Exercise and the Aging Person

Rural Project Summary: CAPABLE (Community Aging in Place—Advancing Better Living for Elders)

Exercise and the Aging Person | Johns Hopkins Medicine

CAPABLE (Community Aging in Place—Advancing Better Living for Elders) is a five-month home visit program that helps low-income seniors age in place.

This program was developed by the Johns Hopkins School of Nursing. There are currently 28 CAPABLE sites across the country, three of which are in rural communities. The rural sites are in Bath and Fort Fairfield, Maine, and the island of Lanai, Hawaii.

Bath, Maine, Site

The CAPABLE site in Bath, ME, partners with Bath Housing, an affordable housing organization that offers home repairs to serve coastal Maine. This site received funding from the Davis Foundations grant and the local hospital to serve up to 20 clients.

Hawaii Site

Kūpuna Aging in Place with Assistance (KAPA) is a program modeled after CAPABLE that serves the rural islands of Lāna'i (population of about 7,400) and Moloka'i (population of about 3,100). This program is funded through the Native Hawaiian Health Care Improvement Act.

The nurse practitioner speaks Hawaiian and incorporates plant medicine and traditional Hawaiian healing into her work with KAPA. KAPA also works with social workers and partners with Maui County's Office on Aging.

For five months, each CAPABLE participant works with:

  • A registered nurse (RN), who visits 3-4 times
  • An occupational therapist (OT), who visits 4-6 times
  • Home repair services, which has a budget of $1,300 to make repairs and install safety features

These visits are client-driven. Instead of the CAPABLE staff deciding what the client needs to do, they use motivational interviewing to help participants set their own goals.

For example, if the participant wants to bathe safely, the RN might partner with the client to identify issues that affect balance, overmedication; the OT could teach strengthening exercises and ways to enter/exit the tub safely; and home repair technicians could install safety features handrails and nonslip treads.

The national CAPABLE model reports a return on investment of over 6 to 1, with over $20,000 in medical costs saved for every $3,000 invested in the program. Participants nationwide have shown reduced symptoms of depression and improved functionality. There have been 15 publications about CAPABLE, but there have not been any rural-focused studies published.

Bath, Maine, Results

The Bath, ME, site has had eight CAPABLE participants since program launch in April 2018. Examples of work that this site has completed:

  • Helping a client exercise so they could leave the house more often
  • Helping a client make doctor's appointments and find transportation
  • Repairing rotten boards in a wheelchair ramp
  • Repairing a drafty front door that wouldn't stay shut
  • Buying a stool so a client could sit at the stovetop while cooking
  • Buying a microwave so a client didn't have to use the stovetop
  • Modifying the house so that a client with a scooter or wheelchair could move more easily
  • Helping someone with incontinence training so they didn't have to urinate so frequently
  • Replacing a shower's glass doors with a curtain and installing grab bars and a tub transfer bench
  • Buying furniture a CD rack to keep items off the floor
  • Installing motion-sensing lights in the laundry room
  • Installing grab bars in the laundry room

One client went from 15 falls, one hospital admission, and one emergency department admission in the six months prior to CAPABLE to one fall and no admissions since starting the program.

Hawaii Results

KAPA has served three clients in the last year. One client wanted to be able to walk around her yard and more safely get in and cars, so the staff bought her a new walker and helped her with car transfers. Thanks to the OT's individualized wraparound services, elders are able to reunite and reconnect with their families and communities.

Since clients benefit from the companionship that comes from these home visits, KAPA staff are also considering partnering with schools so that students can volunteer and earn credits by visiting clients who have graduated from the program.

Program coordinators have identified the following challenges:

  • Raising awareness of the program
  • Addressing skepticism: The program is free to participants, but community members might not understand how these home visits and repairs are free.
  • Working with other organizations that offer similar services and are more established in the community: Talk with these organizations to see how your work can support and supplement theirs.

Hawaii Barriers

The KAPA service area does not have regular public transportation, and many supplies have to be ordered and shipped in. In addition, two staff members do not live in the service area; the nurse practitioner is flown in on the weekends to meet with clients, and the occupational therapist takes a ferry.

Program coordinators are working on establishing a network of licensed plumbers, electricians, carpenters, and other tradespeople so that at least one person is available for home repairs. In addition, many KAPA clients don't own their homes, so staff are limited on the types of repairs they can make.

While aspects the OT and RN are needed to count as a CAPABLE program, national model coordinators can work with rural sites to help them adapt the program to fit their community and clients.

