would decline over the follow-up and that physical activity would play an important role in minimizing weight loss over time . Physical activity and other covariables were self-reported at baseline , while body weight was self-reported annually over 12 years . Multivariable r and om effects regression demonstrated a curvilinear trajectory of weight loss per year with an accelerated loss at older ages . Baseline body weight was 155 ( st and ard deviation , 30 ) pounds ( 70 ( st and ard deviation , 14 ) kg ) for those who survived the entire follow-up and was 153 ( st and ard deviation , 32 ) pounds ( 70 ( st and ard deviation , 15 ) kg ) for those who did not . Each 1-unit increase in baseline total activity score minimized this aging-related weight loss , but this relation was most pronounced among those with chronic disease who did not survive the entire follow-up period ( n=973 ; 0.15 pounds ( 0.07 kg ) per year ) . These data suggest that , among frail older people , even modest levels of physical activity can attenuate the rate of aging- and disease-related weight loss The aim of this study was to determine the efficacy and feasibility of a resistance-training ( RT ) and lifestyle-activity program for sedentary older adults . Eligible participants ( N = 44 ) were r and omized to an 8-wk intervention or a control group . The primary outcome was lower body muscle strength , and participants completed a range of secondary outcomes . There was a significant group-by-time interaction for lower body muscle strength ( difference = 3.9 repetitions [ reps ] , 95 % CI = 2.0 - 5.8 reps ; p < .001 ; d = 1.0 ) . Changes in secondary outcomes were generally small and not statistically significant . Attendance and program satisfaction were both high . A combined elastic-tubing RT and lifestyle-activity program delivered in the community setting is an efficacious and feasible approach to improve health in sedentary older adults OBJECTIVES To assess the association between physical activity and subsequent physical functioning in middle-aged adults across a range of body mass index ( BMI ) categories . DESIGN Prospect i ve nationally representative cohort studies . SETTING The United States and Engl and . PARTICIPANTS Eight thous and seven hundred two individuals in the United States and 1,507 in Engl and aged 50 to 69 and free of impairment at baseline , followed up for 6 years . MEASUREMENTS Self-reported and measured BMI and self-reported level of physical activity .  Outcome measures were score on a physical performance battery and self-reported mobility impairment . RESULTS In both studies , being overweight and being obese were associated with greater risk of impairment ( than being of recommended weight ) . In all weight categories and both countries , higher levels of physical activity were associated with lower risks of mobility impairment . For example , U.S. respondents of recommended weight ( BMI 20 - 25 ) who were active on 3 or more days per week had a relative risk ( RR ) of incident mobility difficulties , compared with those who were less active , of 0.56 ( 95 % confidence interval (CI)=0.40 - 0.78 ) ; for those who were obese ( BMI > /=30 ) the corresponding RR was 0.59 ( 95 % CI=0.45 - 0.76 ) . CONCLUSION Excess bodyweight is a risk factor for impaired physical function  in middle-aged and older people .  Physical activity is protective of impaired physical functioning in this age group in subjects with recommended weight , overweight , and obesity . Older adults should be encouraged to engage in appropriate levels of physical activity irrespective of their weight BACKGROUND Obesity exacerbates the age-related decline in physical function and causes frailty in older adults ; however , the appropriate treatment for obese older adults is controversial . METHODS In this 1-year , r and omized , controlled trial , we evaluated the independent and combined effects of weight loss and exercise in 107 adults who were 65 years of age or older and obese . Participants were r and omly assigned to a control group , a weight-management ( diet ) group , an exercise group , or a weight-management-plus-exercise ( diet-exercise ) group . The primary outcome was the change in score on the modified Physical Performance Test . Secondary outcomes included other measures of frailty , body composition , bone mineral density , specific physical functions , and quality of life . RESULTS A total of 93 participants ( 87 % ) completed the study . In the intention-to-treat analysis , the score on the Physical Performance Test , in which higher scores indicate