The purpose of this Position Stand is to provide an overview of issues critical to understanding the importance of exercise and physical activity in older adult populations. The Position Stand is divided into three sections: Section 1 briefly reviews the structural and functional changes that characterize normal human aging, Section 2 considers the extent to which exercise and physical activity can influence the aging process, and Section 3 summarizes the benefits of both long-term exercise and physical activity and shorter-duration exercise programs on health and functional capacity. Although no amount of physical activity can stop the biological aging process, there is evidence that regular exercise can minimize the physiological effects of an otherwise sedentary lifestyle and increase active life expectancy by limiting the development and progression of chronic disease and disabling conditions. There is also emerging evidence for significant psychological and cognitive benefits accruing from regular exercise participation by older adults. Ideally, exercise prescription for older adults should include aerobic exercise, muscle strengthening exercises, and flexibility exercises. The evidence reviewed in this Position Stand is generally consistent with prior American College of Sports Medicine statements on the types and amounts of physical activity recommended for older adults as well as the recently published 2008 Physical Activity Guidelines for Americans. All older adults should engage in regular physical activity and avoid an inactive lifestyle.

Exercise and physical activity for older adults

https://lsa.umich.edu/psych/research&labs/berridge/publications/Berridge&RobinsonBrResRev1998.pdf

What is the role of dopamine in reward: hedonic impact, reward learning, or incentive salience?

A meta-analytic study was conducted to examine the hypothesis that aerobic fitness training enhances the cognitive vitality of healthy but sedentary older adults. Eighteen intervention studies published between 1966 and 2001 were entered into the analysis. Several theoretically and practically important results were obtained. Most important fitness training was found to have robust but selective benefits for cognition, with the largest fitness-induced benefits occurring for executive-control processes. The magnitude of fitness effects on cognition was also moderated by a number of programmatic and methodological factors, including the length of the fitness-training intervention, the type of the intervention, the duration of training sessions, and the gender of the study participants. The results are discussed in terms of recent neuroscientific and psychological data that indicate cognitive and neural plasticity is maintained throughout the life span.

https://www.jstor.org/stable/pdfplus/40063782.pdf

Fitness Effects on the Cognitive Function of Older Adults: A Meta-Analytic Study

As people get older, they may fall more often for a variety of reasons including problems with balance, poor vision, and dementia. Up to 30% may fall in a year. Although one in five falls may require medical attention, less than one in 10 results in a fracture.
This review looked at the healthcare literature to establish which fall prevention interventions are effective for older people living in the community, and included 159 randomised controlled trials with 79,193 participants.  
Group and home-based exercise programmes, usually containing some balance and strength training exercises, effectively reduced falls, as did Tai Chi. Overall, exercise programmes aimed at reducing falls appear to reduce fractures.
Multifactorial interventions assess an individual's risk of falling, and then carry out treatment or arrange referrals to reduce the identified risks. Overall, current evidence shows that this type of intervention reduces the number of falls in older people living in the community but not the number of people falling during follow-up. These are complex interventions, and their effectiveness may be dependent on factors yet to be determined.  
Interventions to improve home safety appear to be effective, especially in people at higher risk of falling and when carried out by occupational therapists. An anti-slip shoe device worn in icy conditions can also reduce falls.
Taking vitamin D supplements does not appear to reduce falls in most community-dwelling older people, but may do so in those who have lower vitamin D levels in the blood before treatment.  
Some medications increase the risk of falling. Three trials in this review failed to reduce the number of falls by reviewing and adjusting medications. A fourth trial involving family physicians and their patients in medication review was effective in reducing falls. Gradual withdrawal of a particular type of drug for improving sleep, reducing anxiety, and treating depression (psychotropic medication) has been shown to reduce falls.
Cataract surgery reduces falls in women having the operation on the first affected eye. Insertion of a pacemaker can reduce falls in people with frequent falls associated with carotid sinus hypersensitivity, a condition which causes sudden changes in heart rate and blood pressure.
In people with disabling foot pain, the addition of footwear assessment, customised insoles, and foot and ankle exercises to regular podiatry reduced the number of falls but not the number of people falling.
The evidence relating to the provision of educational materials alone for preventing falls is inconclusive.

Interventions for preventing falls in older people living in the community

SUMMARYACSM Position Stand on The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Adults. Med. Sci. Sports Exerc., Vol. 30, No. 6, pp. 975-991, 1998. The combination of frequency, intensity, and duration of chr

http://myweb.facstaff.wwu.edu/chalmers/pdfs/acsm position stand - quantity and quality of exercise.pdf

ACSM Position Stand: The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Healthy Adults

