Physical Activity Prescription Boosts Healthspan, Lifespan, Function

"Physical Activity: A Prescription for Health in Older Adults"

Physical activity reduces chronic disease risks, improves function, and extends lifespan. This supports clinicians’ use of exercise prescriptions as a health intervention, new research suggests.

A review of the effects of physical activity for older adults documents specific benefits, such as preventing or reducing the risks for over 30 chronic conditions. These conditions include coronary artery disease, heart failure, type 2 diabetes, chronic obstructive pulmonary disease, osteoporosis, depression, dementia, and cancer.

Key Benefits of Physical Activity

The researchers assessed evidence from 2002 to 2024 related to the health benefits of physical activity in older adults. They also presented strategies for discussing exercise with patients and tools to make exercise prescriptions useful.

The review outlines the following benefits of physical activity, supported by evidence:

Longevity

A 2023 meta-analysis found that engaging in physical activity for at least 150 minutes each week reduced all-cause mortality by 31% compared to non-active individuals.

Functional Independence

Functional independence refers to the ability to perform daily activities. It also encompasses cognition, social belonging, and quality of life. According to a 2012 meta-analysis involving frail older adults, physical activity improves the ability to complete daily tasks and enhances gait speed and balance.

Fall Prevention

A 2016 systematic review revealed that exercise interventions for older adults decreased falls by 21%. Additionally, a 2021 meta-analysis determined that integrated exercise programs, where patients engaged in physical activity over five times weekly for more than 32 weeks, were the most effective in reducing fall risk.

Bone and Joint Health

A 2018 review on osteoarthritis researched data indicated that while very high physical activity levels might increase osteoarthritis risk, moderate levels do not. Regular exercise also alleviates pain and improves physical function, as noted earlier.

Cognitive Health

A 2021 analysis of longitudinal studies found that higher activity levels in older age correlated with a reduced risk of developing mild cognitive impairment. The study also noted decreased progression from mild dementia to severe dementia, along with increased rates of recovering from severe to mild impairment compared to lower activity levels.

Mental Health

A 2022 systematic review identified that exergaming, or technology-driven physical activities like virtual reality and Wii Sports, is linked with improvement in depressive symptoms.

Quality of Life

Two 2021 meta-analyses highlighted the positive impact of outdoor exercise parks and aquatic exercise on the quality of life, enhancing mood, reducing anxiety, and improving other neuropsychological outcomes among older adults.

“Physical activity is underused as a health intervention both in the community and in healthcare delivery for older adults,” the authors wrote. “Older adults who become more physically active can potentially add years to their lives and enhance the quality of life during those years.”

How to Prescribe Exercise

Clinicians can effectively prescribe exercise for patients by following two initial steps.

Step 1: Tracking Physical Activity Levels

The first step involves tracking patients' physical activity levels. This action signals the importance of physical activity to both patients and providers, prompting further discussions when activity levels change or fall below recommended thresholds.

Step 2: Incorporating Counseling into Treatment Plans

The second step is for clinicians to include physical activity counseling in treatment plans. This approach is similar to prescribing medication or other interventions. The counseling can take the form of written prescriptions or discussions about guidelines and referrals to community resources.

In certain cases, especially when assessing risk factors or symptoms (such as after a cardiac event or with signs of uncontrolled chronic disease), further tests may be necessary. Supervision by an exercise specialist might also be required during initial stages, as noted by Thornton.

Addressing Barriers

Although referrals to exercise specialists can be beneficial, these appointments may not always be covered by insurance or might occur only in specialized settings. This limitation can create barriers to exercise. It’s crucial to emphasize that most individuals can initiate physical activity gradually without needing specialist supervision. Clinicians should aim to follow up and check in with their patients regularly.

The Importance of Action

In pursuit of a healthier lifestyle, older adults should consider incorporating more physical activity into their routines. Simple activities like walking, gardening, or even engaging in social activities that involve movement can all contribute to better health outcomes.

Encouraging family members or friends to join in on these activities may increase motivation and improve adherence. Moreover, as patients become more active, healthcare providers play a vital role in supporting and encouraging this shift.

In summary, the benefits of physical activity are significant but often overlooked. Implementing and prescribing exercise as a core component of healthcare can enhance longevity and improve overall quality of life for older adults. For more comprehensive guidelines, you can explore resources available at health organizations.

Lucas J. Carr, PhD, director of the Behavioral Medicine Lab and of the Community Health Collaborative, authored this article.