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Exercise and elderly: not only for healthy seniors Torna agli editoriali

Anna Giulia Cattaneo - Department of Biotechnologies and Life §Sciences (DBSV), University of Insubria, via J-H. Dunant, 3, Varese, Italy.

The quality of life in healthy elderly is related to a number of factors, both physical and psychological, and it is a common opinion that the exercise and social activities can greatly improve it.

In addition to a healthy lifestyle, with adequate amount of physical activity and social contact, scheduled physical exercise is useful to improve and maintain the wellness in people aged over 65. The main papers on the argument, appeared in the last two years, state its importance and add some news to the modalities in training procedures.

Before programming a schedule of physical training, the physician should generally assess its older patient. Age, sex, overweight, physical fitness and previous amount of exercise, diseases and medications have predictive value for mobility disability in the older patients.

Short assessment test should be helpful, if well standardised: they could be predictive of performance under exercise both in healthy subjects and in those affected by chronic diseases. As an example, we can recall the 6-min walk distance, whose predictivity was recently reviewed by the ALAT group, for seven participating countries Eur. Respir. J., 2011, 37:150-156). Another test similar to the cited is illustrated in Respiration 2011, 81:223-228): a predictive equation for the walking performance at the incremental shuttle walk distance is given, which gives an evaluation of walking disabilities possibly caused by chronic diseases.

Stretching and passive or active mobilisation are common practice in physical therapy for disabled subjects and those suffering of postsurgical or posttraumatic lesions. Resistance training enhances strength and coordination of arms and legs in subjects suffering from postural tremor, reducing the principal symptom too. In seniors other ways healthy, the gait pattern ameliorates after balance training on an instrumented walkway.

Appropriate training is a recognized part of the treatment in medical conditions such as hypertension, diabetes, alone or as a part of the metabolic syndrome. In the elderly, however, to the risk of fall, enhanced by the pharmacological treatment, could be threatening at the beginning. Only after an appropriate period of adherence to the scheduled exercise, the balance and the self-confidence will improve, at the same time the need for medication should reduce.

Even those psychologically or cognitively affected can find help in programmed and regular activity, as demonstrated in depression and cognitive impairment. The benefits of physical exercise are significant and long-standing, even better if conducted in a group therapy and accompanied by mental training and psychological counselling. The active participation to group exercise and especially the adherence to the programmed schedule are very important.

Among non conventional types of exercise, yoga and Tai Chi seem to effectively counteract signs of depression and improve cognition.

In summary, we can conclude that aged healthy persons should be encouraged to conduct an active lifestyle, with physical exercise as a normal and necessary component of it. On the other hand, scheduled exercise should be recommended as an active treatment of associated conditions, and therefore personalized and carefully graded.

Anna Giulia Cattaneo - Department of Biotechnologies and Life §Sciences (DBSV), University of Insubria, via J-H. Dunant, 3, Varese, Italy.

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