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Physical activity, exercise, and sarcopenia – future challenges

Körperliche Aktivität, Training und Sarkopenie – zukünftige Herausforderungen

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Zusammenfassung

GRUNDLAGEN: Viele Studien haben nachgewiesen, dass die Ethologie von Sarkopenie multikausal und sehr komplex ist. Die Verminderung der Muskelmasse führt zu einem Verlust von Muskelkraft, später zu einem abnehmenden funktionellem Status mit eingeschränkter Mobilität, damit wiederum zu einem höheren Sturzrisiko und zum Schluss zu einem höheren Mortalitätsrisiko. Aktuelle Empfehlungen und Leitlinien geben an, dass körperliche Inaktivität oder ein abnehmendes Niveau der körperlichen Aktivität Teil des Entstehungszyklus von Sarkopenie sind und deshalb körperliche Aktivität als wichtige Säule bei der Entwicklung und Behandlung von Sarkopenie berücksichtigt werden muss. THEMA: Ergebnisse zum Zusammenhang von körperlicher Aktivität und dem Alternsprozess haben nicht immer eindeutige Resultate gezeigt. Diese Inkonsistenz der wissenschaftlichen Ergebnisse ist zum Einen darauf zurückzuführen, dass Begriffe und das zugrunde liegende Konstrukt nicht einheitlich benutzt werden. Zum Anderen beruhen die unterschiedlichen Ergebnisse in der Heterogenität der Zielpopulation, Art der Interventionen oder auch den eingesetzten Messinstrumentarien. Diese Aspekte werden in dem Artikel thematisiert. Mit Bezug auf die zukünftigen Herausforderungen für die Rolle und den Einsatz von körperlicher Aktivität werden zusätzlich in diesem Artikel mögliche Barrieren und Anregungen zur Prävention und Behandlung von Sarkopenie diskutiert. Eine Vielzahl von Studien zeigt, dass strukturierte und gut geplante Trainingsprogramme, bestehend aus progressivem Krafttraining oder einem Schnellkrafttraining, positive Effekte auf die Sarkopenie oder Sarkopenie bezogene Komponente haben. Weniger eindeutig ist allerdings der Erkenntnisstand zum Transfer dieser Ergebnisse auf funktionelle Parameter. SCHLUSSFOLGERUNGEN: Beides, körperliche Aktivität und Training, haben gezeigt, dass sie das Sarkopenierisiko und den Beginn von funktionellen Einschränkungen bei älteren Menschen reduzieren können. Unglücklicherweise weist die Kohorte älterer Menschen gerade die höchsten Anteile von inaktiven oder gering aktiven Menschen auf. Deshalb scheint es zwingend notwendig, ältere Menschen zu motivieren, ihr körperliches Aktivitätsniveau zu erhöhen und sicheren Zugang sowie entsprechenden Trainingsprogramme bereit zu stellen.

Summary

BACKGROUND: Numerous studies have demonstrated that the etiology of sarcopenia is multi-causal and very complex process. The degradation of muscle mass leads to a loss of strength, later on to a decreased functional status, impaired mobility, a higher risk of falls, and eventually an increased risk of mortality. Present guidelines state that physical inactivity or a decreased physical activity level is a part of the underlying mechanisms of sarcopenia and therefore physical activity can be seen as an important factor to reverse or modify the development of sarcopenia. TOPIC: Results in the area of physical activity and aging have not always been homogeneous. The inconsistent findings in this research area are related to the different understanding of terms and underlying constructs along with different population, type of intervention, or measurement methods. These aspects will be discussed in the paper. With regard to the formulated future role of physical activity this article will discuss in addition different barriers and challenges in the prevention and treatment of sarcopenia. A multitude of studies shows that structured exercise programs including progressive resistance or power training have positive effects on sarcopenia and sarcopenia-related outcomes but less or inconclusive information is available for the transfer to functional outcomes. CONCLUSIONS: Both physical activities and exercise have shown to decrease risk of sarcopenia and onset of functional limitations in older persons. Unfortunately the cohort of older persons is the one with the highest percentage of individuals classified as inactive or sedentary. Therefore motivating older persons to increase their physical activity level as well as providing safe access to exercise programs seems to be a mandatory task.