The physical aging process progresses every day--and so does our understanding of it. "Physical Dimensions of Aging, Second Edition, " will keep students and professionals up to date on the outcomes of the latest research studies and their implications for the elderly in the real world. Physical aging affects us cognitively, psychologically, socially, and spiritually. The book discusses how people age physically and how this aging affects other dimensions of life.The second edition of "Physical Dimensions of Aging" has been updated to integrate research findings on physical aging from more than 100 different journals in myriad fields, creating interdisciplinary coverage on the topic. It provides students and professionals with what they need to know about physical aging in order to conduct clinical research and to work with clients and patients. In doing so, it retains its landmark status as the definitive reference on aging.Moreover, "Physical Dimensions of Aging, Second Edition, " focuses less on explaining the measurement techniques and research design and more on the outcome of the studies and their practical implications for everyday living. This approach will enable professionals and students to do the following: -Understand the physical aging process and its effects on other dimensions of life.-Apply the latest research in working with adults and the elderly.-Become more effective in their professions.The structure of this new edition is more conducive to learning and features the following: -Chapter objectives-Key terms-Sidebars of capsule research studies-Testimonials, vignettes, and other tidbits that tie the research information to the real world-Review questions to assist students in synthesizing and remembering the information-Short lists of recommended reading for those who want to pursue the topic in more detail-A glossary at the end of the bookThis second edition is organized into five parts. Part I provides an introduction to aging, to the field of gerontology, and to the research process for studying individual differences. Part II describes the physical changes in structure, capacity, and endurance. Part III overviews the factors related to motor coordination, motor control, and skill learning for older adults. Part IV addresses physical-psychosocial relationships, including health, exercise, and cognitive function as well as health-related expectations of quality of life for older adults. Part V highlights physical performance and achievement especially to showcase the results from consistent effort and hard work of physically elite older adults as inspiration for others.At a time when many people are telling older adults what they can't do, professionals should be telling them what they can do. "Physical Dimensions of Aging, Second Edition, " will equip professionals to do so.

Physical dimensions of aging

Purpose: The purpose of this study was to determine if exercise operates in a dose-response fashion to influence well-being and to postpone dependency. Methods: A computer-assisted search was made by using the following key words: resistance training, strength training, function, exercise, elderly, quality of life, frailty, physical activity, independence, performance, aerobic training, mobility, well-being, and disability. Review articles and personal files were also used, and a critical review of research studies meeting the criteria described in the methods section of the article was conducted. Results: In large sample correlational studies and prospective longitudinal studies, researchers consistently report that measures of physical function in old adults are related to feelings of well-being, and that old adults who are physically active also report higher levels of well-being and physical function, but the results of randomized intervention studies of aerobic and/or resistive strength training do not always support this relationship. Even if changes in well-being and physical function were reported, no evidence was found that levels of intensity operated in a dose-response fashion to influence these changes. Research design problems included ineffective aerobic or strength training treatments, widely varying participation and effort of the research participants, and both treatment and physical function tests that were not appropriate for the physical status of the participants. Conclusion: The most consistent results were that long-term physical activity is related to postponed disability and independent living in the oldest-old subjects. Even in individuals with chronic disease, systematic participation in physical activities enhances physical function.

Exercise dose-response effects on quality of life and independent living in older adults.

The SRT, DRT, and MT of older men (OA) who have experienced a life style of chronic physical activity were compared to those of nonactive men of similar age (ONA), and also to active (YA) and nonactive young men (YNA). Although activity level and age were significant factors, most of the activity level-by-age interaction in all but DRT was attributed to the slower performance of the ONAs. At least in this study, a life style of physical activity appeared to play a more dominant role in determining SRT, DRT, and MT than age. The hypothesis that most of the slowing of responses in the aged is attributable to CNS processing rather than MT decrements is repudiated, since MT results paralleled those of SRT and DRT.

Reaction and movement time as a function of age and physical activity level.

We describe and demonstrate the usefulness of a reliable procedure for quantifying “sensorimotor” asymmetries in rats with nigrostriatal damage. Conventional tests, such as the popular Von Frey hair technique are sometimes inadequate in that positive responses are difficult to quantify, they are susceptible to subjective interpretation, and they require that the animal make head movements. Circling behavior has become established as a measure of asymmetrical nigrostriatal activity, but it does not measure stimulus-directed movement. One group of rats was given unilateral microinfusions of 6-OHDA into the nigrostriatal system which decreased levels of dopamine in the ipsilateral striatum and yieded an ipsilateral turning bias. Another group was given electrolytic lesions in the substantia nigra area, which yielded a severe contralateral circling bias. Small pieces of adhesive paper were applied to various parts of the limbs or snout and latencies to remove the stimuli were recorded. Because head and body movements were not required, assessment of stimulus-directed movement asymmetries could be quantified rapidly without the interference of stimulus-independent (“spontaneous”) postural and motor asymmetries. In the 6-OHDA-treated rats there was ipsilateral bias in stimulus-directed activity. Indeed, there was ipsilateral hyper-reactivity relative to sham controls. In rats with electrolytic nigra lesions, despite a strong contralateral “spontaneous” motor bias, there likewise was an ipsilateral bias in stimulus-directed movement, which could only be detected using the adhesive removal test. This similarity in stimulus-directed movement asymmetry between the two groups may reflect a common asymmetry in ascending dopaminergic pathways. The opposite circling bias following electrolytic nigra lesions may reflect differential damage to non-dopaminergic efferent projections. The bilateral adhesive removal (tactile extinction) test appears to permit the separate quantification of stimulus-directed and stimulus-independent movement asymmetries.

Tactile extinction: distinguishing between sensorimotor and motor asymmetries in rats with unilateral nigrostriatal damage

The robustness of a relationship among physical fitness, psychomotor speed, and aging is discussed by reviewing the descriptive and correlational evidence provided by studies from several different research areas. These areas are those that relate psychomotor speed to (a) athletic status, (b) physical fitness status, (c) physical conditioning training programs, (d) hyperbaric oxygenation treatment, and (e) presence of cardiovascular disease. Several potential physiological mechanisms that might support such a relationship are discussed under the general categories of brain function and cerebral circulation, and the trophic influence of physical activity on the central nervous system.

Waneen W. Spirduso

Papers

Physical dimensions of aging

Exercise dose-response effects on quality of life and independent living in older adults.

Reaction and movement time as a function of age and physical activity level.

Tactile extinction: distinguishing between sensorimotor and motor asymmetries in rats with unilateral nigrostriatal damage

Physical fitness, aging, and psychomotor speed: a review