better physical status , increased more in the diet-exercise group than in the diet group or the exercise group ( increases from baseline of 21 % vs. 12 % and 15 % , respectively ) ; the scores in all three of those groups increased more than the scores in the control group ( in which the score increased by 1 % ) ( P<0.001 for the between-group differences ) . Moreover , the peak oxygen consumption improved more in the diet-exercise group than in the diet group or the exercise group ( increases of 17 % vs. 10 % and 8 % , respectively ; P<0.001 ) ; the score on the Functional Status Question naire , in which higher scores indicate better physical function , increased more in the diet-exercise group than in the diet group ( increase of 10 % vs. 4 % , P<0.001 ) . Body weight decreased by 10 % in the diet group and by 9 % in the diet-exercise group , but did not decrease in the exercise group or the control group ( P<0.001 ) . Lean body mass and bone mineral density at the hip decreased less in the diet-exercise group than in the diet group ( reductions of 3 % and 1 % , respectively , in the diet-exercise group vs. reductions of 5 % and 3 % , respectively , in the diet group ; P<0.05 for both comparisons ) . Strength , balance , and gait improved consistently in the diet-exercise group ( P<0.05 for all comparisons ) . Adverse events included a small number of exercise-associated musculoskeletal injuries . CONCLUSIONS These findings suggest that a combination of weight loss and exercise provides greater improvement in physical function than either intervention alone . ( Funded by the National Institutes of Health ; Clinical Trials.gov number , NCT00146107 . ) BACKGROUND Regular physical activity in older adults can facilitate healthy aging , improve functional capacity , and prevent disease . However , factors associated with physical inactivity in older population s are poorly understood . This study attempts to identify social-cognitive and perceived environmental influences associated with physical activity participation in older population s. METHODS In a r and omly selected sample of 449 Australian adults age 60 and older , we assessed self-reported physical activity and a range of social-cognitive and perceived environmental factors . Respondents were classified as sufficiently active and inactive based on energy expenditure estimates ( kcal/week ) derived from self-reported physical activity . Two logistic regression models , with and without self-efficacy included , were conducted to identify modifiable independent predictors of physical activity . RESULTS Significantly more males than females were physically active . Physical activity participation was related to age with a greater proportion of those age 65 - 69 being active than those age 60 - 64 or 70 or older .  High self-efficacy , regular participation of friends and family , finding footpaths safe for walking , and access to local facilities were significantly associated with being active . CONCLUSION Identifying predictors of physical activity in older population s , particularly social support , facility access , and neighbourhood safety , can inform the development of policy and intervention strategies to promote the health of older people Increasing evidence suggests that physical activity can prevent some aspects of mental illness in older people such as depression , dementia and Alzheimer ’s disease . Additionally , limited research has shown that engagement in structured exercise can improve aspects of psychological well-being such as mood and self-perceptions in older adults . However , the relationship between incidental daily activity such as walking or time spent sedentary , with psychological well-being has not been investigated . The Better Ageing Project provided an opportunity to assess well-being and quality of life using st and ardised question naires with 176 adults aged 70 and over .  