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References

  • Vita A, Terry RB, Hubert HB, Fries JF. Aging, health risks, and cumulative disability. New Engl J Med, 338: 1035–1041, 1998

    Article  CAS  PubMed  Google Scholar 

  • Rikli E, Jones CJ. Assessing physical performance in independent older adults: issues and guidelines. JAPA, 5: 244–261, 1997

    Article  Google Scholar 

  • Fries JF, Green LW, Levine S. Health promotion and the compression of morbidity. Lancet, 1: 481–483, 1989

    Article  CAS  PubMed  Google Scholar 

  • Evans W, Rosenberg, IR. Biomarkers: the ten determinants of aging you can control. Simon & Schuster, New York, 1991

    Google Scholar 

  • Evans W, Campbell WW. Sarcopenia and age-related changes in body composition and functional capacity. J Nutr, 123: 465–468, 1993

    CAS  PubMed  Google Scholar 

  • Evans W. What is sarcopenia? J Gerontol A Biol Sci Med Sci, 50(Spec No:5–8): 1995

  • Evans W. Skeletal muscle loss: cachexia, sarcopenia, and inactivity. Am J Clin Nutr, 91: 1123S–1127S, 2010

    Article  CAS  PubMed  Google Scholar 

  • Verdijk L, Gleeson B, Jonkers R, et al. Skeletal muscle hypertrophy following resistance training is accompanied by a fiber type-specific increase in satellite cell content in elderly men. J Gerontol A Biol Sci Med Sci, 64: 332–339, 2009

    Article  PubMed  Google Scholar 

  • Delmonico MJ, Harris TB, Lee J-S, et al. Alternative definitions of sarcopenia, lower extremity performance, and functional impairment with aging in older men and women. J Am Geriatr Soc, 55: 769–774, 2007

    Article  PubMed  Google Scholar 

  • Patel H, Syddall H, Martin H, et al. Hertfordshire sarcopenia study: design and methods. BMC Geriatr, 10: 43, 2010

    Article  PubMed  PubMed Central  Google Scholar 

  • Sayer A. Sarcopenia. BMJ, 341: c4097, 2010

    Article  PubMed  Google Scholar 

  • Sayer A, Syddall H, Martin H, et al. Falls, sarcopenia, and growth in early life: findings from the Hertfordshire cohort study. Am J Epidemiol, 164: 665–671, 2006

    Article  PubMed  PubMed Central  Google Scholar 

  • Muhlberg W, Sieber, C. Sarcopenia and frailty in geriatric patients: implications for training and prevention. Z Gerontol Geriatr, 37: 2–8, 2004

    Article  CAS  PubMed  Google Scholar 

  • Roubenoff R. Sarcopenia: effects on body composition and function. J Gerontol A Biol Sci Med Sci, 58: 1012–1017, 2003

    Article  PubMed  Google Scholar 

  • Janssen I, Heymsfield S, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc, 50: 889–896, 2002

    Article  PubMed  Google Scholar 

  • Janssen I, Shepard D, Katzmarzyk P, et al. The healthcare costs of sarcopenia in the United States. J Am Geriatr Soc, 52: 80–85, 2004

    Article  PubMed  Google Scholar 

  • Cruz-Jentoft A, Baeyens, JP, Bauer JM, et al. European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing, 39: 412–423, 2010

    Article  PubMed  PubMed Central  Google Scholar 

  • Landi F, Abbatecola A, Provinciali M, et al. Moving against frailty: does physical activity matter? Biogerontology, 11: 537–545, 2010

    Article  PubMed  Google Scholar 

  • Chodzko-Zajko W, Proctor DN, Fiatarone Singh MA, et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc, 41: 1510–1530, 2009

    Article  PubMed  Google Scholar 

  • Buchner D. Physical activity and prevention of cardiovascular disease in older adults. Clin Geriatr Med, 25: 661–675, viii, 2009

    Article  PubMed  Google Scholar 

  • US Department of Health & Human Services [USDHHS]. Physical guidelines for American. 2010. Available at: http://www.healthypeople.gov/default.htm. Accessed August 28th 2010

  • Paterson D, Jones GR, Rice CL. Ageing and physical activity: evidence to develop exercise recommendations for older adults. Can J Public Health, 98: S69–S108, 2007

    PubMed  Google Scholar 

  • Bouchard C, Blair SN, Haskell WL. Physical activity and health. 2nd edn. Human Kinetics, Champaign, 2007

    Google Scholar 

  • Nelson ME, Rejeski WJ, Blair SN, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation, 116: 1094–1105, 2007

    Article  PubMed  Google Scholar 

  • Keysor JJ. Does late-life physical activity or exercise prevent or minimize disablement? Am J Prev Med, 25: 129–136, 2003

    Article  PubMed  Google Scholar 

  • Singh MA. Exercise comes of age: rationale and recommendations for a geriatric exercise prescription. J Gerontol A Biol Sci Med Sci, 57: M262–M282, 2002

