Written by Greg Arnold, DC, CSCS. For the researchers, “Physical exercise training leads to improved cognitive functioning and psychological well-being in frail older adults.”
There are a number specific illnesses that can affect the elderly population, including the loss of muscle mass known as sarcopenia (1), loss of bone mass called osteopenia (2) and osteoporosis (3), and loss of memory, thinking, language, judgment, and behavior that can lead to dementia (4). All of this adds up to a financial toll on those caring for the elderly that can surpass $300,000 per year in the form of lost wages and lost Social Security and pension benefits (5).
The loss of muscle, bone, and mental acuity with age is now being combined into a condition called “frailty” which is a complex health state of impairments in multiple systems and increased risks of adverse outcomes such as disability, falls, hospitalization, and death (6). Fortunately, a new study (7) suggests that physical exercise, even in frail elderly, can benefit both physical and mental health.
In the study, 72 patients between the ages of 61 and 89 underwent a geriatric examination and were classified as “frail” if they met at least two of the following:
– 3 of the 5 symptoms of frailty, as defined by previous research (6): Muscular weakness, slow walking speed, fatigability, sedentarity, and unintentional weight loss
– A score of ≤28/36 on the modified Physical Performance Test (8)
– Identified as frail according to the geriatrician’s judgment (mildly frail or worse on the clinical frailty scale) after assessing the 70 possible deficits of the frailty index (9)
The patients then either underwent an exercise program 1 hour per day, 3 days per week for 12 weeks or no exercise at all. Each exercise session included:
– 10 minutes of warm up exercises (stretching and balancing)
– 10–30 minutes of aerobic workout (using treadmills, recumbent bikes, and elliptical)
– 10 minutes of strength training followed by 10 minutes of cool down exercises
The intensity and duration of the aerobic exercises were increased individually using the modified Borg Rating of Perceived Exertion scale to reach moderate to hard intensity (10).
Regarding physical capacity after 12 weeks (p< 0.05), compared to the control group, those in the exercise group had:
– A 6.5-fold increase in the Borg Rating of Perceived Exertion (0.58 vs. 0.09 z-score)
– A 64% increase in walking speed (0.18 vs. 0.11 z-score)
– A nearly 4-fold increase in the 6-mintue walking test (0.27 vs. 0.07 z-score)
– A 0.13 z-score increase in grip strength compared to no change in the control group
For mental function (p< 0.01), the exercise group had:
– A 5-fold increase in “Executive Functions” (0.30 vs. 0.06 z-score)
– A near 3-fold increase in verbal reasoning (0.20 vs. 0.07 z-score)
– A 3.5-fold increase in processing speed (0.29 vs. 0.08 z-score)
Unfortunately, the exact nature of the “Executive Functions” was not specified by the researchers.
Finally, there was a 0.20 z-score increase in “Quality of Life” in the exercise group compared to a 0.19 decrease in the control group (p< 0.001). For the researchers, “Physical exercise training leads to improved cognitive functioning and psychological well-being in frail older adults.”
Source: Langlois, Francis, et al. “Benefits of physical exercise training on cognition and quality of life in frail older adults.” The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 68.3 (2013): 400-404.
© The Author 2012. Published by Oxford University Press on behalf of The Gerontological Society of America.All rights reserved.
Posted September 25, 2012.
Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY. You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com
References:
- Cruz-Jentoft AJ. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010; 39(4):412-423
- “Osteopenia: What Does It Mean?” posted on the National Osteoporosis Foundation website
- “Osteoporosis: Overview” posted on the U.S. National Library of Medicine website
- “Dementia” posted on PubMedHealth
- “Toll of Caring for Elderly Increases” – Wall Street Journal, June 14, 2010
- Fried LP. Frailty in older adults: Evidence for a phenotype. Journal of Gerontology, Biological Sciences and Medical Sciences 2001; 56(3), M146–156. doi:10.1093/gerona/56.3.M146
- Langlois F. Benefits of Physical Exercise Training on Cognition and Quality of Life in Frail Older Adults. J Gerontol B Psychol Sci Soc Sci. 2012 Aug 28. [Epub ahead of print]
- Binder EF. Effects of extended outpatient rehabilitation after hip fracture: A randomized controlled trial. Journal of the American Medical Association 2004; 292(7), 837–846. doi:10.1001/jama.292.7.837
- Rockwood, K. A global clinical measure of fitness and frailty in elderly people. Canadian Medical Association Journal, 2005; 173(5), 489–495. doi:10.1503/cmaj.050051
- “Perceived Exertion (Borg Rating of Perceived Exertion Scale)” posted on the CDC website.
