Physical dimensions of healthy aging
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Physical Dimensions of Healthy Aging. Ellen F. Binder, MD Division of Geriatrics and Nutritional Science [email protected] Disclosures of Interest. Research Support: National Institute of Mental Health National Institute on Aging Consulting Eli Lilly, USA.

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Physical dimensions of healthy aging

Physical Dimensions of Healthy Aging

Ellen F. Binder, MD

Division of Geriatrics and Nutritional Science

[email protected]


Disclosures of interest

Disclosures of Interest

Research Support:

  • National Institute of Mental Health

  • National Institute on Aging

    Consulting

  • Eli Lilly, USA

I own no stocks or equity in any pharmaceutical company.


Yet another national placing for lavelle kelly

“Yet another national placing for Lavelle Kelly”

Tillamook Headlight Herald April 11, 2006


What defines healthy aging

What Defines Healthy Aging?

  • Absence of major disease

  • Absence of disability

    Defined as inability or great difficulty with ADLs or mobility


Significance of the problem

Significance of the Problem

  • U.S. population > 65 yrs. expected to grow to 20% by 2030 and continue to increase until 2050.

  • 40% of the older adult population has some disability or dependency. Such individuals are at high risk for recurrent hospitalization, injurious falls, NH placement, and death.

  • The prevalence of chronic disability is higher in older women than among men.

  • Although women have a longer total life expectancy they are likely to spend more years than men in a disabled state, even among those with severe disability.


Physical dimensions of healthy aging

Disabled Population & Rates

NLTCS 1982-2004


Risk factors for disability in older adults

Risk Factors for Disability in Older Adults

  • Lifestyle and health habits

  • Physiologic changes associated with aging

  • Diseases/Conditions

  • Social factors

  • Economic factors


Physiologic changes associated with aging

Physiologic Changes Associated with Aging

  • Hormonal

  • Body composition, energy intake, and lipids

  • Cardiovascular and pulmonary

  • Renal (kidney)

  • Hepatic (liver)

  • Sensory

  • Cognitive/Neuro-motor


Changes in aerobic power with age women vs men

Changes in Aerobic Power with AgeWomen vs. Men

From Holloszy & Kohrt in

Handbook of Physiology-Aging, 1995


Diseases conditions associated with disability in the elderly

Diseases/Conditions Associated with Disability in the Elderly

  • Vascular disease (heart, brain, arteries)

  • Arthritis

  • Lung Disease (Asthma, COPD)

  • Depression

  • Dementia

  • Cancer

  • Diabetes

  • Malnutrition / Obesity

  • Falls

  • Incontinence

  • Polypharmacy


Prevalence of geriatric impairments by age group from chs

Prevalence of Geriatric Impairments by Age Group from CHS

Chaudhry et al. JAGS 58: 1686-92, 2010


Risk of disability onset over 7 yrs

Risk of Disability Onset over 7 Yrs.

From Chaudhry et al. JAGS 58: 1686-92, 2010


Predictors of healthy aging in chs

Predictors of Healthy Aging in CHS

  • Absence of Hypertension/Lower BP

  • Lower Waist Circumference (non-obese)

  • Higher HDL Cholesterol

  • Absence of diabetes

  • Regular exercise, especially higher intensity

  • Moderate intake of wine

  • Lower clotting factors

  • No cigarette smoking

  • No regular ASA use

  • Stable financial status


Physical dimensions of healthy aging

Predicted Median Life Expectancy by Age and Gait Speed

Studenski, S. et al. JAMA 2011;305:50-58


Exercise can reverse disability risk in older adults

Exercise Can Reverse Disability Risk in Older Adults

  • Muscle strength and power

  • Body composition, lipids, weight

  • Aerobic Power

  • Gait speed

  • Balance

  • Flexibility

  • Bone Density

  • Mood and Psychological Well Being

  • Falls


Components of best practice physical activity programs

Components of “Best Practice” Physical Activity Programs

  • Attention to health education & exercise “readiness”

  • Accessibility

  • Tailoring of the exercise program to physical ability and preferences

  • Multi-component exercises

    flexibility, aerobic, strength training

  • Multiple sessions per week (≥3)

  • Ongoing social support

  • Ongoing feedback


Components of success for community based programs

Components of Success for Community-Based Programs

  • Collaboration with community agencies and organizations.

  • Use of existing programs and infrastructure.

  • Promotion as a social program.

  • Planning for wide variability in functional ability.

  • Use of an expert advisory board.


Successful community based health promotion interventions in older adults

Successful Community-Based Health Promotion Interventionsin Older Adults

  • Multi-component falls prevention

  • Vitamin D replacement

    Potential Areas (not disease-specific):

  • Medication education and compliance

  • Nutrition and weight management


Questions

Questions???


Physical dimensions of healthy aging

From Fried et al. J Gerontol Med Sci 561:M146-156, 2001


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