    Article  PubMed  Google Scholar 

  • Cesari M, Pahor M, Lauretani F, et al. Skeletal muscle and mortality results from the InCHIANTI Study. J Gerontol A Biol Sci Med Sci, 64: 377–384, 2009

    Article  PubMed  Google Scholar 

  • Rolland Y, Lauwers-Cances V, Cournot M, et al. Sarcopenia, calf circumference, and physical function of elderly women: a cross-sectional study. J Am Geriatr Soc, 51: 1120–1124, 2003

    Article  PubMed  Google Scholar 

  • Physical Activity Guidelines Advisory Committee Report [PAACR] (2008) Part C- Key Terms. Available at: http://www.health.gov/paguidelines/Report/Default.aspx. Access August 28th 2010

  • Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep, 100: 126–131, 1985

    CAS  PubMed  PubMed Central  Google Scholar 

  • United States Public Health Service, Office of the Surgeon General, National Center for Chronic Disease Prevention and Health Promotion, President's Council on Physical Fitness and Sports (USPHS). Physical activity and health: a report of the Surgeon General. Atlanta, GA.: U.S. Dept. of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; President's Council on Physical Fitness and Sports; 1996

  • American College of Sport Medicine. ACSM's Guidelines for Exercise Testing and Prescription. 6th edn. Williams & Wilkins, Philadelphia, 2006

  • Brach J, Simonsick EM, Kritchevsky St, et al. The association between physical function and lifestyle activity and exercise in the health, aging and body composition study. J Am Geriatr Soc, 52: 502–509, 2004

    Article  PubMed  Google Scholar 

  • Sallis R. Exercise is medicine and physicians need to prescribe it! Br J Sports Med, 43: 3–4, 2009

    Article  CAS  PubMed  Google Scholar 

  • Bouchard CSRJ, Stephens T. Physical activity, fitness, and health: the model and key concepts. In: Bouchard C, Shephard RJ (eds). Physical activity, fitness, and health: international proceedings and consenus staement. Human Kinetics, Champaign, IL, pp. 77–88, 1994

    Google Scholar 

  • Pate R. The evolving definition of fitness. Quest, 40: 174–179, 1988

    Article  Google Scholar 

  • Cress M, Schechtman KB, Mulrow CD, et al. Relationship between physical performance and self-perceived physical function. J Am Geriatr Soc, 43: 93–101, 1995

    Article  CAS  PubMed  Google Scholar 

  • Guralnik J, Simonsick E, Ferrucci L, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol, 49: M85–M94, 1994

    Article  CAS  PubMed  Google Scholar 

  • Espeland M, Gill TM, Guralnik J, et al. Designing clinical trials of interventions for mobility disability: results from the lifestyle interventions and independence for elders pilot (LIFE-P) trial. J Gerontol A Biol Sci Med Sci, 62: 1237–1243, 2007

    Article  PubMed  PubMed Central  Google Scholar 

  • Balzi D, Lauretani F, Barchielli A, et al. Risk factors for disability in older persons over 3-year follow-up. Age Ageing, 39: 92–98, 2010

    Article  PubMed  Google Scholar 

  • Manini T, Pahor M. Physical activity and maintaining physical function in older adults. Br J Sports Med, 43: 28–31, 2009

    Article  CAS  PubMed  Google Scholar 

  • Peterson M, Giuliani C, Morey M, et al. Physical activity as a preventative factor for frailty: the health, aging, and body composition study. J Gerontol A Biol Sci Med Sci, 64: 61–68, 2009

    Article  PubMed  Google Scholar 

  • Brown D, Brown DR, Heath GW, et al. Association between physical activity dose and health-related quality of life. Med & Scien Sports & Exercise, 36: 890–896, 2004

    Article  Google Scholar 

  • Puthoff M, Janz K, Nielson D. The relationship between lower extremity strength and power to everday walking behaviors in older adults with functional limitations. J Geriatr Phys Ther, 31: 24–31, 2008

    Article  PubMed  Google Scholar 

  • Peterson M, Rhea MR, Sen A, et al. Resistance exercise for muscular strength in older adults: a meta-analysis. Ageing Res Rev, 9: 226–237, 2010

    Article  PubMed  PubMed Central  Google Scholar 

  • Liu CJ, Latham NK. Progressive resistance strength training for improving physical function in older adults. Cochrane Database Syst Rev, 2009; Issue 3. Art. No.: CD002759. Doi: 10.1002/14651858.CD002759.pub2

