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Physical Dimensions of Healthy Aging. Ellen F. Binder, MD Division of Geriatrics and Nutritional Science 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

disclosures of interest
Disclosures of Interest

Research Support:

  • National Institute of Mental Health
  • National Institute on Aging


  • 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.
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

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