Tenth Annual Peter A. Rechnitzer Lecture

Exercise after 80

YoungDr. Archie Young MD

Professor of Geriatric Medicine,
University of Edinburgh

Tuesday August 3, 2004

Exercise after 80
The loss of muscle is central to the declining physical ability, increasing fatigability and progressive frailty of old age. It begins in middle age, proceeds at approximately 1% per year, and impairs all aspects of muscle function.

The age-related loss of muscle performance is greater than the loss of body weight. This has important implications for gait and mobility, especially for women, as they have a lower percentage of their body weight as muscle than men of the same age.

The loss of muscle, and its disabling impact, may be further exacerbated in disease states common in old age. The loss of muscle may be so severe that the patient becomes unable to perform ordinary activities of everyday life. With elderly patients, effective acute treatment of an illness, whilst essential, is no longer sufficient to ensure a return to the patient’s usual level of functional ability and independence.

After 80, especially for women, everyday life is like an Olympic event, requiring the individual to perform, consistently and repeatedly, at the very limit of their physical ability.

Fortunately, octogenarians undergoing physical training experience gains in strength and in aerobic power equivalent to at least some 10-20 years ‘rejuvenation’.

There are urgent humanitarian and financial reasons for further research into the sarcopenia of old age – into its pathophysiology, its response to potential interventions and, the ultimate test, the effect of putative interventions on the elderly person’s ability to perform everyday tasks independently, safety and without distressing fatigue.

In the meantime we should concentrate on promoting safe and effective exercise through interdisciplinary collaboration, appropriate and ongoing assessments, and the imaginative use of adapted and alternative types of exercise.

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