  • Martin H, Syddall HE, Dennison EM, et al. Relationship between customary physical activity, muscle strength and physical performance in older men and women: findings from the Hertfordshire Cohort Study. Age Ageing, 37: 589–593, 2008

    Article  CAS  PubMed  Google Scholar 

  • Spirduso W, Francis KL, MacRae PG. Physical dimensions of aging, 2nd edn. Human Kinetics, Champaign, 2005

    Google Scholar 

  • Buchner D, Beresford SAA, Larson EB, et al. Effects of physical activity on health status in older adults II: intervention studies. Ann Rev Publ Health, 13: 469–488, 1992

    Article  CAS  Google Scholar 

  • Rantanen T, Guralnik JM, Sakari-Rantala R. Disability, physical activity, and muscle strength in older women: the women's health and aging study. Arch Phys Med Rehabil, 80: 130–135, 1999

    Article  CAS  PubMed  Google Scholar 

  • Chalé-Rush A, Guralnik J, Walkup M, et al. Relationship between physical functioning and physical activity in the lifestyle interventions and independence for elders pilot. J Am Geriatr Soc, 58: 1918–1924, 2010

    Article  PubMed  PubMed Central  Google Scholar 

  • Steib S, Schoene D, Pfeifer K. Dose-response relationship of resistance training in older adults: a meta-analysis. Med Sci Sports Exerc, 42: 902–914, 2010

    Article  PubMed  Google Scholar 

  • Bean JF, Kiely DK, LaRose S, et al. Increased velocity exercise specific to task training versus the National Institute on Aging's strength training program: changes in limb power and mobility. J Gerontol A Biol Sci Med Sci, 64: 983–991, 2009

    Article  PubMed  Google Scholar 

  • Protas E, Tissier, S. Strength and speed training for elders with mobility disability. J Aging Phys Act, 17: 257–271, 2009

    Article  PubMed  PubMed Central  Google Scholar 

  • Reid K, Callahan DM, Carabello RJ, et al. Lower extremity power training in elderly subjects with mobility limitations: a randomized controlled trial. Aging Clin Exp Res, 20: 337–343, 2008

    Article  PubMed  PubMed Central  Google Scholar 

  • Fiatarone M, Marks EC, Ryan ND, et al. High-intensity strength training in nonagenarians. Effects on skeletal muscle. JAMA, 263: 3029–3034, 1990

    Article  CAS  PubMed  Google Scholar 

  • Cuoco A, Callaham DM, Sayers ST, et al. Impact of muscle power and force on gait speed in disabled older men and women. J Gerontol A Biol Sci Med Sci, 59: 1200–1206, 2004

    Article  PubMed  Google Scholar 

  • Bean JF, Leveille SG, Kiely DK, et al. A comparison of leg power and leg strength within the InCHIANTI study: which influences mobility more? J Gerontol A Biol Sci Med Sci, 58: M728–M733, 2003

    Article  Google Scholar 

  • Henwood T, Taaffe DR. Short-term resistance training and the older adult: the effect of varied programmes for the enhancement of muscle strength and functional performance. Clin Physiol Funct Imaging, 26: 305–313, 2006

    Article  PubMed  Google Scholar 

  • Frontera W, Hughes VA, Fielding RA, et al. Aging of skeletal muscle: a 12-yr longitudinal study. J Appl Physiol, 88: 1321–1326, 2000

    CAS  PubMed  Google Scholar 

  • Skelton DA, Greig CA, Davies JM, et al. Strength, power and related functional ability of healthy people aged 65–89 years. Age Ageing, 23: 371–377, 1994

    Article  CAS  PubMed  Google Scholar 

  • Bean J, Herman S, Kiely DK, et al. Increased velocity exercise specific to task (InVEST) training: a pilot study exploring effects on leg power, balance, and mobility in community-dwelling older women. J Am Geriatr Soc, 52: 799–804, 2004

    Article  PubMed  Google Scholar 

  • Manini T, Marko M, VanArnam T, et al. Efficacy of resistance and task-specific exercise in older adults who modify tasks of everyday life. J Gerontol A Biol Sci Med Sci, 62: 616–623, 2007

    Article  PubMed  Google Scholar 

  • de Vreede PL, Samson MM, van Meeteren NLU, et al. Functional-task exercise versus resistance strength exercise to improve daily function in older women: a randomized, controlled trial. J Am Geriatr Soc, 53: 2–10, 2005

    Article  PubMed  Google Scholar 

  • Skelton DA, Young A, Greig CA, et al. Effects of resistance training on strength, power, and selected functional abilities of women aged 75 and older. J Am Geriatr Soc, 43: 1081–1087, 1995

