Increased Exercise Over the Age of 60 Reduces Risk of Heart Disease and Stroke

People over the age of 60 should do more exercise not less in order to prevent heart disease and stroke, according to findings from a study of over 1.1 million elderly people published in the European Heart Journal [1] today (Friday).

The researchers in South Korea found that people who did less moderate or vigorous physical activity as they got older had as much as a 27% increased risk of heart and blood vessel problems, while those who increased their levels of activity had a reduced risk of cardiovascular disease of up to 11%.

The link between levels of physical activity and risk of cardiovascular disease in older people held true even for those with disabilities and chronic conditions such as high blood pressure, high cholesterol levels and type 2 diabetes.

Researchers, led by Mr Kyuwoong Kim, a PhD student at Seoul National University Graduate School Department of Biomedical Sciences in Seoul, under the supervision of Professor Sang Min Park, carried out the study in 1,119,925 men and women aged 60 years or older and who underwent two consecutive health checks provided by the Korean National Health Insurance Service (NIHS) from 2009 to 2010 and 2011 to 2012. The NIHS provides healthcare services for approximately 97% of the Korean population. The participants were followed up until December 2016.

At each health check the participants answered questions about their physical activity and lifestyle. The researchers calculated the amount of moderate exercise (e.g. 30 minutes or more a day of brisk walking, dancing, gardening) and vigorous exercise (e.g. 20 minutes or more a day of running, fast cycling, aerobic exercise) per week at each screening, and how it had changed during the two years between the screenings.

The researchers collected data on heart disease and stroke from January 2013 to December 2016. They adjusted their analyses to take account of socioeconomic factors, such as age and sex, other medical conditions and medication taken, and lifestyle behaviours, such as smoking and alcohol consumption.

The average age of the participants was 67 years and 47% were men. About two-thirds said they were physically inactive at both the first and second screening period. A higher proportion of women were physically inactive (78% and 77%) compared to men (67% and 66%) in both screening periods. Only 22% of inactive people increased their physical activity by the time of the second health check, and 54% of people who had been exercising five or more times a week at the time of the first screening had become inactive by the time of the second. During the follow-up period a total of 114,856 cases of heart disease or stroke occurred.

The researchers found that people who moved from being continuously inactive at the 2009-2010 health check to being moderately or vigorously active three to four times a week at the 2011-2012 health check had an 11% reduced risk of cardiovascular problems. Those who were moderately or vigorously active one or two times a week at the first check had a 10% reduced risk if they increased their activity to five or more times a week.

In contrast, those who were moderately or vigorously active more than five times a week at the first check and then became continuously inactive at the second check had a 27% increased risk of cardiovascular problems.

When the researchers looked specifically at people with disabilities and chronic conditions, they found that those who changed from being inactive to being moderately or vigorously active three to four times a week also reduced their risk of cardiovascular problems. People with a disability had a reduced risk of 16%, and those with diabetes, raised blood pressure or cholesterol levels had a reduced risk of between 4-7%.

Mr Kim said: “The most important message from this research is that older adults should increase or maintain their exercise frequency to prevent cardiovascular disease. Globally, this finding is of public health importance because the world’s population aged 60 years and older is expected to total two billion by 2050, which is an increase from 900 million in 2015 according to the World Health Organization. While older adults find it difficult to engage in regular physical activity as they age, our research suggests that it is necessary to be more physically active for cardiovascular health, and this is also true for people with disabilities and chronic health conditions.

“We believe that community-based programmes to encourage physical activity among older adults should be promoted by governments. Also, from a clinical perspective, physicians should ‘prescribe’ physical activity along with other recommended medical treatments for people with a high risk of cardiovascular disease.”

Although the size of the study is a strength, a limitation is that it was carried out in the Korean population and so the researchers cannot be certain their findings will apply to other populations due to differences in ethnicity and lifestyle. Other limitations include: physical activity was assessed by a self-reported survey, which is subject to bias; information was lacking on other types of physical activity, such as housework, and also muscle-strengthening activities; and the researchers were unable to assess the reasons why people changed their levels of physical activity because this was a study based on ‘real world’ data rather than data from an intervention study.

Source: European Society of Cardiology


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Improved Fitness Can Mean Living Longer without Dementia

Anders Revdal wrote . . . . . . . . .

“It is important to say that it is never too late to begin exercising. The average participant in our study was around 60 years old at baseline, and improvement in cardiorespiratory fitness was strongly linked to lower dementia risk. Those who had poor fitness in the 1980s but improved it within the next decade could expect to live two years longer without dementia,” says Atefe Tari of the Cardiac Exercise Research Group (CERG) at the Norwegian University of Science and Technology (NTNU).

Tari is lead author of a new study that was recently published in Lancet Public Health, a highly ranked journal in the prestigious Lancet family.

“Persistently low fitness is an independent risk factor for dementia and death due to dementia,” the authors concluded.

