Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association.

OBJECTIVE To issue a recommendation on the types and amounts of physical activity needed to improve and maintain health in older adults. PARTICIPANTS A panel of scientists with expertise in public health, behavioral science, epidemiology, exercise science, medicine, and gerontology. EVIDENCE The expert panel reviewed existing consensus statements and relevant evidence from primary research articles and reviews of the literature. PROCESS After drafting a recommendation for the older adult population and reviewing drafts of the Updated Recommendation from the American College of Sports Medicine (ACSM) and the American Heart Association (AHA) for Adults, the panel issued a final recommendation on physical activity for older adults. SUMMARY The recommendation for older adults is similar to the updated ACSM/AHA recommendation for adults, but has several important differences including: the recommended intensity of aerobic activity takes into account the older adult's aerobic fitness; activities that maintain or increase flexibility are recommended; and balance exercises are recommended for older adults at risk of falls. In addition, older adults should have an activity plan for achieving recommended physical activity that integrates preventive and therapeutic recommendations. The promotion of physical activity in older adults should emphasize moderate-intensity aerobic activity, muscle-strengthening activity, reducing sedentary behavior, and risk management.

[1]  J. L. Harrison,et al.  The Government Printing Office , 1968, American Journal of Pharmaceutical Education.

[2]  A. Field.  Communications , 1963, The Journal of Asian Studies.

[3]  J L Ankeney.  Assurance , 1981, The Annals of thoracic surgery.

[4]  A. Harper,et al.  Dietary guidelines for Americans. , 1981, The American journal of clinical nutrition.

[5]  G. Borg.  Psychophysical bases of perceived exertion. , 1982, Medicine and science in sports and exercise.

[6]  R. Palmer,et al.  Exercise and hypertension. , 1985, The Medical clinics of North America.

[7]  Lawrence Tagg.  Services , 1987, Veterinary Record.

[8]  A. Boland.  Disability in America: Toward a National Agenda for Prevention , 1992 .

[9]  K. Patrick,et al.  Physical Activity and Public Health: A Recommendation From the Centers for Disease Control and Prevention and the American College of Sports Medicine , 1995 .

[10]  M. Hamilton,et al.  Strength and aerobic training attenuate muscle wasting and improve resistance to the development of disability with aging. , 1995, The journals of gerontology. Series A, Biological sciences and medical sciences.

[11]  P. Williams,et al.  Physical activity and public health. , 1995, JAMA.

[12]  P. Thompson,et al.  ACSM's Guidelines for Exercise Testing and Prescription , 1995 .

[13]  Usdhhs.  Physical Activity and Health: A Report of the Surgeon General , 1996 .

[14]  A. King,et al.  Moderate-Intensity Exercise and Self-rated Quality of Sleep in Older Adults: A Randomized Controlled Trial , 1997 .

[15]  M. Fiatarone,et al.  Randomized Controlled Trial of the Effect of Exercise on Sleep , 2001 .

[16]  S. Heymsfield,et al.  Effects of strength or aerobic training on body composition, resting metabolic rate, and peak oxygen consumption in obese dieting subjects. , 1997, The American journal of clinical nutrition.

[17]  J. Després,et al.  American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. , 1998, Medicine and science in sports and exercise.

[18]  A. Loucks,et al.  Low energy availability, not stress of exercise, alters LH pulsatility in exercising women. , 1998, Journal of applied physiology.

[19]  J. Stoker,et al.  The Department of Health and Human Services. , 1999, Home healthcare nurse.

[20]  M. Desai,et al.  Surveillance for morbidity and mortality among older adults--United States, 1995-1996. , 1999, MMWR. CDC surveillance summaries : Morbidity and mortality weekly report. CDC surveillance summaries.

[21]  I. Piña,et al.  AHA Science Advisory. Resistance exercise in individuals with and without cardiovascular disease: benefits, rationale, safety, and prescription: An advisory from the Committee on Exercise, Rehabilitation, and Prevention, Council on Clinical Cardiology, American Heart Association; Position paper endo , 2000, Circulation.

[22]  I. Piña,et al.  Resistance Exercise in Individuals With and Without Cardiovascular Disease , 2000 .

[23]  Thomas J. Schnitzer,et al.  Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update , 2000 .

[24]  G. Locke,et al.  American Gastroenterological Association Medical Position Statement: guidelines on constipation. , 2000, Gastroenterology.

[25]  P. Skerrett,et al.  Physical activity and all-cause mortality: what is the dose-response relation? , 2001, Medicine and science in sports and exercise.

[26]  Exercise Prescription for Older Adults With Osteoarthritis Pain: Consensus Practice Recommendations , 2001, Journal of the American Geriatrics Society.

[27]  J. Williamson,et al.  Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. , 2001, Archives of internal medicine.

[28]  Christine Jenkins,et al.  GOLD SCIENTIFIC COMMITTEE. GLOBAL STRATEGY FOR THE DIAGNOSIS, MANAGEMENT, AND PREVENTION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE. NHLBI/WHO GLOBAL INITIATIVE FOR CHRONIC OBSTRUCTIVE LUNG DISEASE (COLD) WORKSHOP SUMMARY , 2001 .

[29]  L. Thal,et al.  CME Practice parameter : Management of dementia ( an evidence-based review ) Report of the Quality Standards Subcommittee of the American Academy of Neurology , 2001 .

[30]  K. Swedberg,et al.  Guidelines for the diagnosis and treatment of chronic heart failure. , 2001, European heart journal.

[31]  V F Froelicher,et al.  Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. , 2001, Circulation.

[32]  D. Heil.  Acsm’s Guidelines for Exercise Testing and Prescription, 6th Edition , 2001 .