For example, the Bath, ME, site used a different grading scale, the Patient-Specific Functional Scale, to help clients rate their goals throughout the five months of the program.

In addition, this site also offers safety checks testing or replacing smoke alarms.

The RN and OT each complete five 60-minute online learning modules, up to 8 hours of live online training, and five webinars or coaching calls. CAPABLE FAQs has more information about training, costs, and program support. It costs about $6,000 to train one RN and one OT, and this license is good for three years.

Bath, Maine, Replication

Before launching the program, figure out logistics such as who will coordinate or facilitate home visit scheduling and staff training. Coordinators said it took about four or five meetings before program launch to figure out these details.

Program coordinators recommend reaching out to and partnering with healthcare providers and community-based organizations so they can refer potential contacts to you and you can fill in gaps to their services.

Program coordinators also say that their target population responds better to marketing that's more informational than “sales-y.” In addition, coordinators remind this population that while it's a national model, this local site is run by local people.

For more information about CAPABLE in Bath, ME, contact: Eric Gosselin, Director of Operations CHANS Home Health & Hospice 207.721.1298

egosselin@midcoasthealth.com

Hawaii Replication

Before program launch, think through what challenges you'll face and find community partners.

To recruit clients, program coordinators send direct mailers to older adults, take information packets to physicians' offices, and complete newspaper releases and radio spots. KAPA currently receives most of its referrals from the public health nursing staff at the Hawaii State Department of Health.

For more information about KAPA in Hawaii, contact: Kamahanahokulani Farrar, Executive Director Nā Pu'uwai 898.560.3653

KamahanahokulaniFarrar@napuuwai.org

Topics Aging and aging-related services Elderly population Home and community-based services Nurses Occupational therapy

States served
Hawaii, Maine

Date added
July 11, 2019

Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience.

The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity.

While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.

Source: https://www.ruralhealthinfo.org/project-examples/1064

Myths About Exercise and Older Adults

Exercise and the Aging Person | Johns Hopkins Medicine

From the WebMD Archives

Have you given up on exercise? A lot of older people do — just one four people between the ages of 65 and 74 exercises regularly. Many people assume that they're too out-of-shape, or sick, or tired, or just plain old to exercise. They're wrong.

“Exercise is almost always good for people of any age,” says Chhanda Dutta, PhD, chief of the Clinical Gerontology Branch at the National Institute on Aging. Exercise can help make you stronger, prevent bone loss, improve balance and coordination, lift your mood, boost your memory, and ease the symptoms of many chronic conditions.

Here are some common myths that stop older people from exercising — along with some expert advice to get you started working out.

Exercise Myth: Trying to exercise and get healthy is pointless — decline in old age is inevitable.

“There's a powerful myth that getting older means getting decrepit,” says Dutta. “It's not true. Some people in their 70s, 80s, and 90s are out there running marathons and becoming body-builders.

” A lot of the symptoms that we associate with old age — such as weakness and loss of balance — are actually symptoms of inactivity, not age, says Alicia I.

Arbaje, MD, MPH, assistant professor of Geriatrics and Gerontology at Johns Hopkins University School of Medicine in Baltimore.

Exercise improves more than your physical health. It can also boost memory and help prevent dementia. And it can help you maintain your independence and your way of life. If you stay strong and agile as you age, you'll be more able to keep doing the things you enjoy and less ly to need help.

Exercise Myth: Exercise isn't safe for someone my age — I don't want to fall and break a hip.

In fact, studies show that exercise can reduce your chances of a fall, says Dutta. Exercise builds strength, balance, and agility. Exercises tai chi may be especially helpful in improving balance. Worried about osteoporosis and weak bones? One of the best ways to strengthen them is with regular exercise.

Exercise Myth: Since I'm older, I need to check with my doctor before I exercise.

If you have a medical condition or any unexplained symptoms or you haven't had a physical in a long time, check with your doctor before you start exercising. Otherwise, go ahead. “People don't need to check with a doctor before they exercise just because they're older,” says Dutta. Just go slowly and don't overdo it.

Exercise Myth: I'm sick, so I shouldn't exercise.

On the contrary, if you have a chronic health problem — such as arthritis, diabetes, or heart disease — exercise is almost certainly a good idea. Check with a doctor first, but exercise will probably help.

“Exercise is almost a silver bullet for lots of health problems,” says Arbaje. “For many people, exercise can do as much if not more good than the 5 to 10 medications they take every day.”

