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GENERAL PRINCIPLES

Physical activity has a profound positive impact on health, chronic disease prevention, function, and fall prevention, especially for older adults; higher levels of physical activity have been linked to reduced morbidity and mortality. New evidence has emerged indicating the positive impact of physical activity on cognition and psychological health. Although physical activity has clear benefits to health and function, most older adults are not physically active or do not engage in activity at high enough intensities to obtain the noted health benefits. In fact, <10% of older adults meet the recommended guidelines for physical activity (ie, 30–60 minutes of moderate-to-vigorous physical activity per day, 5 or more days a week), accumulating only 5 to 10 minutes of moderate-to-vigorous physical activity per day.

Physical activity is not synonymous with exercise. Physical activity, as defined by the American College of Sports Medicine, is “any bodily movement produced by skeletal muscles that results in energy expenditure,” whereas exercise, a subset of physical activity, is “planned, structured, and repetitive bodily movement done to improve or maintain one or more components of physical fitness.” Physical activity may not achieve the increased fitness levels that are often expected with exercise; however, physical activity can reduce the risks and complications of many chronic conditions and increase well-being if it is of sufficient intensity.

BEFORE AN OLDER ADULT BEGINS AN EXERCISE PROGRAM

A. Education

Many older adults do not understand the importance of exercise for health promotion or have beliefs that their age or health conditions will limit the benefits of exercise and/or their ability to perform exercises. Most people perceive barriers to starting or continuing an exercise program. It is important for the health provider to explain to the patient how exercise can mitigate the effects of age-associated decrements in physical function, chronic diseases, and “disuse” syndromes and discuss this information in the context of each patient’s limitations and goals for independence, mobility, and quality of life. A discussion of perceived barriers and suggestions about how to manage issues such as access, costs, and time can be extremely helpful for overcoming such barriers.

Several websites exist for both the patient and the clinician to use as resources (Table 72–1).

Table 72–1.Physical activity/exercise web resources for the patient and the clinician.

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