    Article  CAS  PubMed  Google Scholar 

  • Faber M, Bosscher RJ, Chin A, Paw MJ, van Wieringen PC. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: a multicenter randomized controlled trial. Arch Phys Med Rehabil, 87: 885–896, 2006

    Article  PubMed  Google Scholar 

  • Luukinen H, Lehtola S, Jokelainen J, et al. Prevention of disability by exercise among the elderly: a population-based, randomized, controlled trial. Scand J Prim Health Care, 24: 199–205, 2006

    Article  PubMed  Google Scholar 

  • Gill TM, Baker DI, Gottschalk M, et al. A program to prevent functional decline in physically frail, elderly persons who live at home. N Engl J Med, 347: 1068–1074, 2002

    Article  PubMed  Google Scholar 

  • Chandler J, Duncan PW, Kochersberger G, et al. Is lower extremity strength gain associated with improvement in physical performance and disability in frail, community-dwelling elders? Arch Phys Med Rehabil, 79: 24–30, 1998

    Article  CAS  PubMed  Google Scholar 

  • Centers for Disease Control and prevention 2007. US Physical activity statistics. Available at: http://apps.nccd.cdc.gov/PASurveillance/StateSumResultV.asp?CI=&Year=2007&State=0#data. Accessed 4. September 2010

  • Ferrucci LS, Simonsick EM. A little exercise. J Gerontol A Biol Sci Med Sci, 61: 1154–1156, 2006

    Article  PubMed  PubMed Central  Google Scholar 

  • US Department of Health & Human Services [USDHHS]. Healthy people 2010. Available at: www.health.gov/paguidelines. Accessed August 28th 2010

  • Scholz U, Sniehotta F, Burkert S, et al. Increasing physical exercise levels: age-specific benefits of planning. J Aging Health, 19: 851–866, 2007

    Article  PubMed  Google Scholar 

  • Jerome G, Glass T, Mielke M, et al. Physical activity participation by presence and type of functional deficits in older women: the women's health and aging studies. J Gerontol A Biol Sci Med Sci, 61: 1171–1176, 2006

    Article  PubMed  Google Scholar 

  • Belza B, Walwick J, Shiu-Thornton S, et al. Older adult perspectives on physical activity and exercise: voices from multiple cultures. Prev Chronic Dis, 1: A09, 2004

    PubMed  PubMed Central  Google Scholar 

  • McAuley E, Blissmer B. Self-efficacy determinants and consequences of physical activity. Exerc Sport Sci Rev, 28: 85–88, 2000

    CAS  PubMed  Google Scholar 

  • Jonas S, Philipps EM. ACSM's exercise is medicine. Lippincott, Williams & Wilkins, Philadelphia, 2009

    Google Scholar 

  • Ganz K, Rimer BK, Lewis FM. Health behavior and health education 3rd. Jossey-Bass, San-Francisco, 2002

    Google Scholar 

  • Lee L, Arthur A, Avis M. Using self-efficacy theory to develop interventions that help older people overcome psychological barriers to physical activity: a discussion paper. Int J Nurs Stud, 45: 1690–1699, 2008

    Article  PubMed  Google Scholar 

  • Resnick B, Spellbring A. Understanding what motivates older adults to exercise. J Gerontol Nurs, 26: 34–42, 2000

    Article  CAS  PubMed  Google Scholar 

  • Fishbein M, Aijzen I. Beliefs, Attitude, Intention, and Behavior: An Introduction to theory and Research. Addison-Wesley, Reading Mass, 1975

    Google Scholar 

  • Freiberger E, Menz HB, Abu-Omar K, et al. Preventing falls in physically active community-dwelling older people: a comparison of two intervention techniques. Gerontology, 53(5): 298–305, 2007

    Article  PubMed  Google Scholar 

  • McAuley E, Hall KS, Motl RW, et al. Trajectory of declines in physical activity in community-dwelling older women: social cognitive influences. J Gerontol B Psychol Sci Soc Sci, 64: 543–550, 2009

    Article  PubMed  Google Scholar 

  • Rejeski W, Miller M, King A, et al. Predictors of adherence to physical activity in the lifestyle interventions and independence for elders pilot study (LIFE-P). Clin Interv Aging, 2: 485–494, 2007

    PubMed  PubMed Central  Google Scholar 

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Freiberger, E., Sieber, C. & Pfeifer, K. Physical activity, exercise, and sarcopenia – future challenges. Wien Med Wochenschr 161, 416–425 (2011). https://doi.org/10.1007/s10354-011-0001-z

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