Exercise Myth: I'm afraid I might have a heart attack.

We've all heard about people who had heart attacks while exercising. It can happen. However, the many health benefits of exercise far exceed the small risk. “Being a couch potato is actually more dangerous than being physically active,” says Dutta. “That's true for the risk of heart disease and many other conditions.”

Exercise Myth: I never really exercised before — it's too late to make a difference in my health.

It may seem too late to atone for a lifetime of not exercising. “That's absolutely not true,” says Dutta.

Studies have found that even in people in their nineties living in nursing homes, starting an exercise routine can boost muscle strength.

Other research shows that starting exercise late in life can still cut the risk of health problems — such as diabetes –and improve symptoms. “It really is never too late to start exercising and reaping the benefits,” Dutta tells WebMD.

Exercise Myth: Exercise will hurt my joints.

If you're in chronic pain from arthritis, exercising may seem too painful. Here's a counterintuitive fact: studies show that exercising helps with arthritis pain. One study of people over age 60 with knee arthritis found that those who exercised more had less pain and better joint function.

Exercise Myth: I don't have time.

This is a myth that's common in all age groups. Experts recommend a minimum of 150 minutes of aerobic exercise a week. That might sound a lot. Actually, it's only a little over 20 minutes a day.

What's more, you don't have to do it all in one chunk. You can split it up. For instance, take a 10-minute walk in the morning and pedal on a stationary bike for 15 minutes in the evening — you're done.

Exercise Myth: I'm too weak to start exercising.

Maybe you just recovered from an illness or surgery and are feeling too weak even to walk around the block. Maybe you only get the chair each day to go to the bathroom. If so, start there. Decide today to get in and your chair 10 times. As you do it more, your strength will increase and you can set higher goals.

Exercise Myth: I'm disabled, so I can't exercise.

“A disability can make exercise challenging, but there really is no excuse for not doing some sort of exercise,” says Arbaje.

If you’re in a wheelchair, you can use your arms to get an aerobic workout and build strength. Even people who are bedridden can find ways to exercise, she says.

Talk to a doctor or a physical therapist about ways you can modify exercises to work around your disability.

Exercise Myth: I can't afford it — I don't have the budget to join a gym or buy equipment.

Gym memberships and home treadmills can be expensive. Still, that's no reason to skip exercising, Dutta says. You can exercise for free. Walking doesn't cost anything. Look into free demonstration classes at your local senior center.

If you want to lift weights at home, use soup cans or milk jugs filled with sand. Use your dining room chair for exercises that improve balance and flexibility. If you have a health problem, insurance may cover a few sessions with a physical trainer or an occupational therapist, says Arbaje.

There are lots of ways to get fit at low or no cost.

Exercise Myth: Gyms are for young people.

“The gym scene can be intimidating for older people,” says Dutta. Look to see if gyms in your area have offerings for seniors or people new to exercise. If you're retired, try going in the middle of the day, so you can avoid the before and after-work rush. “Find an environment where you feel comfortable exercising,” says Arbaje.

Exercise Myth: Exercise is boring.

If exercise is boring, you're not doing it right. Exercise doesn't even have to feel exercise.

Remember that any physical activity counts. Whether it's catching up with a friend while you walk the mall, or taking a dance class, or chasing your grandchildren, or bowling, or raking, or gardening, or volunteering at your local school system or park, it's physical activity.

“Don’t forget sex,” says Arbaje. “That's good exercise too.”

The key is to figure out something you enjoy doing and do that. When you get tired of it, try something new. “The type of exercise doesn't matter,” says Arbaje. “The best exercise is the one that you actually do.”

SOURCES:

Alicia I. Arbaje, MD, MPH, assistant professor, Geriatrics and Gerontology; associate director of Transitional Care Research, Johns Hopkins University School of Medicine, Baltimore.

Chhanda Dutta, PhD, Chief, Clinical Gerontology Branch, Division of Geriatrics and Clinical Gerontology, National Institute on Aging, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD.

Centers for Disease Control and Prevention: Physical Activity: Strength Training for Older Adults: Introduction.

National Institute on Aging — Go4Life: Being physically active without spending a dime, Fitness Centers Aren't Just for Kids, Stay Safe, 4 Types of Exercise, How Exercise Can Help You, New Go4Life campaign focuses on fitness for older adults.

© 2011 WebMD, LLC. All rights reserved.

