Exercise in older people
Dr Richard A. Ferguson
Musculo-Skeletal Muscle Biology Research Group
School of Sport, Exercise and Health Sciences
Loughborough University
“The biggest issue is loss of function. Not everyone
has cancer, not everyone has Alzheimer's, but almost
everyone loses function”.
David Muller
Dean of Medical Education
Mount Sinai School of Medicine in New York City
The background issues …
• Skeletal muscle function
• Aerobic function
THE BIG QUESTIONS
THE BIG QUESTIONS
THE BIG QUESTIONS
THE BIG QUESTIONS
THE BIG QUESTIONS
THE BIG QUESTIONS
Resistance / strength exercise
Age range 60 – 72 yrs
80% 1-RM (progressive)
3 sets of 8 reps
3 days per week for 12 weeks
Frontera et al (1988)
Resistance / strength exercise
Even in VERY old people
Age range 85 – 97 yrs
80% 1-RM (progressive)
3 sets of 8 reps
3 days per week for 12 weeks
Harridge et al (1999)
Resistance / strength exercise
Even in VERY old people
Age range 85 – 97 yrs
80% 1-RM (progressive)
3 sets of 8 reps
3 days per week for 12 weeks
Harridge et al (1999)
UK Physical Activity Guidelines
UK Physical Activity Guidelines
UK Physical Activity Guidelines
Older adults should also undertake
physical activity to improve muscle
strength on at least two days a week.
Effects of strength training on physical function
Physical function – systematic reviews
“…. resistance training increased muscle strength and had
a modest significant effect on some measures of physical
functioning (e.g., gait speed)”.
Physical function – systematic reviews
“Evidence shows that older people who exercise their muscles against a
force or resistance become stronger. They also improve their performance
of simple activities such as walking, climbing steps, or standing up from a
chair more quickly. The improvement in activities such as getting out of a
chair or stair climbing is generally greater than walking speed”
Liu & Latham (2009)
Physical function – systematic reviews
“Evidence shows that older people who exercise their muscles against a
force or resistance become stronger. They also improve their performance
of simple activities such as walking, climbing steps, or standing up from a
chair more quickly. The improvement in activities such as getting out of a
chair or stair climbing is generally greater than walking speed”
Liu & Latham (2009)
Alternative interventions
Alternative interventions
Muscle power = force x velocity
Narici et al. (2005)
Alternative interventions
Traditional resistance training velocity
Narici et al. (2005)
Alternative interventions
High velocity resistance training
Narici et al. (2005)
InVEST – Increased Velocity Exercise Specific to Task
Age ~74 yrs
3 days per week for 16 weeks
NIA – National Institute of Aging strength training
program (2 sets of 10)
concentric phase performed slowly (3 sec)
InVEST – task specific movement pattern
concentric phase performed as quickly as
possible
SPPB – short physical performance battery
Bean et al (2009)
InVEST – Increased Velocity Exercise Specific to Task
Bean et al (2009)
InVEST – Increased Velocity Exercise Specific to Task
Bean et al (2009)
“human muscle agerelated molecular
processes appear distinct
from the processes
directly regulated by
those of physical activity”
Marr explained he had fallen into the "terrible" trap of believing what he read in
newspapers, which encouraged people to "take very intensive exercise in short
bursts - and that's the way to health".
He went on: "I went onto a rowing machine and gave it everything I had, and had
a strange feeling afterwards - a blinding headache, and flashes of light - served
out the family meal, went to bed, woke up the next morning lying on the floor
unable to move.
Summary
• Resistance training into later life attenuates the decline in
muscle strength
• Does not necessarily enhance functional
RESEARCH FUNDING OPPORTUNITIES ;-)
• Large variability
interventions
in
“responsiveness”
to
ability
exercise
• Exercise for older people should be personalised
(baseline physiology / genetic screening!!)
RESEARCH FUNDING OPPORTUNITIES ;-)
THANK YOU
R.Ferguson@lboro.ac.uk
http://twitter.com/ncsemem