Accelerometry was used to objective ly assess daily energy expended in physical activity at different levels of intensity . In addition , an assessment of the impact of the 12-month Better Ageing structured group exercise programme was assessed through question naires and interviews . Total daily physical activity energy expenditure ( joules/day ) and amount of time spent in activity of at least moderate intensity were weakly related ( r = 0.20–0.28 ) to quality of life , subjective well-being and physical self-perceptions . Time spent sedentary ( min/day ) was weakly and negatively related to several mental health indicators . The quantitative data showed only minor psychological benefits of the exercise intervention . In contrast , interviews with 27 research participants and 4 exercise leaders suggested that important improvements in perceived function and social benefits had been experienced OBJECTIVE : To determine whether habitual leisure time physical activity and body mass change of working-aged men and women are associated . DESIGN : Prospect i ve 10 y follow-up study . SUBJECTS : A regionally representative cohort of 19–63 y old men ( n=2564 ) and women ( n=2695 ) in three municipalities in Finl and . MEASUREMENTS : The main outcome measures were average body mass change during the 10 y of follow-up and the clinical ly significant body mass gain defined as a body mass gain of 5 kg or more during the follow-up and a body mass index of 26 or higher at the end of the follow-up .  Leisure time physical activity  was determined from self-administered question naires . RESULTS : After adjustment for the potential confounders , the logistic regression analysis showed that the men and women with no regular weekly activity at the end of the follow-up had an odds ratio of 2.59 ( 95 % confidence interval , 1.69–3.97 ) and 2.67 ( 1.65–4.31 ) , respectively for clinical ly significant body mass gain in comparison with the most active groups . The men who had decreased their activity during the 10 y follow-up had an odds ratio of 1.96 ( 1.39–2.75 ) , and the men who were physically inactive all the time had an odds ratio of 1.62 ( 1.18–2.20 ) for clinical ly significant body mass gain when compared with the subjects who were active all the time . Among the women the odds ratios for clinical ly significant body mass gain after adjustment for potential confounders were 2.49 ( 1.72–3.60 ) and 1.61 ( 1.17–2.21 ) , respectively . CONCLUSION : These findings are consistent with the hypothesis that regular physical activity prevents body mass gain and physical inactivity is a risk factor for body mass gain and obesity among adults We examined the hypothesis that physical activity will have favorable effects on measures of self-efficacy for a 400-m walk and satisfaction with physical functioning in older adults 70 + years of age who have deficits in mobility . We r and omized a total of 412 adults aged 70 - 89 years at elevated risk for mobility disability to either a physical activity or a successful aging educational control intervention for 12 months . Participants in the physical activity intervention had more favorable changes in both outcomes as a result of treatment than those in the successful aging intervention . Gender , age , and scores on a short physical performance battery did not moderate these effects . Physical activity is an effective means of intervening on self-efficacy and satisfaction with physical function in older adults with impaired lower extremity functioning . This is an important finding in light of the importance of these process variables in behavior change and quality of life PURPOSE To evaluate the effect of adding exercise to a hypocaloric diet on changes in appendicular lean mass and strength in frail obese older adults undergoing voluntary weight loss . METHODS Thirty frail older ( age , 70 + /- 5 yr ) obese ( body mass index , 37 + /- 5 kg.m ) adults were r and omly assigned to 6 months of diet/behavioral therapy ( diet group , n = 15 ) or diet or behavioral therapy plus exercise that incorporated progressive resistance training ( PRT ; diet + exercise group ; n = 15 ) . Body composition was assessed using dual-energy x-ray absorptiometry , and muscle strength was assessed using one-repetition maximum . The volume of upper extremity ( UE ) and lower extremity ( LE ) exercise training was determined by multiplying the average number of repetitions performed by the average weight lifted during the first three exercise sessions and during the last three exercise sessions of the study . RESULTS The diet and the diet + exercise groups had similar ( P > 0.05 ) decreases in weight ( 10.7 + /- 4.5 vs 9.7 + /- 4.0 kg ) and fat mass ( 6.8 + /- 3.7 vs 7.7 + /- 2.9 kg ) . However , the diet + exercise group lost less fat-free mass ( FFM ; 1.8 + /- 1.5 vs 3.5 + /- 2.1 kg ) , LE lean mass ( 0.9 + /- 0.8 vs 2.0 + /- 0.9 kg ) , and UE lean mass ( 0.1 + /- 0.2 vs 0.2 + /- 0.2 kg ) than the diet group ( P < 0.05 ) . The diet + exercise group had greater increases in percent of weight as FFM ( FFM / weight x 100 ) than the diet group ( 7.9 + /- 3.3 vs 5.4 + /- 3.7 % ; P < 0.05 ) . Despite lean mass losses , the diet + exercise group increased UE and LE strength in response to exercise ( 