Source: https://www.webmd.com/healthy-aging/features/exercise-older-adults

Exercise levels predict lifespan better than smoking, medical history

Exercise and the Aging Person | Johns Hopkins Medicine

Wearable activity trackers may pave the way for a better method to predict short term death risk, suggests a new study, which found that exercise data was more accurate than other risk factors, such as smoking and medical history.

Share on PinterestNew research suggests that physical activity levels might be a better predictor of lifespan than medical history or other lifestyle choices among older adults.

Being able to make an accurate prediction about a person’s risk of death can help them prolong their lives. Usually, doctors base these estimates on lifestyle choices, such as smoking and alcohol consumption, and health factors, such as cancer or heart disease history.

But new findings published in The Journal of Gerontology: Medical Sciences suggest that wearable activity trackers may provide more reliable predictions.

Researchers at John Hopkins Medicine in Baltimore, MD, studied the association between physical activity and risk of death.

“We’ve been interested in studying physical activity and how accumulating it in spurts throughout the day could predict mortality because activity is a factor that can be changed, un age or genetics,” says professor Ciprian Crainiceanu, Ph.D., from the Johns Hopkins Bloomberg School of Public Health.

Their work is not the first to find such a link, but, according to the team, the results might be some of the first to offer concrete proof that wearable technology works better for predicting a person’s risk of mortality than other means.

The study’s data set came from the National Health and Nutrition Examination Survey (NHANES) carried out in 2003–2004 and 2005–2006.

Involving almost 3,000 U.S. adults between the ages of 50 and 84, it examined more than 30 predictors of 5-year all-cause mortality, using survey responses, medical records, and laboratory test results.

Physical activity made up 20 of these predictors, including total activity, time spent doing moderate to vigorous activity, and time spent not moving at all.

To measure such activity, participants — 51% of whom were men — were asked to wear a wearable activity tracker on their hip for 7 days in a row. They were told only to remove the device when showering, swimming, or sleeping.

The research team was able to use the data to categorize which factors best predicted death risk within the next 5 years. However, they were unable to tell when people were sleeping or whether they had removed the tracker for other reasons.

Wearable trackers predicted the risk of death more accurately than surveys and other methods that doctors commonly use.

“The most surprising finding,” says lead author Ekaterina Smirnova, M.S., Ph.D., “was that a simple summary of measures of activity derived from a hip-worn accelerometer over a week outperformed well-established mortality risk factors, such as age, cancer, diabetes, and smoking.”

Smirnova is an assistant professor of biostatistics at Virginia Commonwealth University, VA.

The wearable trackers designated death risk 30% better than smoking-related information did, and was 40% more accurate than using data involving stroke or cancer history.

The researchers found that total daily physical activity was the strongest mortality predictor. Age came second, followed by time spent performing moderate to vigorous physical exercise.

Specifically, examining the amount of physical activity that a person performed between noon and 2 p.m. proved to be a better indicator of death risk than more established risk factors, such as alcohol consumption and diabetes.

Andrew Leroux, co-author and Ph.D. candidate at John Hopkins, says the study confirms “a link between physical activity and short term mortality risk in an older population.”

But, he adds, “the data [do not] guarantee that one’s risk of mortality is going to be lower with more physical activity.”

This does not take away from the fact that wearable tracker measurements, rather than self-reported data, may help doctors “intervene” more appropriately and therefore improve patient health.

Assistant professor of medicine at the John Hopkins University School of Medicine, Jacek Urbanek, Ph.D., notes that “the technology is readily available and relatively inexpensive, so it seems feasible to be able to incorporate recommendations for its use into a physician’s practice.”

But it does mean that further study is necessary. Researchers are hoping to use their findings in clinical trials designed to strengthen the link between physical activity and lifespan.

Source: https://www.medicalnewstoday.com/articles/326958

About IRP | National Institute on Aging

Exercise and the Aging Person | Johns Hopkins Medicine

The Intramural Research Program (IRP) in the National Institute on Aging (NIA) is comprised of nine scientific laboratories, the Translational Gerontology Branch, and ten core facilities, with leadership from the Scientific Director. The research program has three main focus areas: Neuroscience, Aging Biology and Translational Gerontology.

IRP scientists conduct research in many different disciplines that range from basic science to clinical research and epidemiology. Medical problems, which typically affect older persons, are studied in depth using the tools of modern laboratory and clinical research, with a translational perspective.

The central focus of our research is understanding age-related changes in physiology and the ability to adapt to environmental stress. This understanding is then applied to developing insight about the pathophysiology of age-related diseases.