[33]  W. Kapoor,et al.  Guidelines on management (diagnosis and treatment) of syncope. , 2001, European heart journal.

[34]  Michael D. Jensen,et al.  Dose-response issues concerning physical activity and health: an evidence-based symposium. , 2001, Medicine and science in sports and exercise.

[35]  R. Pauwels,et al.  Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. , 2001, American journal of respiratory and critical care medicine.

[36]  Orthopaedic Surgeons Panel On Falls Prevention.  Guideline for the Prevention of Falls in Older Persons , 2001 .

[37]  A. Campbell,et al.  Preventing Injuries in Older People by Preventing Falls: A Meta‐Analysis of Individual‐Level Data , 2002, Journal of the American Geriatrics Society.

[38]  J. Blumenthal,et al.  Exercise and the Treatment of Clinical Depression in Adults , 2002, Sports medicine.

[39]  Maria A. Fiatarone Singh,et al.  Exercise to prevent and treat functional disability. , 2002, Clinics in geriatric medicine.

[40]  S. Blair,et al.  Lower Extremity Muscle Strength And Risk Of Hip/knee Osteoarthritis , 2002 .

[41]  G. Jamtvedt,et al.  The Cochrane Review of Advice to Stay Active As a Single Treatment for Low Back Pain and Sciatica , 2002, Spine.

[42]  Barbara E Ainsworth,et al.  Epidemiology of musculoskeletal injuries among sedentary and physically active adults. , 2002, Medicine and science in sports and exercise.

[43]  J. Manson,et al.  Walking compared with vigorous exercise for the prevention of cardiovascular events in women. , 2002, The New England journal of medicine.

[44]  J. Regensteiner,et al.  Exercise training for claudication. , 2002, The New England journal of medicine.

[45]  A. Persons.  The management of persistent pain in older persons. , 2002, Journal of the American Geriatrics Society.

[46]  P. Corso,et al.  The effectiveness of interventions to increase physical activity. A systematic review. , 2002, American journal of preventive medicine.

[47]  N. Latham,et al.  Progressive resistance strength training for physical disability in older people. , 2003, The Cochrane database of systematic reviews.

[48]  P. O’Connor,et al.  Changes in physical activity and short-term changes in health care charges: a prospective cohort study of older adults. , 2003, Preventive medicine.

[49]  J. Keysor,et al.  Does late-life physical activity or exercise prevent or minimize disablement? A critical review of the scientific evidence. , 2003, American journal of preventive medicine.

[50]  Daniel W. Jones,et al.  The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. , 2003, JAMA.

[51]  U. P. S. T. Force.  Screening for Obesity in Adults: Recommendations and Rationale , 2003, Annals of Internal Medicine.

[52]  Harold W. Kohl,et al.  Prevalence of physical activity, including lifestyle activities among adults--United States, 2000-2001. , 2003, MMWR. Morbidity and mortality weekly report.

[53]  Pedro Teixeira,et al.  Effects of exercise on bone mineral density in calcium-replete postmenopausal women with and without hormone replacement therapy , 2003, Osteoporosis International.

[54]  Fernando Costa,et al.  Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Ph , 2003, Circulation.

[55]  J. Manson,et al.  Physical activity, including walking, and cognitive function in older women. , 2004, JAMA.

[56]  Julie Gilchrist,et al.  The impact of stretching on sports injury risk: a systematic review of the literature. , 2004, Medicine and science in sports and exercise.

[57]  Andrea Nuernberger,et al.  The effects of multidimensional home-based exercise on functional performance in elderly people. , 2004, The journals of gerontology. Series A, Biological sciences and medical sciences.

[58]  Carmen Castaneda-Sceppa,et al.  Physical activity/exercise and type 2 diabetes. , 2004, Diabetes care.

[59]  A. Manley.  Physical Activity And Health: A Report Of The Surgeon General , 2004 .

[60]  R. Abbott,et al.  Walking and dementia in physically capable elderly men. , 2004, JAMA.

[61]  B. Franklin,et al.  Exercise and Hypertension , 2004 .

[62]  E. Roth,et al.  Physical activity and exercise recommendations for stroke survivors: an American Heart Association scientific statement from the Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention; the Council on Cardiovascular Nursing; the Council on Nutrition, Physical , 2004, Circulation.

[63]  H. Kohl,et al.  Prevalence of no leisure-time physical activity--35 States and the District of Columbia, 1988-2002. , 2004, MMWR. Morbidity and mortality weekly report.

[64]  Patricia J. Jordan,et al.  Screening, safety, and adverse events in physical activity interventions: Collaborative experiences from the behavior change consortium , 2005, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[65]  Li Wang,et al.  Exercise Is Associated with Reduced Risk for Incident Dementia among Persons 65 Years of Age and Older , 2006, Annals of Internal Medicine.

[66]  Michael E. Miller,et al.  Effects of a physical activity intervention on measures of physical performance: Results of the lifestyle interventions and independence for Elders Pilot (LIFE-P) study. , 2006, The journals of gerontology. Series A, Biological sciences and medical sciences.

[67]  Lu Tian,et al.  Physical Performance in Peripheral Arterial Disease: A Slower Rate of Decline in Patients Who Walk More , 2006, Annals of Internal Medicine.

[68]  Ian Janssen,et al.  Influence of physical activity on mortality in elderly with coronary artery disease. , 2006, Medicine and science in sports and exercise.

[69]  I-Min Lee,et al.  Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. , 2007, Medicine and science in sports and exercise.

[70]  A. Bauman,et al.  Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. , 2007, Circulation.