The higher, the better

Dementia involves a progressive decline in cognitive functions, severe enough to interfere with the ability to function independently. Alzheimer’s disease is the most common form of dementia.

By 2050, it is estimated that 150 million people in the world will have dementia – a tripling of the incidence of the disease today. There is no cure. Men live on average five years after being diagnosed with dementia, while women live for seven years on average after the diagnosis.

“As there is currently no effective drug for dementia, it is important to focus on prevention. Exercise that improves fitness appears to be one of the best medicines to prevent dementia,” says Tari.

Tari’s study is far from the first to show a link between good fitness and lower risk of getting dementia. What is unique, however, is that Tari and her research colleagues have measured the fitness level of participants twice ten years apart.

Thus, they have been able to evaluate how changes in fitness over time are related to dementia risk. And the results were clear.

Exercise that improves fitness appears to be one of the best medicines to prevent dementia.

“If you increase your cardiorespiratory fitness from poor to good you almost halve the risk of getting dementia. You also reduce the risk of dying from or with dementia. In our study, each increase of 1MET was associated with a 16% lower risk of getting dementia and a 10% lower risk of dementia-related death. This is an improvement that is very achievable for most people”, says Tari.

A MET is a measurement unit used by researchers to quantify the rate at which a person expends energy relative to their body weight.

Followed for 30 years

Between 1984 and 1986, almost 75,000 Norwegians participated in the first wave of the HUNT Survey (HUNT1). Eleven years later, HUNT2 was organized, and 33,000 of the same people participated. More than 30,000 of them answered enough questions to be included in Tari’s analyses.

The researchers calculated cardiorespiratory fitness with a formula previously developed and validated by the Cardiac Exercise Research Group, called the Fitness Calculator.

Previous studies have shown that those who score poorly on this calculator have an increased risk of heart attack, atrial fibrillation, depression and non-alcoholic fatty liver disease, and also that they generally die younger than people who achieve a higher fitness level.

The new study links results from the Fitness Calculator to the risk of dementia and dementia-related deaths up to 30 years later. To investigate these associations, Tari has used data from two different databases, the Health and Memory Study in Nord-Trøndelag and the Norwegian Cause of Death Registry.

Almost half the risk

Between 1995 and 2011, 920 people with dementia were included in the Health and Memory Study in Nord-Trøndelag. A total of 320 of them had also participated in both HUNT1 and HUNT2 and provided enough information about their own health to be included in the analyses.

It turned out that poor cardiorespiratory fitness in both the 1980s and 1990s was significantly more common in this group than among otherwise comparable HUNT participants who had not been diagnosed with dementia.

In fact, the risk of developing dementia was 40% lower for those who were among the 80% with the best fitness in both the 1980s and 1990s. Furthermore, it was 48% lower if one had changed from poor to higher fitness levels between the two surveys.

All participants were followed until death or end of follow-up in the summer of 2016. Via the Norwegian Cause of Death Registry, the NTNU researchers found 814 women and men who had died from or with dementia during the period. This means that dementia was stated as the underlying, immediate or additional cause of death.

The risk was lowest for those who had good fitness at both HUNT surveys. However, also those who had changed from poor to better fitness over the years had a 28% reduced risk.

Cause or coincidence?

In observational studies, there will always be questions about cause-effect relationships. For example, one might ask what causes what: Is it bad fitness that weakens the brain, or do people with cognitive impairment find it more difficult to be physically active and increase their fitness?

“Our study made it easy to see which came first. We estimated the fitness of the participants for the first time in the 1980s, and looked for dementia cases and deaths from 1995 onwards. We have also done separate analyses where we excluded those who got dementia or died during the first few years of the follow-up period, and the results were the same,” says Tari.

It’s also reasonable to ask if the association is random; it might not be the poor fitness that increases the risk of dementia, but people with poor fitness might also have several of the more well-known risk factors for dementia – such as high blood pressure, low level of education and a family history of brain diseases. That is an unlikely explanation, says Tari.

“The HUNT studies give us very broad information about the health of the participants, including body composition, smoking habits, educational level, blood pressure, diabetes, cholesterol levels and family history of stroke. By adjusting the analyses for these factors, we have ruled out that they fully explain the relationship between fitness and dementia risk in our study,” she says.

Physical activity vs. fitness

In other words, the study provides very good evidence that maintaining good fitness is also good for the brain. However, Tari points out that this does not necessarily mean that everyone who is physically active on a regular basis is guaranteed that a good effect on brain health.

“High-intensity exercise improves fitness faster than moderate exercise, and we recommend that everyone exercise with a high heart rate at least two days each week. Regular exercise that makes you sweaty and out of breath will ensure your fitness will be good for your age. Our study suggests that good fitness for your age can delay dementia by two years and that you can also live two to three years longer after being diagnosed with dementia,” she said.

Source: Norwegian SciTech News

Run for Your Life, New Study Recommends

Even a little running on a regular basis can extend your life, Australian researchers say.