17 - 43 % ) , whereas the diet group maintained strength . The volume of UE and LE exercises correlated with the amount of UE and LE lean mass ( r = 0.64 - 0.84 ; P < 0.05 ) . CONCLUSION Exercise added to diet reduces muscle mass loss during voluntary weight loss and increases muscle strength in frail obese older adults . Regular exercise that incorporates PRT should be used to attenuate muscle mass loss in frail obese older adults on weight-loss therapy OBJECTIVES : This study examined cross-sectional and prospect i ve relationships between macronutrient intake , behaviors intended to limit fat intake , physical activity and body weight . DESIGN : The overall goal was to identify diet and exercise behaviors that predict and /or accompany weight gain or loss over time . Specific questions addressed included : ( a ) are habitual levels of diet or exercise predictive of weight change ; ( b ) are habitual diet and exercise levels associated cross-sectionally with body weight ; and ( c ) are changes in diet and exercise associated with changes in body weight over time ? PARTICIPANTS : Subjects were a sample of community volunteers ( n=826 women , n=218 men ) taking part in a weight gain prevention project over a 3-year period . MEASURES : Body weight was measured at baseline and annually over the study period . Self-report measures of diet and exercise behavior  were also measured annually . RESULTS : Among both men and women , the most consistent results were the positive association between dietary fat intake and weight gain and an inverse association between frequency of physical activity and weight gain . Individuals who weighed more both ate more and exercised less than those who weighed less . Individuals who increased their physical activity level and decreased their food intake over time were protected from weight gain compared to those who did not . Frequency of high-intensity physical activity was particularly important for both men and women . Additionally , women who consistently engaged in higher levels of moderate physical activity gained weight at a slower rate compared to women who were less active . CONCLUSIONS : Overall results indicated that both cross-sectionally and prospect ively , the determinants of weight and weight change are multifactorial . Attention to exercise , fat intake and total energy intake all appear important for successful long term control of body weight Objective This study determined whether adding a self-regulatory intervention ( SRI ) focused on self-monitoring of spontaneous physical activity and sedentary behavior to a st and ard weight loss intervention improved maintenance of lost weight . Design and Methods Older ( 65–79 yrs ) , obese ( BMI = 30–40 kg/m2 ) adults ( n=48 ) were r and omized to a five-month weight loss intervention involving a hypocaloric diet ( DIET ) and aerobic exercise ( EX ) with or without the SRI to promote spontaneous physical activity and decrease sedentary behavior ( SRI+DIET+EX compared to DIET+EX ) . Following the weight loss phase , both groups transitioned to self-selected diet and exercise behavior during a 5-month follow-up . Throughout the 10-months , the SRI+DIET+EX group utilized real-time accelerometer feedback for self-monitoring . Results There was an overall group by time effect of the SRI ( P < 0.01 ) ; DIET+EX lost less weight and regained more weight than SRI+DIET+EX . The average weight regain during follow-up was 1.3 kg less in the SRI+DIET+EX group . Individuals in this group maintained ~10 % lower weight than baseline compared to those in the DIET+EX group whom maintained ~5 % lower weight than baseline . Conclusions Addition of a self-regulatory intervention , design ed to increase spontaneous physical activity and decrease sedentary behavior , to a st and ard weight loss intervention enhances successful maintenance of lost weight
In sum , exercise and physical activity can effectively prevent weight gain in older adults and postmenopausal women either in terms of weight loss or maintenance .
They can preserve lean body mass and thus are important for the balance between potentially positive and negative effects of weight reduction in later life .
In addition , since all intervention studies were conducted with an overweight sample , it seems that primordial prevention ( in terms of preventing the development of risk factors such as excess weight in the first place ) might be a neglected issue in geriatric and postmenopausal prevention
This review examines the role of exercise and physical activity for preventing  weight gain in older people .