The program seeks to understand the changes associated with healthy aging and to define the criteria for evaluating when changes should be considered pathologic and require treatment.

Thus, in addition to study common age-related diseases, such as Alzheimer's Disease, Parkinson's Disease, stroke, atherosclerosis, osteoarthritis, diabetes and cancer, we also explore the determinants of healthy aging as possible targets for interventions aimed at improving health and quality of life in the older population at large.

The goals of the IRP are to support a broad-based research program centered around critical issues regarding the general biology of aging and age-associated diseases and disabilities.

The specific areas of study on the general biology of aging have focused on: (1) characterization of normal aging, (2) cell cycle regulation and programmed cell death, (3) stress response, and (4) DNA damage and repair.

Age-associated disease and disabilities research has included the study of: (1) Alzheimer's disease, (2) cancer, and (3) osteoporosis, osteoarthritis, and frailty, (4) cardiovascular disease and hypertension, and (5) diabetes.

Additionally, researchers at the IRP continue to develop and/or test different intervention strategies (pharmacotherapy, gene therapy, and behavioral or lifestyle changes) to treat many of these age-associated diseases.

IRP research is conducted in multiple sites; most of the basic science laboratories are located at the Biomedical Research Center on the Johns Hopkins Bayview Campus in Baltimore, Maryland. The Laboratory of Clinical Investigation is located at Harbor Hospital, a few miles south of the Bayview Campus in Baltimore, Maryland.

The NIA Clinical Research Unit at Harbor Hospital is also home of the Baltimore Longitudinal Study of Aging, a longitudinal study of aging that was started as far in time as 1958.

 The Laboratory of Neurogenetics are located on the NIH main campus in Bethesda, and the Laboratory of Epidemiology, and Population Science is co-located in the Gateway Building in Bethesda and the Biomedical Research Center in Baltimore.

Finally, the Healthy Aging in Neighborhoods of Diversity across the Life Span study (HANDLS), a longitudinal study that addresses health disparities associated with race and socio-economic status, is profoundly rooted in several Baltimore neighborhoods.

The IRP provides a stimulating academic setting that encourages and fosters a comprehensive effort to understand aging through multidisciplinary investigator-initiated research.

Particular emphasis is put on the value of synergistic interaction and collaboration through inter-laboratory collaboration. The program offers many excellent training opportunities in both laboratory and clinical medicine with a wealth of valuable resources.

The NIA is committed to training researchers for lifetime careers in the biomedical and behavioral sciences.

About Our Founder: Nathan W. Shock, Ph.D. 

NIA's Intramural Research Program was founded by Nathan Wetherell Shock, Ph.D.

began his gerontology career in 1941 as the chief of the newly formed Unit on Gerontology of the Division of Physiology of the five-year-old National Institute of Health.

He took this two-man aging unit and built it into the internationally respected Gerontology Research Center of the National Institute on Aging, NIH.

Dr. Shock was the catalyst for the emergence of aging research in the United States and overseas for nearly half a century. It was Dr.

Shock's insistence on answering what he considered the discipline's two critical questions that made an impact on the field of gerontology: “What are the underlying biological factors that produce what we perceive as aging?” and, “What are the mechanisms that produce impaired performance with age?” For aging, he insisted, was not a disease.

Dr. Shock directed NIH intramural aging studies for 35 years until his retirement as first Scientific Director of the National Institute on Aging in 1976. During his leadership he helped plan and implement the construction of the gerontology building located on the grounds of what is now the Johns Hopkins Bayview Medical Center in Baltimore, Maryland.

In addition, he presided over the recruitment and training of hundreds of scientists and clinicians and the development of five major laboratories covering a wide range of biomedical and psychological research on aging. Dr. Shock was one of the first scientists to foresee the importance of using longitudinal methods to study human aging.

In the late fifties, he and his colleagues began the Baltimore Longitudinal Study of Aging. Officially retiring in 1977, Dr. Shock continued his work as Scientist Emeritus until his death in 1989. Dr.

Shock was the recipient of awards from every major national society on aging, he was a founder (with Kornchevsky) and president of the International Association of Gerontological Societies, and a founding member and president of the Gerontological Society of America.

Source: https://www.nia.nih.gov/research/labs/about-irp

Fragmented physical activity linked to greater mortality risk

Exercise and the Aging Person | Johns Hopkins Medicine

Although reduced physical activity during the day is widely seen as a harbinger of mortality in older people, fragmentation of physical activity — spreading daily activity across more episodes of brief activity — may be an earlier indicator of mortality risk than total amount of daily activity, according to a new study from scientists at the Johns Hopkins Bloomberg School of Public Health.