They analyzed 14 studies that included more than 232,000 people whose health was tracked for between 5.5 and 35 years. During the study periods, nearly 26,000 participants died.

The collective data showed that any amount of running was associated with a 30% lower risk of death from heart disease, and a 23% lower risk of death from cancer.

Even as little as 50 minutes of running once a week at a pace slower than 6 mph appeared to be protective, according to the authors of the study published online in the British Journal of Sports Medicine.

They said that makes running a good option for people who say they are too busy to exercise.

The reasons running is associated with a reduced risk of premature death are unclear, and the study doesn’t establish cause and effect, said lead researcher Zeljko Pediscic. He’s an associate professor of public health at Victoria University in Melbourne, Australia.

His team also noted that the number of studies analyzed was small and considerable variation in their methods may have influenced the results.

Even so, any amount of running is better than none, the authors suggested.

“Increased rates of participation in running, regardless of its dose, would probably lead to substantial improvements in population health and longevity,” they concluded in a journal news release.

Source: HealthDay


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Being Physically Active Can Lower Older Adults’ Risk For Dying

For older adults, being physically active is an important part of overall good health. In fact, experts say that nine percent of all premature deaths are caused by not getting enough physical activity. Physical activity is known to reduce deaths from heart disease, diabetes, chronic lung disease, and mental illness.

A team of researchers looked more carefully at the relationship between death and physical exercise among older adults in Brazil (where the number of older adults grew 40 percent between 2002 and 2012). Their study was published in the Journal of the American Geriatrics Society.

They drew on information from the “COMO VAI?” (Consórcio de Mestrado Orientado para a Valorização da Atenção ao Idoso) study. During the study, from January to August 2014, researchers conducted home interviews with 1,451 adults older than 60. Of these, 971 participants were given wrist monitors to measure their physical activity. Researchers also asked participants about their smoking habits and how they would rate their health.

Additionally, researchers learned about the chronic health conditions participants said they had, including high blood pressure, diabetes, heart problems, Parkinson’s disease, kidney failure, high cholesterol, depression, stroke, and cancer. The researchers then rated participants’ ability to perform their normal daily activities, including bathing, dressing, getting from bed to chair, going to the bathroom, and feeding.

Not surprisingly, the researchers learned that people who had the lowest levels of physical activity had higher rates of death compared to people who had higher levels of activity.

The researchers concluded that their main findings suggest that low levels of physical activity are associated with higher risks of death, no matter what a person’s level of health was. Overall, physical activity was important for avoiding early death in older men and women.

Source: Health in Aging

Interval Walking Training Improves Fitness and Health in Elderly Individuals

In Japan, health-conscious folks have been known to carry around pedometers to track the number of steps they walk everyday. The target number: 10,000 steps, as a foundation for a healthy lifestyle. Conscientious walkers can now update their device from a pedometer to a smartphone and forget about ten thousand steps with the latest study from Dr. Shizue Masuki of Shinshu University who found an effective way to increase overall fitness and decrease lifestyle-related disease (LSD) through Interval Walking Training (IWT). It’s not how much you walk, but how intensely you do so for a minimum amount of time to get positive results. This finding may be welcome news for those who want to save time and get the most out of their workout.

Interval Walking Training is the method of walking at 70% of the walker’s maximum capacity for 3 minutes, then at 40% of their capacity for the next 3 minutes. This is continued for 5 or more sets. Dr. Masuki studied a group of 679 participants with a medium age of 65 over the course of 5 months. Every two weeks data was collected from participants at a local community office and via the internet through the data measuring device (triaxial accelerometer). The triaxial accelerometer is a device that beeped to let the walker know when they were at least 70% of their peak aerobic capacity (VO2peak), and at 3 minutes to switch. It recorded their walking data to the central server at the administrative center for automatic analysis.

VO2peak is the amount (volume) of oxygen (O2) the body is able to use during physical activity. It is the milliliters of oxygen used by kilogram of body weight per minute. It is determined by measuring the concentration of oxygen and carbon dioxide in the participants breath. When the VO2 number reaches a figure and plateaus during intense exercise, that is the maximum amount of oxygen the person is able to utilize, and is an indicator of fitness. The higher the number, the more they are able to use, and the more intensely they can exert their body. Endurance athletes such as cyclists can have VO2peak in the 70s.

Dr Masuki found that her method outperformed the recommendation of the American Heart Association that to achieve peak oxygen capacity 75 minutes a week of high-intensity workout is needed for improvement. Participants in Dr Masuki’s study had significant improvements in their aerobic capacity (VO2peak), with 50 minutes of IWT a week. Improvements to their VO2peak were plateaued above 50 minutes a week.

With the study published in the Mayo Clinic Proceedings, Dr. Masuki’s participants achieved a 14% increase in VO2peak and a 17% decrease in lifestyle-related disease (LSD) through IWT. This method is highly desirable due to an ease of maintenance. Many participants remained highly motivated and went beyond their prescribed regimen and does not require expensive equipment to administer.

Source: Science Daily