The study, to be published October 2 in JAMA Network Open, used physical activity data collected using wearable monitors in 548 well-functioning older adults enrolled in the National Institute on Aging's Baltimore Longitudinal Study of Aging.

The scientists found that for this group of people during the period 2007-17 there was no association between overall daily activity levels and greater mortality risk.

However, there was an association between mortality risk and more fragmented physical activity.

“Fragmentation of physical activity may be an early indicator of increasing mortality risk,” says study lead author Amal Wanigatunga, PhD, assistant scientist in the Bloomberg School's Department of Epidemiology.

“By examining these patterns of routine activity and the decline in patterns of fragmented activity, we can begin to identify trajectories toward premature serious illness and death sooner and work to develop interventions and preventive strategies to reverse it.”

Adults age 65 and older are one of the fastest growing segments of the U.S. population. They are also increasingly sedentary, and prior studies have shown that less physical activity among older adults is a predictor of more illness and premature death.

But in recent years, Wanigatunga, along with study senior author Jennifer Schrack, PhD, associate professor in the Department of Epidemiology at the Bloomberg School, and their colleagues, have begun to explore activity fragmentation as a complementary and potentially more sensitive marker of overall health and functioning among older adults.

For the new study the scientists analyzed data from the ongoing Baltimore Longitudinal Study of Aging (BLSA), the U.

S's longest-running study of human aging, which began in 1958 and in recent years has included the use of accelerometers by participants to track both quantities and patterns of daily physical activity.

The analysis was accelerometer data collected between 2007 and 2015 and subsequent mortality data collected between 2007 and 2017 from 548 BLSA participants aged 65 and older.

Of the 548 participants studied, 487 were alive at the end of 2017, and 61 were deceased. The living participants engaged in an average of 5.7 hours of activity per day, compared to 4.7 hours for those who later died.

But after accounting for confounding factors such as age, sex, race, body mass index, and existing illnesses, Wanigatunga and colleagues found that total physical activity overall was too weakly associated with mortality risk to reach statistical significance.

Not so for activity fragmentation. The researchers found that for each 10 percent higher activity fragmentation there was a 49 percent increase in the risk of mortality. The researchers defined activity fragmentation as the probability of transitioning from an active state to a sedentary state for each participant, so shorter average activity periods meant higher fragmentation.

The researchers also analyzed the duration of each participant's bouts of activity, and found that “percent of activity spent in bouts of less than five minutes” appeared to be another good marker of mortality risk.

Each additional 10 percent of active time spent in such short bouts was associated with a 28 percent increase in the chance of mortality.

Percent of active time spent in 5- to 10-minute bouts was not a significant indicator of mortality risk.

Percent of active time spent in bouts longer than 10 minutes — such as deliberate physical exercise — also didn't reach statistical significance as a marker of mortality risk, but unsurprisingly showed a trend towards being a marker of reduced mortality risk.

Wanigatunga notes that the BLSA cohort they studied had an average age of 76 but was, on the whole, healthier than the general population of older adults in the U.S.

He notes too that although time spent exercising, such as brisk walking, is often examined as a marker for mortality risk, most physical activity for older adults comes from the ordinary, lighter-intensity activity routinely performed throughout the day, such as doing laundry, preparing meals, gardening, and even getting the mail.

Wanigatunga and Schrack and their colleagues are continuing to study activity fragmentation as a potential indicator of health decline, including cognitive decline and dementia. In principle, older adults could have their activity fragmentation monitored this way with wearable monitoring devices to help maintain a high quality of life and preserve the ability to live independently.

“A doctor seeing a patient transitioning into a more fragmented activity pattern and a more sedentary state might initiate a prescription for a tailored physical activity regimen, hopefully as an effective way to restore normal patterns of activity, rather than just saying 'You need to exercise more!'” Wanigatunga says. “I think that type of clinical application, where we aim to wield exercise formally as medicine, is where the study of activity fragmentation can take us.”

The research was supported by the National Institutes of Health (R21AG053198, U01AG057545 and R01AG061786). The BLSA is funded by the National Institute on Aging (ZIAAG000015).

Story Source:

Materials provided by Johns Hopkins University Bloomberg School of Public Health. Note: Content may be edited for style and length.

Source: https://www.sciencedaily.com/releases/2019/10/191002110420.htm